Current therapies for neovascular age-related macular degeneration, retinal vein occlusions and diabetic macular oedema

An overview of the background and current treatment options available for the macular diseases retinal vein occlusion, diabetic macular oedema and age-related macular degeneration.

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Abstract

With an ageing population, healthcare professionals have seen a rise in age-related macular diseases resulting in an increased demand for the development of effective therapeutic agents. Treatment of macular conditions such as age-related macular degeneration, diabetic macular oedema and retinal vein occlusion has undergone a paradigm shift in recent years. This follows progress in basic science and clinical research which has led to the identification and understanding of the complex pathological pathways involved in disease development and progression and, in turn, the production of therapeutic agents which target these pathways. One such example is the use of anti-VEGF agents, such as ranibizumab, which has transformed the management of neovascular (wet) age-related macular degeneration, diabetic macular oedema and retinal vein occlusion. These agents have demonstrated remarkable improvements in visual acuity which were unattainable with previous laser treatment and therefore anti-VEGF agents have become a routine course of therapy. Yet, the variability in visual gain amongst patients and frequent administration of expensive intravitreal injections place a burden on patients and healthcare. What is more, this route of administration has been associated with sight-threatening adverse effects, such as retinal detachment, endophthalmitis and haemorrhage. Therefore, there is an ongoing need for the development of cheaper, alternative therapy which has a lower frequency of administration or, better still, is administered via a less invasive route. This review provides an overview of the macular diseases age-related macular degeneration, diabetic macular oedema and retinal vein occlusion, outlining disease classification, progression and diagnosis, as well as the current treatment options available.

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