Age-related macular degeneration (AMD) is a common cause of visual loss in the elderly, with increasing prevalence due to increasing life expectancy. While the introduction of anti-VEGF therapy has improved outcomes, there are still major unmet needs and gaps in the understanding of underlying biological processes. These include early, intermediate, and atrophic disease stages. Recent studies have assessed therapeutic approaches addressing various disease-associated pathways, including complement inhibitors. Drug-delivery aspects are also relevant, as many agents have to be administered repeatedly. Herein, relevant pathogenetic factors and underlying mechanisms as well as recent and potential therapeutic approaches are reviewed.
Frank G. Holz, Steffen Schmitz-Valckenberg, Monika Fleckenstein
Schematic showing morphological changes in the macula during evolution of early/intermediate AMD, exudative/neovascular AMD, and GA, respectively, along with several known pathogenetic factors.