This narrative review highlights routes of ocular drug delivery for age-related macular degeneration (AMD). AMD is the leading cause of irreversible blindness in industrialized countries and accounts for 8.7% of blindness worldwide. Advanced AMD can be classified into two subtypes: late-stage dry AMD [known as geographic atrophy (GA)] and neovascular AMD (nAMD). GA is often bilateral and results from progressive and irreversible loss of photoreceptors and areas of the retinal pigment epithelium. Wet AMD is characterized by angiogenesis from the choroid to the normally avascular regions underneath the retinal pigment epithelium (RPE) or retina, a process known as choroidal neovascularization (CNV). Various targeted therapeutic options are currently available to reduce the progression rate and maintain vision in patients with nAMD. Intravitreal delivery of anti-VEGF protein treatments to halt CNV is currently the gold-standard of care for nAMD. Subretinal and suprachoroidal delivery approaches are also being explored for gene and molecular therapies. Advancements in nanotechnology and biomaterials have also led to the development of microscopic drug delivery systems, including hydrogels, microparticles, nanoparticles, implants, and liposomes. Gene therapy and stem cell therapy has recently emerged as a potential candidate treatment modality for AMD and other retinal degenerations. New drug targets and modalities have stimulated exciting developments in ocular drug delivery with the promise of greater efficacy and durability of AMD treatment.
Israilevich, Rachel; Mahmoudzadeh, Raziyeh; Salabati, Mirataollah; and David Xu, "Narrative review-drug delivery in age-related macular degeneration" (2021). Wills Eye Hospital Papers. Paper 147.
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