[Pharmacotherapy of Non-neovascular AMD].

Abstract:

BACKGROUND:Non-neovascular age-related macular degeneration (AMD) is not yet treatable. This article summarises current clinical research approaches. The reasons for the current lack of success are analysed. METHODS:Literature and databank search. RESULTS:The number of therapeutic approaches and mechanisms is limited. Only reduction in lipofuscin containing deposits is specific for AMD. Further approaches include modulation of inflammation and neuroprotection. Confirmatory studies have failed to demonstrate efficacy in AMD, i.e. slowing or stopping AMD progression. DISCUSSION:To increase the probability of success for future developments, the pharmacological target space needs to be broadened. This may be achieved by application of molecular network analyses. As visual acuity is commonly not primarily affected by non-neovascular AMD, research on patient perspective is required to define reasonable target profiles for future therapies. HINTERGRUND:Die nicht neovaskuläre (trockene) altersbedingte Makuladegeneration (AMD) ist bis heute nicht behandelbar. Dieser Artikel fasst die klinischen Forschungsansätze für eine medikamentöse Therapie zusammen und analysiert, warum diese nicht zum Erfolg geführt haben. MATERIAL UND METHODEN:Literatur und Datenbankrecherche. ERGEBNISSE:Insgesamt ist die Zahl der verfolgten Therapieansätze begrenzt. Nur die Reduktion von Lipofuscinablagerungen und Drusen ist spezifisch für die AMD. Weitere Ansätze sind die Modulation der Entzündung und Neuroprotektion. Derzeit konnte mit keinem der Verfahren in einer konfirmatorischen Studie das Voranschreiten der AMD gestoppt oder verlangsamt werden. DISKUSSION:Um die Chancen für Entwicklungserfolge zu erhöhen, muss der aktuell begrenzte pharmakologische Target Space durch die Anwendung molekularer Netzwerkanalysen erweitert werden. Da bei der trockenen AMD der Visus oft nicht der primär betroffene Parameter ist, muss flankierend die Perspektive Betroffener näher untersucht werden, um sinnvolle Therapieziele jenseits des Visus zu definieren.

journal_name

Klin Monbl Augenheilkd

authors

Zeitz O,Frentzel DP,Rübsam A,Seibel I,Riechardt AI,Brockmann C,Meißner F,Joussen AM

doi

10.1055/a-0914-3183

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

1076-1080

issue

9

eissn

0023-2165

issn

1439-3999

journal_volume

236

pub_type

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