Degeneración macular asociada a la edadtratamiento y perspectivas

Résumé

Age-related macular degeneration (AMD) is a multifactorial disease that is the leading cause of vision loss and blindness in people over 65 in developed countries. Except for the recommendation of changes in diet and lifestyle aimed to reduce oxidative stress in the retina, there is currently no approved pharmacological treatment for geographic atrophy or dry AMD, which constitutes 85-90% of cases. The neovascular form, which comprises 10-15% of the cases, and which is responsible for 90% of the cases of legal visual loss, is addressed mainly with monoclonal antibodies and fusion proteins directed against vascular endothelial growth factor (VEGF), in order to reduce the neovascularization. Despite its efficacy, current anti-VEGF therapy requires repeated intravitreal injections, with associated risks and discomfort. New drugs are currently being developed, focused on reducing the oxidative stress, inflammation and cell death, always present in a neurodegenerative process. In order to obtain a safer administration and a better treatment compliance, new drug delivery systems such as refillable devices or cell encapsulation that deliver drugs in situ are also being tested. Current scientific and technical development suggest that AMD treatment will improve significantly in the future with gene therapy, stem cell transplants, optogenetics, or photopharmacological therapy.