老年性黄斑变性的治疗进展:全面回顾。

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Postgraduate Medical Journal Pub Date : 2024-06-28 DOI:10.1093/postmj/qgae016
Christos Papaioannou
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引用次数: 0

摘要

老年性黄斑变性(AMD)是导致不可逆失明的主要原因,尤其影响中心视力,妨碍日常工作。本文对老年黄斑变性进行了深入探讨,区分了它的两个主要亚型--湿性和干性老年黄斑变性,同时阐明了发病率和风险因素,包括年龄、遗传和吸烟。重点转向当前和未来的治疗方案,对干性和湿性老年黄斑变性进行了研究。关于干性黄斑变性,抗氧化剂补充等干预措施和正在进行的临床试验带来了希望。其中值得注意的是Pegcetacoplan,它是唯一获得美国食品和药物管理局(FDA)批准的药物,在减少地理萎缩病变方面显示出良好的效果。对于湿性老年黄斑病变,Ranibizumab(Lucentis®)等抗血管内皮生长因子疗法发挥了重要作用,Faricimab 和 OPT-302 等新药在延长用药间隔后也显示出了相当的疗效。此外,RGX-314 等基因疗法带来了潜在的模式转变,减少或消除了频繁注射的需要。生物仿制药提供了具有成本效益的替代品。论文还深入探讨了 AMD 管理中技术与人工智能的整合,强调了智能手机应用程序在患者监测以及人工智能算法在诊断和监控中的作用。此外,患者对人工智能的看法表明,理解与信任之间存在正相关。文章最后介绍了视网膜植入和仿生芯片等突破性技术,为视力恢复带来了希望。总之,本文强调了解决老年性黄斑病变的多方面方法,结合了传统和创新策略,为治疗老年性黄斑病变铺平了道路,使其前景更加广阔。
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Advancements in the treatment of age-related macular degeneration: a comprehensive review.

Age-related macular degeneration (AMD) stands as a leading cause of irreversible blindness, particularly affecting central vision and impeding daily tasks. This paper provides a thorough exploration of AMD, distinguishing between its two main subtypes-Wet and Dry AMD-while shedding light on the prevalence and risk factors, including age, genetics, and smoking. The focus shifts to the current and future treatment landscape, examining both Dry and Wet AMD. Regarding Dry AMD, interventions such as antioxidant supplementation and ongoing clinical trials offer hope. Notable among these is Pegcetacoplan which is the only Food and Drug Administration (FDA)-approved medication, displaying promising results in reducing geographic atrophy lesions. For Wet AMD, anti-Vascular Endothelial Growth Factor therapies like Ranibizumab (Lucentis®) have been instrumental, and newer drugs like Faricimab and OPT-302 show comparable efficacy with extended dosing intervals. Additionally, gene therapies such as RGX-314 present a potential paradigm shift, reducing or eliminating the need for frequent injections. Biosimilars offer cost-effective alternatives. The paper also delves into the integration of technology and artificial intelligence in AMD management, highlighting the role of smartphone apps for patient monitoring and artificial intelligence algorithms for diagnosis and surveillance. Furthermore, patient perspectives on artificial intelligence demonstrate a positive correlation between understanding and trust. The narrative concludes with a glimpse into ground-breaking technologies, including retinal implants and bionic chips, offering hope for vision restoration. Overall, this paper underscores the multifaceted approach in addressing AMD, combining traditional and innovative strategies, paving the way for a more promising future in AMD treatment.

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来源期刊
Postgraduate Medical Journal
Postgraduate Medical Journal 医学-医学:内科
CiteScore
8.50
自引率
2.00%
发文量
131
审稿时长
2.5 months
期刊介绍: Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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