Outcome prediction of anti-vegf therapy in age-related macular degeneration

Abstract

Introduction. Age-related macular degeneration (AMD) is one of the leading causes of irreversible blindness in adults over 50 years old. At present it has no cure. In advanced AMD stages, the patient has no ability to perform basic activities such as reading, recognizing faces, and driving. The global prevalence of AMD is expected to increase to 288 million by 2040. This review article comes with useful information on the anti-VEGF effects in various clinical situations, bringing real benefit to the clinical activity. It aims to study the factors that predict the evolution of AMD in order to understand the therapy response. Aim of study. Age- related macular degeneration is a very frequent, acquired retinal pathology that causes loss of central vision. There are specific therapeutic methods used in each stage of the pathology. In contrast to the atrophic (dry) form, exudative (wet) form of AMD requires inhibitors of the vascular endothelial growth factor (anti-VEGF remedies). Treatment is applied in some specific patterns. The analysis of the factors involved in the variability of the pathological process response to anti-VEGF treatment allows the development of an algorithm for stratification of patients with AMD. Methods and materials. PubMed, NCBI and SCOPUS databases were used to find relevant information on the topic, using the next keywords: age-related macular degeneration, anti-VEGF, predictive factors. We studied 50 of 175 articles. Results. AMD outcome depends on age, sex, genetics, environmental, clinical and social factors. This important clinical factors could help us to give some prognosis about disease evolution under treatment. Very often, the clinician can predict from the beginning what the subsequent evolution of the pathology will be. Conclusion. The analysis of the factors involved in the variability of the pathological process response to anti-VEGF treatment allows the development of an algorithm for stratification of patients with age-related macular degeneration.