BASIC PRINCIPLES OF TREATMENT OF PATIENTS WITH AGE-RELATED MACULAR DEGENERATION

12.13.2019

Age-related macular degeneration (AMD) is a chronic slowly progressive disease of the retina of both eyes, leading to low vision, blindness and visual disability.

 

The basic principles of treating patients with AMD include:

1. timeliness;

2. pathogenetic approach;

3. differentiation (from the stages and forms of the disease);

4. duration, sometimes throughout life;

5. complexity (drug therapy, laser or surgical treatment).

 

Treatment of patients with AMD includes:

1. Drug therapy:

   · antioxidant drugs and vitamin and mineral complexes;

   · peptide bioregulators;

   · inhibitors of antiogenesis.

2. Laser treatment:

   · photodynamic therapy (PDT);

   · transpupillary laser thermotherapy (TTT);

   · laser coagulation (LC);

3. Surgical treatment:

   · translocation of the macula;

   · retinal pigment epithelium transplantation.

4. Radiotherapy.

A modern method in the treatment of AMD is the use of drugs that suppress the production of vascular endothelial growth factor (VEGF).

The reasons for neovascularization in age-related macular degeneration are not fully understood, but recent studies indicate an important role of VEGF in its development, therefore pharmacological inhibition of VEGF is a promising direction in the treatment of this form of the disease.

The VEGF (Vascular Endothelial Growth Factor) family of proteins potentiates the growth of new defective blood vessels. Anti-VEGF therapy is aimed at slowing the progression of wet AMD and, in some cases, it can improve your vision. This therapy is especially effective if applied before the scarring stage — this is when the treatment can preserve vision.

The first drug for anti-VEGF therapy in the form of intravitreal injections certified in Russia for use in ophthalmology was LUCENTIS, which revolutionized the treatment of AMD and became the “gold standard”.

LUCENTIS and EYLEA have been specially developed for ophthalmic use, which makes them more effective and safer.

LUCENTIS contains molecules of the active substance — ranibizumab, which reduces excessive stimulation of angiogenesis (growth of pathological vessels) in age-related macular degeneration and normalizes the thickness of the retina.

LUCENTIS quickly and completely penetrates into all layers of the retina, reduces macular edema and prevents an increase in the size of the lesion, the progression of the formation and germination of blood vessels, and new hemorrhages.

LUCENTIS is the first drug in the group of VEGF inhibitors, the treatment with which leads both to slowing down the process of reducing central vision and to partial restoration of visual acuity. It has been clinically proven to stabilize visual acuity in 95% and increase it in 25-40% of patients.

EYLEA is a drug containing an active substance — aflibercept, the molecules of which act as a “trap”, being fused with molecules of not only vascular endothelial growth factor (VEGF), but also placental growth factor (PIFG).

EYLEA is characterized by a longer intraocular effect, which makes it possible to inject less frequently. In addition, this drug can be used not only for the “wet” form of age-related macular degeneration, but also in cases of visual impairment caused by diabetic macular edema.

With strict adherence to the entire technological process: conducting a thorough diagnostic examination of the visual system, followed by dynamic observation using high-tech equipment — an optical coherence tomograph, it is possible to achieve high treatment results.

 

This publication has been prepared with the support of the Presidential Grants Fund

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