Emerging treatments for dry age-related macular degeneration with geographic atrophy: a systematic review
Keywords:Cell- and tissue-based therapy, Complement inactivating agents, Dietary supplements, Geographic atrophy, Macular degeneration
We aim to summarize various emerging treatments for geographic atrophy (GA) secondary to dry age-related macular degeneration (AMD). The PubMed database was searched using keywords: ‘treatment’ and ‘geographic atrophy’ or ‘dry age-related macular degeneration’ on 19 June 2021. Of 121 articles yielded, 20 relevant clinical studies that were of ‘English language’ and ‘published within 10 years’ were included. The emerging treatments of dry AMD with GA were categorized into complement inhibitors, diet and supplement, cell-based therapies, and pharmacological agents. Complement inhibitors (C3 inhibitor pegcetacoplan, complement factor D, and C5 inhibitors) can significantly reduce the GA lesion area growth, as can Mediterranean diet and α-lipoic acid. Cell-based therapies such as palucorel and biosynthetic retinal pigment epithelium monolayer delivery can minimize GA lesion area and improve the best-corrected visual acuity. Pharmacological agents such as fenretinide, ciliary neurotrophic growth factor, trimetazidine, and brimonidine have prominent effects on GA, but emixustat hydrochloride, tandospirone, and sirolimus lack such effects. The Age-Related Eye Disease Study formulation remains important in reducing the risk of progression of GA secondary to dry AMD. A thorough understanding of the emerging treatment of GA may enable more personalized treatment. Nonetheless, the safety and efficacy of the treatment ought to be tested in trials with larger sample size, longer duration, and optimized dosage.
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