Abstract
SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.
Abstract
Choroidal neovascularization (CNV) is characterized by the growth of new blood vessels from the choroid to the subretinal pigment epithelium, subretinal space, or both. Newer diagnostic and treatment methods, such as, Optical Coherence Tomography Angiography and anti-vascular Endothelial Growth Factors, are becoming increasingly effective for CNV diagnosis and management, respectively. Anti-VEGF (Ranibizumab, Bevacizumab, and Aflibercept) treatment has become the first-line treatment for CNV and has replaced other methods, such as laser photocoagulation and photodynamic therapy. The current literature has established similar safety and efficacy of the three drugs (Ranibizumab, Bevacizumab, and Aflibercept) in the treatment of CNV, especially when the visual loss is mild. However, Aflibercept has been reported to result in slightly better long-term visual outcomes. Newer molecules such as Brolucizumab and Faricimab show the potential to decrease the treatment frequency and increase efficacy due to better penetration and by increasing drug concentration in the retina, addressing the limitations of the currently available drug options.
However, their investigation was in the early stages and may have taken some time before being seen in the clinic. Innovative methods for continuous drug delivery to the vitreous through the use of dedicated ocular implants filled with anti-VEGF drugs for controlled release (port delivery systems) have also shown promising results in clinical trials. The development of this technique is expected to reduce the total number of injections and maintain stable vision. Different clinical trial protocols across studies remain an issue in addressing research questions related to dosing frequency and gaps.
Keywords:
Aflibercept, Anti-VEGF, Bevacizumab, Brolucizumab, Faricimab, Choroidal neovascularization (CNV), Myopic choroidal neovascularization, Agerelated CNV, Idiopathic CNV, Inflammatory CNV.
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Authors:Bentham Science Books