Optymalizacja leczenia wysiękowej postaci AMD w świetle aktualnej wiedzy klinicznej

• Authors: Andrzej Gębka

Title variants

EN

Exudative age-related macular degeneration (AMD) – clinical knowledge treatment optimisation

• Languages of publication: PL

Abstracts

PL

Zwyrodnienie plamki żółtej związane z wiekiem (AMD) jest najczęstszą przyczyną funkcjonalnej ślepoty w krajach uprzemysłowionych. Głównym czynnikiem biorącym udział w patomechanizmie wysiękowego AMD jest VEGF (vascular endothelial growth factor). Między rokiem 2004 a 2006 wprowadzono do użycia 3 leki wiążące VEGF (pegaptanib, bewacyzumab i ranibizumab), a w 2012 r. kolejną cząsteczkę – alfibercept. Leki te stały się podstawą terapii u chorych z wysiękowym AMD. Ponad 71% leczonych lekami anty-VEGF uzyskuje obiektywną poprawę widzenia i tylko u 5% widzenie się pogarsza. Jednocześnie u 55–71% chorych w siatkówce utrzymuje się resztkowy obrzęk. Część chorych początkowo dobrze odpowiadających na terapię wykazuje cechy tachyfilaksji. Konieczna jest wtedy indywidualizacja terapii z modyfikacją protokołów, z zastosowaniem różnych leków pozwalających uzyskać możliwie największą poprawę anatomiczną i funkcjonalną przy jak najmniejszej liczbie iniekcji.

EN

Age-related Macular Degeneration (AMD) is the leading cause of blindness in developed countries. Vascular endothelial growth factor (VEGF) has emerged as a key factor playing role in patomechanism of wet AMD. Between 2004 and 2006, 3 anti-VEGF drugs were introduced to ophthalmology (pegaptanib, bevacizumab i ranibizumab). Soon after in 2012 a new molecule – alfibercept was registered. Those VEGF inhibitors played a major role in wet AMD treatment. Over 71% of patients benefit from treatment while only 5% of cases faces visual impairment. From 55% to 71% of eyes have persistent retinal fluid despite injections. A small proportion of eyes that respond to initial therapy subsequently develop tachyphylaxis. In those cases modifying the protocol, switching drugs can individualize treatment to gain maximum anatomic and functional effect with minimum interventions.

Keywords

EN

AMD; optymalizacja leczenia; terapia anty-VEGF

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OphthaTherapy
• Year: 2014
• Volume: 1
• Issue: 1
• Pages: 13-20

Contributors

author

Andrzej Gębka

• Klinika Okulistyki, Gdański Uniwersytet Medyczny

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• Document Type: article