Medikamentöse Therapieansätze für die nicht neovaskuläre AMD

Zusammenfassung

Hintergrund Die nicht neovaskuläre (trockene) altersbedingte Makuladegeneration (AMD) ist bis heute nicht behandelbar. Dieser Artikel fasst die klinischen Forschungsansätze für eine medikamentöse Therapie zusammen und analysiert, warum diese nicht zum Erfolg geführt haben.

Material und Methoden Literatur und Datenbankrecherche.

Ergebnisse Insgesamt ist die Zahl der verfolgten Therapieansätze begrenzt. Nur die Reduktion von Lipofuscinablagerungen und Drusen ist spezifisch für die AMD. Weitere Ansätze sind die Modulation der Entzündung und Neuroprotektion. Derzeit konnte mit keinem der Verfahren in einer konfirmatorischen Studie das Voranschreiten der AMD gestoppt oder verlangsamt werden.

Diskussion Um die Chancen für Entwicklungserfolge zu erhöhen, muss der aktuell begrenzte pharmakologische Target Space durch die Anwendung molekularer Netzwerkanalysen erweitert werden. Da bei der trockenen AMD der Visus oft nicht der primär betroffene Parameter ist, muss flankierend die Perspektive Betroffener näher untersucht werden, um sinnvolle Therapieziele jenseits des Visus zu definieren.

Abstract

Background Non-neovascular age-related macular degeneration (AMD) is not yet treatable. This article summarises current clinical research approaches. The reasons for the current lack of success are analysed.

Methods Literature and databank search.

Results The number of therapeutic approaches and mechanisms is limited. Only reduction in lipofuscin containing deposits is specific for AMD. Further approaches include modulation of inflammation and neuroprotection. Confirmatory studies have failed to demonstrate efficacy in AMD, i.e. slowing or stopping AMD progression.

Discussion To increase the probability of success for future developments, the pharmacological target space needs to be broadened. This may be achieved by application of molecular network analyses. As visual acuity is commonly not primarily affected by non-neovascular AMD, research on patient perspective is required to define reasonable target profiles for future therapies.

Schlüsselwörter

altersbedingte Makuladegeneration - geografische Atrophie - Pharmakologie der Netzhaut - Sehzyklus - Komplementsystem

Key words

age-related macular degeneration - geographic atrophy - retinal pharmacology - visual cycle - complement system

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