抗血管内皮生长因子药物治疗渗出型老年性黄斑变性的局限性研究现状

The limitation of anti-vascular endothelial growth factor treatment for wet age-related macular degeneration

渗出型老年性黄斑变性(wAMD)是由于脉络膜新生毛细血管通过破裂的Bruch膜到达RPE层和光感受器细胞层形成脉络膜新生血管(CNV),继而导致新生血管出血、渗漏以及瘢痕形成。鉴于VEGF在CNV发生发展过程中具有重要作用,各种眼内抗VEGF药物靶向治疗是目前wAMD治疗的一线选择。但抗VEGF药物治疗wAMD的疗效受多种因素影响,仍有部分患者存在治疗无应答、药物耐受、需要长期反复注射以及严重副作用等问题。深入探究wAMD发病的生理病理过程,寻找导致CNV形成的最根本原因,从病因出发探寻更优的治疗方案是未来研究的方向。

Wet age-related macular degeneration(wAMD)is caused by choroidal neovascularization(CNV),which occurs when the choroidal new capillaries reach the RPE layer and photoreceptor cell layer through the ruptured Bruch membrane,leading to neovascularization bleeding,leakage,and scarring.In view of the important role of VEGF in the development of CNV,targeted therapy with various intraocular anti-VEGF drugs is the first-line treatment for wAMD.However,the efficacy of anti-VEGF drugs in the treatment of wAMD is affected by a variety of factors,and some patients still have problems such as unresponsiveness,drug resistence,tachyphylaxis,long・term repeated injections,and severe adverse effects.It is the direction of future researches to deeply explore the physiological and pathological process of wAMD,find the cause of CNV formation,and seek better therapies.