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Research Article: Serum Amyloid A as a Common Marker of Persistent Inflammation in Patients with Neovascular Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy

Date Published: 2023-08-29

Abstract:
Age-related macular degeneration (AMD) is the leading cause of severe vision loss among elderly people worldwide. The projected number of patients with AMD was million in and is expected to increase to million in . Many AMD risk factors have been identified, including aging, smoking, genetics and some environmental factors. AMD can be classified into the early, intermediate and late stages. A small number of medium-sized drusen and/or pigment changes can be found in early-stage AMD. As the disease progresses, some AMD patients develop from the early stage to the late stage. There are two types of late-stage AMD: geographic atrophy (GA) and neovascular AMD (nAMD). At its worst, late AMD can cause irreversible vision loss. nAMD is characterized by choroidal neovascularization (CNV), which can lead to vascular leakage, macular edema and subretinal fibrosis accompanied by vision loss. The branching vascular network (BVN), with polyp-like aneurysmal lesions, is a defining characteristic of polypoidal choroidal vasculopathy (PCV), which can be detected by indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCTA). Some studies support the notion that PCV is a subtype of nAMD due to the many similarities between PCV and nAMD, including their pathologies, manifestations and, most importantly, the fact that they both fall into the category of choroidal vasculopathy., In recent years, researchers have found that inflammation plays an essential role in the pathogenesis of both nAMD and PCV. Several inflammatory factors are involved in the progress of these diseases., Vascular endothelial growth factor (VEGF) is an important stimulator of CNV development. Intravitreal injection of anti-VEGF agents is one of the promising treatments for choroidal vasculopathy. However, the standard treatment is still limited by certain issues, such as a high treatment burden, increased risk of developing subretinal fibrosis, GA development and the fact that nearly % of patients have a poor or non-response to the standardized treatment.– Today, Efdamrofusp alfa, a bispecific fusion protein, can enhance the efficacy of anti-VEGF monotherapies for nAMD patients owing to its targeting of both Cb/Cb and VEGF. Other inhibitors of inflammatory factors, including Interleukin (IL)-?, IL- and IL-, have also been demonstrated to have deleterious effects on angiogenesis.– Although these new advances in choroidal vasculopathy mentioned above represent a promising approach, the future direction of choroidal vasculopathy treatment exploration should aim to identify a factor that can inhibit both VEGF and inflammatory factors.

Introduction:
Age-related macular degeneration (AMD) is the leading cause of severe vision loss among elderly people worldwide. The projected number of patients with AMD was million in and is expected to increase to million in . Many AMD risk factors have been identified, including aging, smoking, genetics and some environmental factors. AMD can be classified into the early, intermediate and late stages. A small number of medium-sized drusen and/or pigment changes can be found in early-stage AMD. As the disease progresses, some…

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