Combination therapy for the treatment of ocular neovascularization
Combination therapy for the treatment of ocular neovascularization
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DOI：
10.1007/s10456-007-9069-x
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发表时间：
2007-01-01
期刊：
影响因子：
9.8
通讯作者：
Robinson, Gregory S.
中科院分区：
文献类型：
--
作者：
Bradley, John;Ju, Meihua;Robinson, Gregory S.
不适当调节的渗漏血管的生长是几种使人衰弱的眼部疾病的重要组成部分，例如年龄相关性黄斑变性（AMD）、增殖性糖尿病视网膜病变（PDR）和早产儿视网膜病变（ROP）。靶向血管内皮生长因子-A（VEGF-A）的新药物疗法通过限制疾病进展，并在某些情况下通过改善视力，显著增强了AMD的治疗。虽然抗VEGF治疗无疑将证明在治疗其他眼部新生血管性疾病中有价值，但仍需要改进这种类型的治疗。目前，抗VEGF治疗需要玻璃体内注射和相对频繁的给药方案（4-6周）。此外，在新血管形成的实验模型中，随着新血管形成的发展，抗VEGF治疗在阻断血管生长和使血管消退方面变得不那么有效。因此，抗VEGF疗法在晚期AMD中的使用可能受到限制。改善眼部新生血管性疾病治疗的一个重要策略可能是联合治疗。抗VEGF药物与已建立的治疗方法（如用维替泊芬（PDT-V）的光动力疗法）或与靶向特定激酶的新开发药物的组合疗法提供了增加功效和改善治疗结果的机会。在这篇综述中，我们评估了联合治疗新生血管性眼部疾病的机会。
The growth of inappropriately regulated, leaky blood vessels is a prominent component of several debilitating eye diseases, such as age-related macular degeneration (AMD), proliferative diabetic retinopathy (PDR), and retinopathy of prematurity (ROP). New pharmacological therapies that target vascular endothelial growth factor-A (VEGF-A) have significantly enhanced the treatment of AMD by limiting the progression of the disease, and in some cases, by improving vision. Although anti-VEGF therapy will undoubtedly prove valuable in the treatment of other neovascular diseases of the eye, improvements with this type of therapy are still required. At present, anti-VEGF therapy requires intravitreal injection and a relatively frequent dosing regimen (4-6 weeks). Furthermore, in experimental models of neovascularization, anti-VEGF treatment becomes less effective at blocking vessel growth and at regressing vessels as the neovascularization develops over time. As such, the use of anti-VEGF therapy in late-stage AMD may be limited. An important strategy for improved treatment of neovascular diseases of the eye could be combination therapy. Combination therapy of anti-VEGF drugs with established treatments, such as photodynamic therapy with verteporfm (PDT-V), or with newly-developed drugs targeting specific kinases, presents opportunities for increased efficacy and improved therapeutic outcome. In this review, we evaluate the opportunities for combination therapy for the treatment of neovascular diseases of the eye.