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Prog Retin Eye Res ; 29(6): 466-75, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20452456

ABSTRACT

This article aims to provide an interpretation and perspective on current concepts and recent literature regarding the evidence for individualizing intravitreal therapy (IVT), particularly considering iatrogenic and patient factors in the management of neovascular age-related macular degeneration (AMD). As ocular parameters that govern IVT pharmacokinetics do vary between individuals with AMD, developing a personalized strategy could improve safety and efficacy. This has to be derived from clinical measurements and data from laboratory animals; however, it is recognized that the animal models used in the development of intraocular formulations differ in their vitreous geometry from humans. These factors may be of relevance to the design of ophthalmic formulations and optimizing treatment outcomes in AMD. Further studies are needed to drive improvements in clinical practice which are aimed at maximizing the efficacy profile in IVT for AMD by a more rigorous evaluation of patient and surgeon-related variables.


Subject(s)
Angiogenesis Inhibitors/pharmacokinetics , Choroidal Neovascularization/therapy , Individuality , Intravitreal Injections/methods , Macular Degeneration/physiopathology , Macular Degeneration/therapy , Angiogenesis Inhibitors/therapeutic use , Animals , Choroidal Neovascularization/complications , Humans , Intravitreal Injections/instrumentation , Models, Biological , Vitrectomy/methods , Vitreous Body/anatomy & histology , Vitreous Body/metabolism , Vitreous Body/pathology
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