Age-related Macular Degeneration (1)

Question 1

AMD Risk Factors

Answer 1

Age > 55 years
Smoking (32% increase)

Question 2

Hard drusen

Answer 2

small, round, well-defined spots located far away from one another on the retina (Not a concern)

Question 3

Soft drusen

Answer 3

larger, not well-defined
Increased risk for AMD (specifically wet AMD)

Question 4

Two Forms of AMD

Answer 4

Dry and Wet

Question 5

Dry AMD

Answer 5

Less severe form
subretinal hard and soft drusen deposits, macular thinning, photoreceptor–retinal pigment epithelial (RPE) atrophy, and hyperpigmentation of the retina
Can evolve into wet macular degeneration

Question 6

Wet AMD

Answer 6

More severe form
loss of central vision caused by choroidal neovascularization (abnormal growth of new blood vessels from the choroid into the macula and retina)
Causes a faster and more severe form of visual loss

Question 7

Symptoms of AMD

Answer 7

Difficulty reading or driving
Visual distortion
Blurred images
Difficulty seeing in low light
Decreasing central vision
Colors may not appear as bright as they once were

Question 8

VEGFs

Answer 8

Vascular endothelial growth factor - ligands
major factor responsible for angiogenesis, inducing blood vessel development, after injury and in tumors

Question 9

VEGF inhibitors

Answer 9

Monoclonal antibody VEGF inhibitors
Nonmonoclonal antibody VEGF inhibitors

Question 10

Monoclonal antibody VEGF inhibitors

Answer 10

bevacizumab (Avastin and Byooviz)
ranibizumab (Lucentis)
brolucizumab (Beovu)
faricimab (Vabysmo)

Question 11

Nonmonoclonal antibody VEGF inhibitors

Answer 11

aflibercept (Eylea)
oligonucleotide pegaptanib (Macugen)

Question 12

VEGF receptors (VEGFR)

Answer 12

receptor tyrosine kinases

Question 13

Bevacizumab

Answer 13

Humanized monoclonal IgG1 antibody binds to VEGF
Prevents the interaction of VEGF with its receptors on the surface of endothelial cells
Administered by injection into the vitreous cavity of the eye

Question 14

Ranibizumab

Answer 14

modified fragment of bevacizumab

Question 15

Aflibercept

Answer 15

Acts as a trap for VEGFR ligands
AEs: hypertension and diarrhea
Contraindicated in active eye infection or active ocular inflammation

Question 16

Brolucizumab

Answer 16

Single-chain antibody

Question 17

Pegaptanib

Answer 17

A pegylated anti-vascular endothelial growth factor (VEGF) aptamer
Intravitreal injection into the eye to be treated
Patient should be monitor after injection for elevation in Intraocular pressure (IOP) and for endophthalmitis

Question 18

Verteporfin

Answer 18

A photodynamic therapy
Activation of the drug in the presence of O2 generates free radicals - vessel damage and subsequent platelet activation, thrombosis, and occlusion of choroidal neovascularization
Administered IV