Implantable anti-angiogenic scaffolds for treatment of neovascular ocular pathologies
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Implantable anti-angiogenic scaffolds for treatment of neovascular ocular pathologies Biplab Sarkar 1 & Zain Siddiqui 1 & Ka Kyung Kim 1 & Peter K. Nguyen 1 & Xavier Reyes 1 & Trevor J. McGill 2 & Vivek A. Kumar 1,3,4
# Controlled Release Society 2020
Abstract The retinal physiology can accrue oxidative damage and inflammatory insults due to age and metabolic irregularities. Two notable diseases that involve retinal and choroidal neovascularization are proliferative diabetic retinopathy and wet age-related macular degeneration. Currently, these diseases are mainly treated with anti-VEGF drugs (VEGF = vascular endothelial growth factor), generally on a monthly dosage scheme. We discuss recent developments for the treatment of these diseases, including bioactive tissue-engineered materials, which may reduce frequency of dosage and propose a path forward for improving patient outcomes. Keywords Pathological neovascularization . Age-related macular degeneration . Diabetic retinopathy . Self-assembly . Hydrogel . Peptide nanofibers . Anti-angiogenic materials
Introduction The retina is the only part of the central nervous system (CNS) that can be non-invasively imaged via simple photography and hence offers fascinating insight into CNS health. In spite of the relative ease of detection of retinal features and the adoption of techniques such as spectral domain optical coherence tomography (SD-OCT) [1] in clinical practice, patients often seek medical attention only after significant progression of retinal diseases. There may be several factors to potentially explain this delay in presentation. As patients use binocular vision to interpret their surroundings, reduced central vision in one eye may not be readily noticed unless the normal eye is covered. In the case of diabetic retinopathy, affected patients
are usually of working age and treatment burden may impact the decision to seek medical attention. These patients may not easily be able to take a day off work every month for treatment. Finally, access to care may limit a patient’s ability to reach a retina specialist. Often these patients must drive long distances, and for a patient with compromised vision, especially elderly patients, a caretaker/family member generally has to accompany the patient. Thus, there is an unmet clinical need to reduce the frequency of treatment and visit burden for patients. To understand some of the current clinical options employed to treat these diseases, it is instructive to explore the root causes.
Scope * Vivek A. Kumar [email protected] 1
Department of Biomedical Engineering, New Jersey Institute of Technology, 138 Warren St. LSEB 316, Newark, NJ 07102, USA
2
Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
3
Department of Chemical and Materials Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA
4
Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
Retinal diseases such as wet age-related macular degeneration (wAMD) and p
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