Exploring the Use of Molecular Biomarkers for Precision Medicine in Age-Related Macular Degeneration

Mol Diagn Ther. 2018 Jun;22(3):315-343. doi: 10.1007/s40291-018-0332-1.

Abstract

Precision medicine aims to improve patient care by adjusting medication to each patient's individual needs. Age-related macular degeneration (AMD) is a heterogeneous eye disease in which several pathways are involved, and the risk factors driving the disease differ per patient. As a consequence, precision medicine holds promise for improved management of this disease, which is nowadays a main cause of vision loss in the elderly. In this review, we provide an overview of the studies that have evaluated the use of molecular biomarkers to predict response to treatment in AMD. We predominantly focus on genetic biomarkers, but also include studies that examined circulating or eye fluid biomarkers in treatment response. This involves studies on treatment response to dietary supplements, response to anti-vascular endothelial growth factor, and response to complement inhibitors. In addition, we highlight promising new therapies that have been or are currently being tested in clinical trials and discuss the molecular studies that can help identify the most suitable patients for these upcoming therapeutic approaches.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Antibodies, Monoclonal / therapeutic use*
  • Biomarkers / metabolism
  • Complement Inactivating Agents / therapeutic use*
  • Complement System Proteins / genetics*
  • Complement System Proteins / immunology
  • Dietary Supplements
  • Gene Expression
  • Humans
  • Macular Degeneration / diagnosis
  • Macular Degeneration / genetics
  • Macular Degeneration / immunology
  • Macular Degeneration / therapy*
  • Precision Medicine / methods
  • Retina / drug effects
  • Retina / immunology
  • Retina / pathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / genetics*
  • Vascular Endothelial Growth Factor A / immunology
  • Vitamins / administration & dosage
  • Zinc / administration & dosage

Substances

  • Antibodies, Monoclonal
  • Biomarkers
  • Complement Inactivating Agents
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Vitamins
  • Complement System Proteins
  • Zinc