Rationale for Combination Therapie for Choroidal Neovacularization

Purpoe To provide a conceptual framework for the development and ue of combination therapie for choroidal neovacularization econdary to age-related macular degeneration. Deign Literature review, integration of data, and creation of hypothei. Method An aement of angiogenei, cancer therapy, and inflammation wa performed a they may pertain to choroidal neovacularization. A conceptual framework wa created in which therapie for choroidal neovacularization could be evaluated alone or in combination. Reult Angiogenei occur becaue cell produce angiogenic timuli to encourage blood veel to develop. Thi growth of veel involve an orchetrated interaction among many mediator offering opportunity to modulate or inhibit the entire proce. A two-component model for choroidal neovacularization i propoed. The vacular component of choroidal neovacularization i compried of vacular endothelial cell, endothelial cell precuror, and pericyte. The extravacular component, which by hitopathology appear to be both the ource of angiogenic timuli and often the larget component volumetrically, i compried of inflammatory, glial and retinal pigment epithelial cell, and fibroblat. Tiue damage can be caued by either component. Each component can be targeted through a variety of monotherapie. Combination therapie offer the poibility of attacking one component in more than one way or by attacking both component imultaneouly. Concluion The two-component model of choroidal neovacularization can be ued to evaluate the mechanim of action and poible interaction of thee agent in a conceptual framework. Extenion of thee idea can help guide development of new treatment agent and approache.