Molecular Pathology-Based Therapeutic Interventions of Macular Degeneration: Unraveling Complexity

Age-related macular degeneration (AMD) is a multifaceted retinal degeneration linked to ageing, resulting in central vision impairment or blindness. Stargardt disease, a juvenile macular dystrophy, impacts younger persons. Diagnosis encompasses angiography, tomography, photography, and artificial intelligence-based methodologies. AMD manifests in two variants: dry and wet, with the wet variant resulting in significant vision impairment. Genetic mutations, oxidative stress, aberrant lipid peroxidation, aging, and iron accumulation lead to damage in the retinal pigment epithelium and photoreceptors. Impaired proteostasis, dysfunctional autophagy, and mitochondrial abnormalities contribute to drusen development, a characteristic of dry AMD. This mechanism initiates the complement system, resulting in damage to retinal tissue. The gut microbiota contributes to AMD pathogenesis via TLR signaling. Treatments seek to impede the advancement of the disease, while no cure exists. Therapies encompass anti-angiogenic approaches utilizing high-energy laser light, monoclonal antibodies, and recombinant fusion proteins. Low-vision devices and implantable telescopes enhance visual acuity. Nutraceutical supplements demonstrate potential in illness management. In 2021, the USFDA sanctioned Byooviz, the inaugural biosimilar for AMD. Current clinical trials are investigating gene therapy, innovative drug delivery technologies, and medicines based on induced pluripotent stem cells for prospective AMD treatment.