In the United States and Europe, age-related macular degeneration (AMD) is the leading cause of blindness in older adults. The neovascular form of AMD is characterized by abnormal vessels growing from the choroid to the subretinal area, choroidal neovascularization (CNV).At present we do not have an effective therapy for subfoveal CNV. As CNV is a form of angiogenesis, there has been considerable research in using angiogenesis inhibitors to stop subfoveal CNV and AMD. Tetrathiomolybdate (TM) is a drug developed as an orphan therapy for Wilson's disease by Brewer and colleagues. TM is the most potent and the most rapid acting anticopper agent known. Copper is a major co-factor in angiogenesis; a variety of studies have shown that reducing copper levels results in inhibition of angiogenesis. Extensive experience has shown that the only demonstrable toxicity of TM is a reversible anemia due to bone marrow copper deficiency, if the daily dosage is increased beyond about 100 mg for maintenance therapy. This anemia is readily reversible by stopping TM.
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