Choroidal neovascularization (CNV) represents the most common cause of severe vision loss in patients with age-related macular degeneration (AMD). It is also the most common cause of legal blindness in the United States in patients over the age of 60. Therefore, the study of the diagnosis, prevention and treatment of this condition would have a major impact on the public health. The laboratory is heavily involved in drug development for the treatment of neovascular AMD. These efforts are within the realm of drug delivery and drug formulation development. Within drug delivery, the laboratory is focusing on the use of substained implant technology. We have studied extraocular drug delivery and have made the seminal observation that choroidal flow may limit drug penetration. In addition, we are working on substained drug delivery of two integrin antagonists, EMD 0587 and a short peptide, C16Y, both of which have been shown in the laboratory ot have anti-angiogenic effects in a laser-induced model of CNV. The laboratory has made progess in modifying a formulation of triamcinolone acetonide for intraocular use. By generating a preservative free formulation which is also of more uniform particle size, a phase I clinical trial within the intramural program has been completed to test this formulation in patients. A multi-center phase III study of this NEI formulation as an adjunct therapy to photodynamic therapy is being planned.
