wAMD Is a Chronic, VEGF-Mediated Disease That Primarily Affects an Older Population1-3

Typical risk factors
Common comorbidities
age, smoking, female, Caucasian, family history, cardiovascular disease, hypertension1
hyperlipidemia, hypertension, diabetes, myocardial infarction, renal dysfunction4

Elevated levels of VEGF lead to abnormal formation of CNV

  • In wAMD, VEGF plays a significant role in formation of blood vessels that grow abnormally and leak beneath the macula5,6
  • Overexpression of VEGF initiates abnormal growth of choroidal blood vessels5,6
  • These choroidal neovascular vessels leak blood and fluid, forming the characteristic lesions of wAMD5,6
  • wAMD is the leading cause of vision loss in people over 65 years of age7

Systemic VEGF plays multiple roles in cellular functions, including angiogenesis and vascularization8

  • Complications attributed to decreased systemic VEGF levels include hypertension, and arterial thromboembolic events9

Patients with wAMD may be at a higher risk for some of these conditions, including10,11:

  • Stroke
  • Myocardial infarction
CNV, choroidal neovascularization; RPE, retinal pigment epithelium; VEGF, vascular endothelial growth factor; wAMD, neovascular (wet) age-related macular degeneration.

References: 1.National Institutes of Health, National Eye Institute. Age-related macular degeneration. Available at: http://www.nei.nih.gov/health/maculardegen/armd_facts.asp. Accessed August 8, 2012.2. Ferrara N, Damico L, Shams N, Lowman H, Kim R. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration. Retina. 2006;26:859-870. 3. Griffioen AW, Molema G. Angiogenesis: potentials for pharmacologic intervention in the treatment of cancer, cardiovascular diseases, and chronic inflammation. Pharmacol Rev. 2000;52:237-268. 4. Alexander SL, Linde-Zwirble WT, Werther W, et al. Annual Rates of Arterial Thromboembolic Events in Medicare Neovascular Age- Related Macular Degeneration Patients. Ophthalmology 2007;114:2174–2178. 5. Ma W, Lee SE, Guo J, et al. RAGE ligand upregulation of VEGF secretion in ARPE-19 cells. Invest Ophthalmol Vis Sci. 2007;48:1355-1361. 6. Ikeda E, Achen MG, Breier G, Risau W. Hypoxia-induced transcriptional activation and increased mRNA stability of vascular endothelial growth factor in C6 glioma cells. J Biol Chem. 1995;270:19761-19766. 7. Quillen DA. Common Causes of Vision Loss in Elderly Patients. Am Fam Physician. 1999;60:99-108. 8. Wirostko B, Wong TY, Rafael Simo. Vascular endothelial growth factor and diabetic complications. Progress in Retinal and Eye Research. 2008;27:608–621. 9. Chen HX, Cleck JN. Adverse effects of anticancer agents that target the VEGF pathway. Nat. Rev. Clin. Oncol. 2009;6:465–477. 10. Ikram MK et al. Age-Related Macular Degeneration and Long-Term Risk of Stroke Subtypes. Stroke. 2012;43:1-3. 11. Tan JSL et al. Age-related macular degeneration and mortality from cardiovascular disease or stroke. Br J Ophthalmol 2008;92:509–512.