1. Emerging treatments on
Neovascular Age Related
Macular Degeneration
Narciso F. Atienza, Jr. MD, DPBO
Cardinal Santos Medical Center
St. Luke’s Medical Center, QC
Legaspi Eye Center

2. FINANCIAL DISCLOSURE
Novartis
Bausch and Lomb Pharmaceuticals

3. Acknowledgements
Pravin Dugel, MD
Allen Ho, MD
Michael Tolentino, MD
Baruch Kupperman, MD

4. Age Related Macular
Degeneration

5. Age Related Macular
Degeneration
Progressive eye disease, where photoreceptors loss
function and die
Common in patients 55 years old or above
More common in Caucasians, rare in Negroes
2 broad types
Neovascular (Wet type - Exudative)
Non-neovascular (Dry type - Non exudative)

6. Non-neovascular AMD

7. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:

8. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen

9. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen

10. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen

11. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen
Geographic Atrophy

12. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen
Geographic Atrophy

13. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen
Geographic Atrophy

14. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen
Geographic Atrophy
Retinal pigment
epithelial changes

15. Non-neovascular AMD
Accounts for 90% of all
AMD cases
Could either be:
Drusen
Geographic Atrophy
Retinal pigment
epithelial changes

16. Natural course of AMD (dry)

17. Natural course of AMD (dry)
Majority retain useful vision
10-15% progress to
neovascular AMD
(Risk factors for progression)
Soft drusen
Areas of hyperpigmentation
Presence of CNV on fellow
eye

18. Neovascular AMD

19. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as

20. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment

21. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment

22. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment

23. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment

24. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment

25. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

26. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

27. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

28. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

29. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

30. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

31. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization

32. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization
Subretinal hemorrhage

33. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization
Subretinal hemorrhage

34. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization
Subretinal hemorrhage

35. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization
Subretinal hemorrhage
Fibrovascular proliferation

36. Neovascular AMD
10% of AMD cases
Main cause of severe visual
loss in AMD
Manifests as
Retinal pigment epithelial
detachment
Choroidal Neovascularization
Subretinal hemorrhage
Fibrovascular proliferation

37. Classification of “wet” AMD
Location
Subfoveal
Juxtafoveal
Extrafoveal

38. Classification of “wet” AMD

39. Classification of “wet” AMD
Angiographically

40. Classification of “wet” AMD
Angiographically
Classic

41. Classification of “wet” AMD
Angiographically
Classic

42. Classification of “wet” AMD
Angiographically
Classic

43. Classification of “wet” AMD
Angiographically
Classic

44. Classification of “wet” AMD
Angiographically
Classic
Occult

45. Classification of “wet” AMD
Angiographically
Classic
Occult

46. Classification of “wet” AMD
Angiographically
Classic
Occult

47. Classification of “wet” AMD
Angiographically
Classic
Occult

49. What has been done.........

50. What has been done.........
Macular Photocoagulation Study (MPS)

51. What has been done.........
Macular Photocoagulation Study (MPS)
Photodynamic Therapy (VIP - Verteforfin in Photodynamic
Therapy. TAP - Treatment Of Age-Related Macular
Degeneration With Photodynamic Therapy)

52. What has been done.........
Macular Photocoagulation Study (MPS)
Photodynamic Therapy (VIP - Verteforfin in Photodynamic
Therapy. TAP - Treatment Of Age-Related Macular
Degeneration With Photodynamic Therapy)
Pegaptanib (Macugen)

53. What has been done.........
Macular Photocoagulation Study (MPS)
Photodynamic Therapy (VIP - Verteforfin in Photodynamic
Therapy. TAP - Treatment Of Age-Related Macular
Degeneration With Photodynamic Therapy)
Pegaptanib (Macugen)
V.I.S.I.O.N. - (VEGF Inhibition Study in Ocular
Neovascularization)

55. Ranibizumab (Lucentis)

56. Ranibizumab (Lucentis)
M.A.R.I.N.A - Minimally classic/occult trial of the Anti-
VEGF antibody Ranibizumab (Lucentis) In the
treatment of Neovascular AMD

57. Ranibizumab (Lucentis)
M.A.R.I.N.A - Minimally classic/occult trial of the Anti-
VEGF antibody Ranibizumab (Lucentis) In the
treatment of Neovascular AMD
ANCHOR (ANti-VEGF Antibody for the Treatment of
Predominantly Classic CHORoidal
Neovascularization in AMD)

59. Submacular Surgery Trials (SST)

60. Submacular Surgery Trials (SST)
Limited Macular Translocation/360 Macular
Translocation (LMT/TMT)

61. Submacular Surgery Trials (SST)
Limited Macular Translocation/360 Macular
Translocation (LMT/TMT)
Anecortave (Retaane) - Alcon

62. Submacular Surgery Trials (SST)
Limited Macular Translocation/360 Macular
Translocation (LMT/TMT)
Anecortave (Retaane) - Alcon
Bevasiranib - OPKO Health - Si-RNA inhibitor

66. Present thrust of research

67. Present thrust of research
Combination therapy

68. Present thrust of research
Combination therapy
Anti-VEGF + PDT +/- Steroids

69. Present thrust of research
Combination therapy
Anti-VEGF + PDT +/- Steroids
Epimacular Brachytherapy (Radiation)

70. Present thrust of research
Combination therapy
Anti-VEGF + PDT +/- Steroids
Epimacular Brachytherapy (Radiation)
Complement immune system alteration / modulation

72. Combination therapy

73. Combination therapy
Combining treatment modalities:

74. Combination therapy
Combining treatment modalities:
anti-VEGF antibodies (Lucentis, Macugen, Avastin)

75. Combination therapy
Combining treatment modalities:
anti-VEGF antibodies (Lucentis, Macugen, Avastin)
microvascular occlusion (Visudyne)

76. Combination therapy
Combining treatment modalities:
anti-VEGF antibodies (Lucentis, Macugen, Avastin)
microvascular occlusion (Visudyne)
inflammatory control (Dexamethasone)

78. What’s on the horizon

79. What’s on the horizon
RADICAL (Reduced fluence visudyne Anti-VEGF-
Dexamethasone In Combination for AMD Lesions).

80. What’s on the horizon
RADICAL (Reduced fluence visudyne Anti-VEGF-
Dexamethasone In Combination for AMD Lesions).
SUMMIT (PDT + Ranibizumab)

81. What’s on the horizon
RADICAL (Reduced fluence visudyne Anti-VEGF-
Dexamethasone In Combination for AMD Lesions).
SUMMIT (PDT + Ranibizumab)
Mont Blanc (European arm) - Standard fluence

82. What’s on the horizon
RADICAL (Reduced fluence visudyne Anti-VEGF-
Dexamethasone In Combination for AMD Lesions).
SUMMIT (PDT + Ranibizumab)
Mont Blanc (European arm) - Standard fluence
DENALI (North American arm) - Reduced fluence
arm

83. What’s on the horizon
RADICAL (Reduced fluence visudyne Anti-VEGF-
Dexamethasone In Combination for AMD Lesions).
SUMMIT (PDT + Ranibizumab)
Mont Blanc (European arm) - Standard fluence
DENALI (North American arm) - Reduced fluence
arm
Everest (Asia arm) - done on polypoidal vasculopathy

84. Schimidt, Retina Congress, 2009, NYC

85. Preliminary results
Schimidt, Retina Congress, 2009, NYC

86. Preliminary results
Mont Blanc study:
Schimidt, Retina Congress, 2009, NYC

87. Preliminary results
Mont Blanc study:
Primary objective - Combination therapy is non-
inferior v.s. Monotherapy (+2.5 v.s. 4.4 letters). At 3
months (+4.6 v.s. 7.1 letters)
Schimidt, Retina Congress, 2009, NYC

88. Preliminary results
Mont Blanc study:
Primary objective - Combination therapy is non-
inferior v.s. Monotherapy (+2.5 v.s. 4.4 letters). At 3
months (+4.6 v.s. 7.1 letters)
Secondary objective - Retreatment rates -
combination (1.8 and 0.7) vs monotherapy (2.1 and
0.9)
Schimidt, Retina Congress, 2009, NYC

90. VEGF Trap

91. VEGF Trap
fusion protein specifically designed to bind all forms of
Vascular Endothelial Growth Factor-A (VEGF-A) and
Placental Growth Factor (PLGF).

92. VEGF Trap
fusion protein specifically designed to bind all forms of
Vascular Endothelial Growth Factor-A (VEGF-A) and
Placental Growth Factor (PLGF).

94. VEGF TRAP-EYE

95. VEGF TRAP-EYE
Nguyen QD, Shah SM, Browning DJ, Hudson H, Sonkin P, Hariprasad SM, Kaiser P, Slakter JS, Haller
J, Do DV, Mieler WF, Chu K, Yang K, Ingerman A, Vitti RL, Berliner AJ, Cedarbaum JM, Campochiaro
PA.A phase I study of intravitreal vascular endothelial growth factor
trap-eye in patients with neovascular age-related macular
degeneration.
Ophthalmology. 2009 Nov;116(11):2141-8.e1. Epub 2009 Aug 22.

96. VEGF TRAP-EYE
Doses are as follows: 0.05 mg, 0.15 mg , 0.5 mg, 1
mg, 2 mg, or 4 mg.
Nguyen QD, Shah SM, Browning DJ, Hudson H, Sonkin P, Hariprasad SM, Kaiser P, Slakter JS, Haller
J, Do DV, Mieler WF, Chu K, Yang K, Ingerman A, Vitti RL, Berliner AJ, Cedarbaum JM, Campochiaro
PA.A phase I study of intravitreal vascular endothelial growth factor
trap-eye in patients with neovascular age-related macular
degeneration.
Ophthalmology. 2009 Nov;116(11):2141-8.e1. Epub 2009 Aug 22.

97. VEGF TRAP-EYE
Doses are as follows: 0.05 mg, 0.15 mg , 0.5 mg, 1
mg, 2 mg, or 4 mg.
Decreased foveal thickness average - 104.5 um
Nguyen QD, Shah SM, Browning DJ, Hudson H, Sonkin P, Hariprasad SM, Kaiser P, Slakter JS, Haller
J, Do DV, Mieler WF, Chu K, Yang K, Ingerman A, Vitti RL, Berliner AJ, Cedarbaum JM, Campochiaro
PA.A phase I study of intravitreal vascular endothelial growth factor
trap-eye in patients with neovascular age-related macular
degeneration.
Ophthalmology. 2009 Nov;116(11):2141-8.e1. Epub 2009 Aug 22.

98. VEGF TRAP-EYE
Doses are as follows: 0.05 mg, 0.15 mg , 0.5 mg, 1
mg, 2 mg, or 4 mg.
Decreased foveal thickness average - 104.5 um
Mean increase in VA - 4.43 letters. Higher doses have
13.5 letters improvement (3 lines)
Nguyen QD, Shah SM, Browning DJ, Hudson H, Sonkin P, Hariprasad SM, Kaiser P, Slakter JS, Haller
J, Do DV, Mieler WF, Chu K, Yang K, Ingerman A, Vitti RL, Berliner AJ, Cedarbaum JM, Campochiaro
PA.A phase I study of intravitreal vascular endothelial growth factor
trap-eye in patients with neovascular age-related macular
degeneration.
Ophthalmology. 2009 Nov;116(11):2141-8.e1. Epub 2009 Aug 22.

100. VEGF TRAP-
EYE(Regeneron, Bayer)

101. VEGF TRAP-
EYE(Regeneron, Bayer)
A Randomized, Double Masked, Active Controlled
Phase III Study of the Efficacy, Safety, and Tolerability of
Repeated Doses of Intravitreal VEGF Trap in Subjects
With Neovascular Age-Related Macular Degeneration.

102. VEGF TRAP-
EYE(Regeneron, Bayer)
A Randomized, Double Masked, Active Controlled
Phase III Study of the Efficacy, Safety, and Tolerability of
Repeated Doses of Intravitreal VEGF Trap in Subjects
With Neovascular Age-Related Macular Degeneration.
VIEW 1 - US, CANADA

103. VEGF TRAP-
EYE(Regeneron, Bayer)
A Randomized, Double Masked, Active Controlled
Phase III Study of the Efficacy, Safety, and Tolerability of
Repeated Doses of Intravitreal VEGF Trap in Subjects
With Neovascular Age-Related Macular Degeneration.
VIEW 1 - US, CANADA
VIEW 2 - Europe, Asia, South America

105. Epimacular Brachytherapy

106. Epimacular Brachytherapy
Application of
Strontium 90 on
macular area.

107. Epimacular Brachytherapy
Application of
Strontium 90 on
macular area.
EPIRAD

108. Epimacular Brachytherapy
Application of
Strontium 90 on
macular area.
EPIRAD
VIDION

109. Epimacular Brachytherapy
Application of
Strontium 90 on
macular area.
EPIRAD
VIDION
Marketed by NeoVista

110. Epimacular Brachytherapy
Application of
Strontium 90 on
macular area.
EPIRAD
VIDION
Marketed by NeoVista

115. Epimacular Brachytherapy -
Pilot study

116. Epimacular Brachytherapy -
Pilot study
NVI-068
effect of Epimacular
Brachytherapy 24 Gy
Mean gain of 8.9
letters in VA
No loss of vision in
68%
38% gained more
than 15 letters at 12
months

117. Epimacular Brachytherapy -
Pilot study
NVI-068
effect of Epimacular
Brachytherapy 24 Gy
Mean gain of 8.9
letters in VA
No loss of vision in
68%
38% gained more
than 15 letters at 12
months

118. Epimacular Brachytherapy -
Pilot study
NVI-068
effect of Epimacular
Brachytherapy 24 Gy
Mean gain of 8.9
letters in VA
No loss of vision in
68%
38% gained more
than 15 letters at 12
months

120. NVI-111
Strontium 90 + anti-
VEGF agent
(Bevacizumab
1.25mg)
second injection of
Bevacizumab 30
days thereafter.

121. NVI-111
Strontium 90 + anti-
VEGF agent
(Bevacizumab
1.25mg)
second injection of
Bevacizumab 30
days thereafter.

122. NVI-111
Strontium 90 + anti-
VEGF agent
(Bevacizumab
1.25mg)
second injection of
Bevacizumab 30
days thereafter.

123. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

124. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

125. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

126. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

127. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

128. Mean change in BCVA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

129. Mean change in BCVA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

130. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

131. % of patients losing < 3
more lines in BCVA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

132. % of patients losing < 3
more lines in BCVA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

133. Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

134. % of patients that gained >
3 lines of VA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

135. % of patients that gained >
3 lines of VA
Dugel, P NVI-111 study group
Presented at Retina Congress 2009
Sheraton Towers, New York

137. CABERNET

138. CABERNET
CABERNET - (Cnv
secondary to AMD
treated with BEta
RadiatioN Epiretinal
Therapy)

139. CABERNET
CABERNET - (Cnv
secondary to AMD
treated with BEta
RadiatioN Epiretinal
Therapy)
Strontium 90 + anti-
VEGF agent (Lucentis)

140. CABERNET
CABERNET - (Cnv
secondary to AMD
treated with BEta
RadiatioN Epiretinal
Therapy)
Strontium 90 + anti-
VEGF agent (Lucentis)
second injection of
Lucentis 30 days
thereafter.

141. Off-shoots of the
CABERNET study

142. Off-shoots of the
CABERNET study

143. Off-shoots of the
CABERNET study
MERLOT (Macular EpiRetinal Brachytherapy versus
Lucentis Only Treatment)
Evaluate safety and efficacy of focal delivery of radiation
for the treatment of subfoveal CNV associated with wet
AMD previously treated with anti-VEGF therapy.

146. MERITAGE - still in feasibility.
Evaluate epiretinal beta radiation therapy when used to
treat wet AMD drug persistence in those patients who
have received anti-VEGF therapy.

147. MERITAGE - still in feasibility.
Evaluate epiretinal beta radiation therapy when used to
treat wet AMD drug persistence in those patients who
have received anti-VEGF therapy.

148. MERITAGE - still in feasibility.
Evaluate epiretinal beta radiation therapy when used to
treat wet AMD drug persistence in those patients who
have received anti-VEGF therapy.
ROSE - still in feasibility.
determine the safety and efficacy of epiretinal beta
radiation therapy in those who do not respond to
treatment with anti-VEGF medication.

150. Comparison of Age Related Macular
Degeneration Treatment Trials

151. Comparison of Age Related Macular
Degeneration Treatment Trials

152. Comparison of Age Related Macular
Degeneration Treatment Trials
Head on comparison between Ranibizumab v.s.
Bevacizumab

153. Comparison of Age Related Macular
Degeneration Treatment Trials
Head on comparison between Ranibizumab v.s.
Bevacizumab
Issues on difference in costs

154. Comparison of Age Related Macular
Degeneration Treatment Trials
Head on comparison between Ranibizumab v.s.
Bevacizumab
Issues on difference in costs
$2000 v.s. $50-100 injection

155. Comparison of Age Related Macular
Degeneration Treatment Trials
Head on comparison between Ranibizumab v.s.
Bevacizumab
Issues on difference in costs
$2000 v.s. $50-100 injection
Resistance from Genentech

156. Regimen

157. Regimen
Lucentis on a fixed schedule of every 4 weeks for 1
year; at 1 year, re-randomization to Lucentis every 4
weeks or to variable dosing.
Avastin on a fixed schedule of every 4 weeks for 1
year; at 1 year, re-randomization to Avastin every 4
weeks or to variable dosing.
Lucentis on variable dosing for 2 years; i.e., after initial
treatment, monthly evaluation for treatment based on
signs of lesion activity.
Avastin on variable dosing for 2 years; i.e., after initial
treatment, monthly evaluation for treatment based on
signs of lesion activity.

158. C.A.T.T

159. C.A.T.T

160. C.A.T.T
Recruitment has been finished last July 2009
Preliminary results will come out in 1 year
47 centers in the US/Canada

162. Complement in AMD

163. Complement in AMD
Complement factor H (CFH) gene.
variant Y402H polymorphism significantly increases
the risk for AMD.

167. Complement 3 inhibitor

168. Complement 3 inhibitor
POT-4 - derived from Compstatin

169. Complement 3 inhibitor
POT-4 - derived from Compstatin
Potentia Pharmaceuticals

170. Complement 3 inhibitor
POT-4 - derived from Compstatin
Potentia Pharmaceuticals
ASaP trial (Assessment of Safety of POT-4) - Phase 1
clinical trials.

171. Complement 3 inhibitor
POT-4 - derived from Compstatin
Potentia Pharmaceuticals
ASaP trial (Assessment of Safety of POT-4) - Phase 1
clinical trials.
Well tolerated after a single intra-vitreal dose (1050 ug/
mL)

172. Complement 3 inhibitor
POT-4 - derived from Compstatin
Potentia Pharmaceuticals
ASaP trial (Assessment of Safety of POT-4) - Phase 1
clinical trials.
Well tolerated after a single intra-vitreal dose (1050 ug/
mL)
Now being partnered with Alcon

181. Complement 5 inhibitor

182. Complement 5 inhibitor
ARC1905 Phase I

183. Complement 5 inhibitor
ARC1905 Phase I
Ophthotech Corp.

184. Complement 5 inhibitor
ARC1905 Phase I
Ophthotech Corp.
used with concomitance with Ranibizumab

185. Complement 5 inhibitor
ARC1905 Phase I
Ophthotech Corp.
used with concomitance with Ranibizumab
Preliminary reports showed a 9.5 letters
improvement and decrease in central macular
thickness by 104 um in 1 month.

186. Complement 5 inhibitor
ARC1905 Phase I
Ophthotech Corp.
used with concomitance with Ranibizumab
Preliminary reports showed a 9.5 letters
improvement and decrease in central macular
thickness by 104 um in 1 month.
No retinal toxicity

188. Other targets for AMD
treatment

189. Other targets for AMD
treatment
Platelet derived growth factor inhibition with E10030
(anti-PDGF aptamer)
Phase 1 - with ranibizumab
59% of subjects gained > 15 lines in 12 weeks
+14 letters at 12 weeks from baseline
Mean change in in OCT was 157 um
FA shows decrease in CNV area in 12 weeks by
86%

191. CCR3 - chemokine receptor specifically expressed on
the choroidal endothelium.

192. CCR3 - chemokine receptor specifically expressed on
the choroidal endothelium.
Maybe a more specific target compared to VEGF A

193. CCR3 - chemokine receptor specifically expressed on
the choroidal endothelium.
Maybe a more specific target compared to VEGF A
Can be used as a screening and therapeutic target in
the future.

195. Adenovirus Associated Gene Transfer Vector in murine
equivalent

196. Adenovirus Associated Gene Transfer Vector in murine
equivalent
Maybe used to continually synthesize Bevacizumab in
one single intraocular injection

198. Remicade:

199. Remicade:
Tumor Necrosis factor antibody

200. Remicade:
Tumor Necrosis factor antibody
Not well tolerated for intra-vitreal use.

201. AMD advances

202. AMD advances
Sustained growth in numbers of patients

203. AMD advances
Sustained growth in numbers of patients
Billion dollar industry

204. AMD advances
Sustained growth in numbers of patients
Billion dollar industry
Treatment now entails vision improvement and not
just vision preservation

205. AMD advances
Sustained growth in numbers of patients
Billion dollar industry
Treatment now entails vision improvement and not
just vision preservation
Multifaceted approach may work best in treatment.

206. Thank you