A review.Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in older individuals living in developed countries.There are two major clin. presentations of AMD: atrophic or "dry" and neovascular or "wet." Geog. atrophy (GA) is the most severe manifestation of dry AMD which represents the form of the disease characterized by the highest prevalence.A smaller fraction of AMD patients (10-20%) develop choroidal neovascularization (CNV) which represents the key feature of neovascular AMD.Historically, laser photocoagulation, surgery, and photodynamic therapy were the first treatment options for patients with CNV.In recent years, the emergence of anti-VEGF therapeutics has transformed the treatment of patients with neovascular AMD.Current anti-VEGF biologics that represent a standard of care (ranibizumab, bevacizumab, and aflibercept) are very effective in improving or maintaining visual acuity in CNV patients over long periods of time.The work on the new generation of anti-VEGF agents with higher potency and long-lasting efficacy is ongoing with the goal of reducing the frequency of intravitreal injections required for achieving good visual acuity outcomes.Brolucizumab, abicipar pegol, and faricimab exemplify the efforts toward the development of novel therapeutic agents with lower frequency of intravitreal injections.While neovascular AMD can be effectively managed with current anti-VEGF therapeutics, there are no FDA-approved treatments for the atrophic form of AMD.Similarly, there is no therapy for inherited Stargardt disease, an orphan genetic form of macular dystrophy that shares phenotypic similarities with atrophic AMD.Due to the multigenic and multifactorial nature of AMD, it is believed that a combination of several factors may contribute to pathogenesis of atrophic AMD.This includes a complement system dysregulation in the retina and exposure of retinal cells to toxins produced in the visual retinoid cycle reactions (lipofuscin bisretinoids and retinaldehydes).Several therapeutic agents are currently being evaluated in clin. trials for geog. atrophy related to atrophic AMD or Stargardt disease.This includes pegcetacoplan (C3 inhibitor), avacincaptad pegol (C5 inhibitor), emixustat (RPE65 inhibitor), ALK-001 (deuterated form of vitamin A: C20-D3-retinyl acetate), STG-001 (RBP4 antagonist), and tinlarebant (RBP4 antagonist).These ongoing clin. trials may yield a therapy that will address a significant unmet medical need that exists for the currently untreatable forms of macular degeneration.