Since ancient times, various herbal medicines have been used in folk medicine to treat a variety of diseases. While the majority of drugs belong to the Kingdom of Plantae, some drugs from the Kingdom of Animalia are listed in various Materia medica of alternative medicines. Animal-derived drugs are mentioned in the Unani system of Medicine (USM) and have been used successfully to treat a variety of diseases. Marjan (Corallium rubrum) is a vital marine drug of animal origin that has been used in USM since ancient times and continues to be used today. It possesses a variety of beneficial pharmacological properties, including tonic effects on the heart, brain, stomach, and eyes, pregnancy protection, expectorant, and hemostyptic properties. It is used to treat hemoptysis, palpitation, bleeding piles, hemiplegia, heart failure, and general weakness. It is also an ingredient in a variety of Unani formulations with pharmacological significance. Unani physicians expanded the uses of Marjan and successfully used it to treat a variety of new diseases. There is a dearth of scientific research on its pharmacological and medicinal properties. The urgent need is to validate the Unani claims about its beneficial cardiac and nervine actions, as well as other significant actions mentioned in the Unani literature.

Since ancient times, various herbal medicines have been used in folk medicine to treat a variety of diseases. While the majority of drugs belong to the Kingdom of Plantae, some drugs from the Kingdom of Animalia are listed in various Materia medica of alternative medicines. Animal-derived drugs are mentioned in the Unani system of Medicine (USM) and have been used successfully to treat a variety of diseases. Marjan (Corallium rubrum) is a vital marine drug of animal origin that has been used in USM since ancient times and continues to be used today. It possesses a variety of beneficial pharmacological properties, including tonic effects on the heart, brain, stomach, and eyes, pregnancy protection, expectorant, and hemostyptic properties. It is used to treat hemoptysis, palpitation, bleeding piles, hemiplegia, heart failure, and general weakness. It is also an ingredient in a variety of Unani formulations with pharmacological significance. Unani physicians expanded the uses of Marjan and successfully used it to treat a variety of new diseases. There is a dearth of scientific research on its pharmacological and medicinal properties. The urgent need is to validate the Unani claims about its beneficial cardiac and nervine actions, as well as other significant actions mentioned in the Unani literature.

Objective To assess the efficacy and safety ofintravitreal aflibercept injection (IAI) compared with photodynamic therapy (PDT) in the treatment of Chinese patients with predominantly classic subfoveal choroidal neovascularization (CNV) lesions secondary to neovascular age-related macular degeneration (nAMD).Methods A randomized,double-blind,multi-center phase-3 clinical trial lasting for 52weeks (from December 2011 to August 2014).Subjects were randomized in a 3:1 ratio to either IAI group or PDT-to-IAI group.Subjects in the IAI group received 2 mg IAI at baseline and at week 4,8,16,24,32,40,48,with sham injection at week 28,36.Subjects in the PDT-to-IAI group were forced to receive PDT once at baseline and more time at week 12,24 if PDT retreatment conditions were met.Sham injections were given in PDT-to-IAI group at baseline and at week 4,8,16 and 24,followed by 2 mg IAI at week 28,32,36,40,48.The primary outcome of efficacy were the change in mean Best Corrected Visual Acuity (BCVA) from baseline to week 28,and that of week 52.Safety evaluation included the percentage of subjects who suffered treatment emergent adverse events (TEAEs).Results Among the 304 subjects enrolled,there were 228 and 76 cases in IAI group and PDT-to-IAI group respectively.At week 28,the changes of mean BCVA in IAI group,PDT-to-IAI group compared to baseline were +14.0,+3.9 letters,respectively.At week 52,the changes of mean BCVA in two groups were + 15.2,+8.9 letters respectively with the difference of +6.2 letters (95％CI 2.6-9.9,P=0.000 9).At week 52,the mean foveal retinal thickness in the two groups decreased by-189.6,-170.0 μm,respectively.Subjects with the most BCVA increase in IAI group were those aged ＜65,and those with active CNV lesion area ＜50％ of total lesion area.The most common TEAEs in IAI group and PDT-to-IAI group are macular fibrosis [11.8％ (27/228),6.6％ (5/76)] and BCVA decline [6.6％ (15/228),21.1％ (16/76)].There were 3 cases of arterial thromboembolic events defined in the antiplatelet experimental collaboration group,but all were considered unrelated to interventions.Conclusions The efficacy of aflibercept is superior to that of PDT in nAMD patients in China.The therapeutic effect of aflibercept persisted to week 52 in all subjects.The rate of adverse events was consistent with the safety data of aflibercept known before.