Dr. Katia Taba, Board-Certified Ophthalmologist and Retinal Specialist
For over a decade, ophthalmologists have been at the forefront of treating age-related macular degeneration (AMD), using innovative techniques to combat both wet and dry AMD. These treatments have changed the final visual outcome for millions of Americans afflicted with this potentially vision-stealing disease. As the field of ophthalmology continues to evolve, the coming decade promises a continuing plethora of exciting advancements aimed at providing even more effective ways to safeguard the eyesight of those affected by AMD. In this article, we delve into the most promising treatments on the horizon for both wet and dry AMD.
Wet AMD Breakthroughs
Wet AMD is a condition that ensues when abnormal blood vessels form beneath the retina and subsequently leak blood or fluids, leading to rapid vision loss. Thanks to groundbreaking research, anti-VEGF drugs emerged about 15 years ago as a game-changer. These drugs function by obstructing vascular endothelial growth factor (VEGF), a key protein involved in the growth of these detrimental blood vessels.
Before the advent of anti-VEGF drugs, individuals with wet AMD faced a grim prognosis of severe vision loss or even legal blindness. Drugs like Lucentis, Avastin and Eylea have revolutionized the management of wet AMD by either stabilizing in most or even improving vision in a significant proportion of patients. Nevertheless, there’s a catch – they require regular injections into the eye.
The good news is that more enduring therapies are now emerging, and there are new drugs that promise fewer scheduled intraocular injections while maintaining eyesight.
However, while clinical trials demonstrate that anti-VEGF injections have allowed more than 90% of patients to preserve their vision, real-world statistics indicate a figure closer to 50%. The major reason behind this gap is the challenge of sticking to a demanding injection schedule, often requiring monthly or bi-monthly appointments, which can be arduous for elderly patients dealing with multiple health issues.
Gene Therapy for Wet AMD
One promising avenue is gene therapy, which could replace the need for frequent drug injections. The objective is to develop a “one-and-done” treatment that stimulates the eye to produce its own anti-VEGF medicine. Two distinct methods are under exploration: one involves surgical injection of gene therapy under the retina, while the other, more convenient approach is an injection performed in an ophthalmologist’s office.
Gene therapy offers substantial potential, but its long-term effectiveness and affordability remain uncertain. It might not be a universal solution for all AMD patients, given the potential costs and individual suitability.
Drugs that Target Multiple Causes of Wet AMD
In addition to gene therapy, there’s excitement about drugs that could tackle more than one underlying factor contributing to AMD. Faricimab, sold under the brand name Vabysmo, is one such drug that targets both VEGF and the protein angiopoietin-2. It’s injected into the eye, similar to traditional anti-VEGF treatments and may offer the advantage of extended effectiveness, allowing patients to go longer than monthly between treatments.
Moreover, the prospect of combining two drugs to address wet AMD more comprehensively is on the horizon. Other drugs are currently in clinical trials, and have shown better outcomes when compared to anti-VEGF agents alone.
Advancements in Dry AMD Treatments
Dry AMD is a condition that affects approximately 8 out of 10 AMD patients. It manifests as the gradual thinning of the macula with age, accompanied by the growth of tiny protein clumps called drusen. Central vision is progressively lost, and the severity categorizes it as early, intermediate, or late stage. For those in the intermediate stage, the AREDS2 formula, a combination of antioxidant vitamins, helps reduce the risk of vision loss. However, a small percentage of individuals in the late stage, known as geographic atrophy (GA), have had limited treatment options.
Dry AMD Treatments Targeting the Immune System
A significant breakthrough in the treatment of dry AMD is the identification of the immune system’s “complement cascade” as a key contributor to the condition. These drugs aim to halt the complement cascade’s attack on the retina and are administered through eye injections, similar to wet AMD treatments. Two novel drugs that target this cascade, Syfovre and Izervay were both recently granted FDA approval and are available for eligible patients.
Replacing Vision Cells in Dry AMD
Another intriguing avenue of research for late-stage dry AMD involves the potential replacement of deteriorating retinal cells. Stem cells hold the promise of replacing these damaged cells, and various methods are being explored to transplant them into the eye. This includes layering stem cells on thin scaffolds or injecting them in a fluid suspension under the retina. Early clinical trials have not revealed any unexpected side effects, but it may take another decade or more to refine and validate these therapies for human application.
In conclusion, the future of AMD treatment is rife with innovation. New therapies, including gene therapy, multifactor-targeting drugs, and stem cell treatments, offer hope for patients affected from both wet and dry AMD. With ongoing research and clinical trials, the next decade may indeed witness a transformation in the management of this sight-threatening condition, providing a brighter outlook for the nearly 20 million Americans currently grappling with AMD.
Retina Group of Florida
If you are experiencing any changes in your eye health, whether it is blurry vision, pain, impaired vision, or any other visual irregularities, you should see an ophthalmologist right away. The earlier a disease is detected, the better the outcome and treatment options are for you. You will find a friendly and warm environment at Retina Group of Florida.
Please call (239) 325-3970 today to schedule your eye exam. When necessary same day appointments can often be accommodated.
Retina Group of Florida provides comprehensive diagnosis and treatment for retinal disorders. Dr. Taba also gives second opinions on retinal and general eye conditions. Dr. Taba is a Board-Certified Ophthalmologist and is Fellowship trained in surgical and medical retinal diseases.
www.retinagroupflorida.com | 239-325-3970
3467 Pine Ridge Rd., Suite 103, Naples 34109
Source:
https://www.aao.org/eye-health/tips-prevention/promising-new-
treatments-amd