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How A Cancer Drug Has Saved People From Going Blind

If you developed wet age-related macular degeneration, a disease that wreaks havoc on central vision and limits the ability to read, recognize faces and generally see up close, there wasn't much we could do. If you were lucky and had a specific form of the disease, the best we had to offer was a laser treatment called photodynamic therapy, or PDT. Sadly, it didn't really do enough to help save vision; most people's sight still worsened. Then some brilliant minds applied principles of cancer therapy to come up with a treatment that could actually improve vision in people with wet AMD. They realized that the two diseases had an important trait in common — they both involved the growth of new…

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 Experimental gene therapy for wet age-related macular degeneration offers promise for older adults

Unlike stem cell therapies used to treat eye diseases — which involve injecting cells with regenerative or restorative capabilities into the eye — gene therapy generally uses an empty viral envelope (a vector) to deliver a gene with specific genetic instructions for making protein.

 Making a decision about Wet Age-related Macular Degeneration (Wet AMD)

This document is for you if you have been diagnosed with Wet AMD. This document is called a decision aid. It will help you decide between different treatments for Wet AMD. You should go through it and talk to your specialist to make a decision...

 Wet Age-Related Macular Degeneration: Understanding Disease Impact and Refining Treatment Approaches

Although wet AMD is responsible for nearly 10% of total blindness worldwide, several treatment approaches can provide clinical benefit by slowing, halting, or even reversing the progression of vision loss.3,4 Anti-VEGF agents are the most effective therapy, constitute the first line of treatment and are cost-effective. However, prices of anti-VEGF medications range widely, and clinic visits for injections and follow-up can be frequent.

Articles of Interest

How to spot age-related macular degeneration

“The initial diagnosis of wet AMD, and the need for follow-up treatments, is determined with a form of retinal imaging called optical coherence tomography (OCT),” says Keane. OCT is a relatively new form of medical imaging, having been around since 1991. It is analogous to ultrasound except that it measures the reflection of light waves, rather than sound. Most people with known retinal disease have an OCT scan at every hospital eye clinic appointment and get offered more injections into the eye if there are signs of “fluid”.

Learning to Live with Wet AMD

For me, it was a frightening event that occurred overnight that led to a diagnosis of wet age-related macular degeneration (AMD). Because of my age, the diagnosis wasn’t unusual, but the suddenness was — and it took me by surprise. Apparently, blood vessels deep within my eye grew and then leaked or burst, causing a rapid loss of vision.

Overview of Wet Age-Related Macular Degeneration

Unlike other ocular or systemic conditions, the treatment for wet macular degeneration is almost exclusively in physician offices. Typically the patient will initially present to their primary eye care provider, who may be an optometrist or may be a comprehensive ophthalmologist. Those physicians will make the initial diagnosis and then refer the patient to a vitreoretinal surgeon for evaluation and management. Typically these patients are treated in the office with ongoing therapies that I know we’ll discuss later in the course, but primarily the treatment is done in the office.

Overview of Wet Age-Related Macular Degeneration (AMD) and Diabetic Macular Edema (DME)

For wet macular degeneration, we have currently intravitreal therapies, injections of medicine that we give directly to the eye to stop that fluid from building up, to stop that bleeding. What that does is stabilizes the retina and allows those people to continue seeing. In many cases, as I said, we can sometimes improve the vision in those patients. That’s wet macular degeneration. Dry macular degeneration is a little bit different. It doesn’t cause that rapid vision loss.

The Progression of Wet Age-Related Macular Degeneration

Many patients have asked me when longer-lasting drugs will become available, and some are in clinical trials. One is an implanted, inside-the-eye, storage device for Lucentis, which in some patients can last more than a year between refills. Also, two types of gene therapy, one injected into the vitreous, and the other injected under the retina, are now being tested, and early results suggest they may decrease or eliminate the need for further injections.

Wet AMD

The goal of treatment is to maintain functional vision to the greatest extent possible for the greatest duration possible. Current standard of care for wet AMD targets the protein VEGF and requires injections in the eye every 4 to 8 weeks with some patients able to extend beyond 8 weeks. Newer treatments are becoming available that provide every 12 to 16-week dosing for some patients in clinical studies. These treatment intervals have yet to be validated in the real-world, however. In addition to a high treatment burden, many patients with wet AMD do not respond well to anti-VEGF treatment alone, even with frequent dosing.

What Is Wet Age-Related Macular Degeneration (Wet AMD)?

Wet AMD occurs in people with dry AMD, and experts suggest these abnormal, leaky vessels grow in response to the damage and functional problems that dry AMD causes.

What is Wet Macular Degeneration? Causes, Symptoms, and Treatment Options

Wet macular degeneration, also known as neovascular age-related macular degeneration (AMD), is a serious eye condition characterized by the growth of abnormal blood vessels beneath the retina and macula. This condition is one of the two main types of age-related macular degeneration, with the other being the more common dry macular degeneration. In wet AMD, these abnormal vessels are prone to leakage, causing fluid or blood to seep into the retina and elevate the macula, leading to a rapid and significant loss of central vision. This impairment significantly affects activities that require detailed vision, such as reading, driving, and recognizing faces.

Why There’s New Hope About Ending Blindness

Thanks to medical advances and expanding treatment, it's no longer just a dream.

Resources

Lucentis

LUCENTIS® (ranibizumab injection) is a prescription medicine for the treatment of patients with wet age-related macular degeneration (wAMD), macular edema following retinal vein occlusion (RVO), and diabetic macular edema (DME).

Vabysmo

VABYSMO® improves vision quickly and delivers a chance for up to 4 months between treatments.

American Macular Degeneration Foundation

In the “wet” type of macular degeneration, abnormal blood vessels (known as choroidal neovascularization or CNV) grow under the retina and macula. These new blood vessels may then bleed and leak fluid, causing the macula to bulge or lift up from its normally flat position, thus distorting or destroying central vision. Under these circumstances, vision loss may be rapid and severe.

Macular Society

Wet age-related macular degeneration (AMD) develops when abnormal blood vessels grow into the macula. These leak blood or fluid which leads to scarring of the macula and rapid loss of central vision. Wet AMD can develop very suddenly, but it can now be treated if caught quickly. Fast referral to a hospital specialist is essential.

StatPearls

Wet (exudative or neovascular) age-related macular degeneration is the most common cause of visual impairment among older patients in developed countries. Approximately 10% of patients with age-related macular degeneration develop choroidal neovascularization, which is the hallmark of wet age-related macular degeneration.