Treatment for Macular Degeneration

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Current treatments for wet AMD

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Several drugs are used to treat wet AMD. They are known as ‘anti-VEGF’ drugs.

VEGF is short for vascular endothelial growth factor. It is the substance in the body that is responsible for the development of healthy blood vessels.

In wet AMD, too much VEGF is produced in the eye, causing the growth of unwanted, unhealthy blood vessels. Anti-VEGF drugs block the production of VEGF and stop the development of abnormal blood vessels. All the anti-VEGF drugs are given as an injection into the eye. Don’t be alarmed – the injections are much less frightening than they sound.

The Royal College of Ophthalmologists recommends that people with suspected wet AMD should be referred to a retinal specialist immediately and seen within two weeks.

If treatment is needed it should be given within two weeks of the diagnosis. Optometrists who suspect someone has wet AMD should refer the person directly to a retinal specialist.

What medication do they use?

Lucentis® (medical name ranibizumab) was the first anti-VEGF to be licensed for wet AMD.

Or you might be given Eylea® (medical name aflibercept).

A third drug, Avastin® (medical name bevacizumab) may be used in some circumstances. But Avastin® is an anti-VEGF drug used to treat cancer and is not yet licensed for use in the eye.

A new medication called BEOVU has been approved by the Scottish medicines consortium in 2020 following some successful trials in the US. We are expecting NICE to approve this for the rest of the UK in 2021.

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How does treatment begin?

In accordance with NICE AMD guidelines, all patients receive a standard ‘loading dosage’ at the start of their treatment: normally three or more consecutive monthly injections.

After this initial phase there are a number of treatment regimens that an ophthalmologist can choose. Each regimen has a subtle difference in the frequency of appointments. They also vary as to whether or not you have an injection at every appointment.

Medical trials suggest that the effects of Eylea® last longer than those of Lucentis® and so people may need fewer injections over time.

Top tip

Ask your eye doctor, after the original loading dose, what treatment regimen you are on. If you understand the planned timescale between injections, you can feel confident that you are not being overlooked or missing any treatment.

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