There is currently no known cure for Macular Degeneration, but there are things you can do to reduce your risk and possibly slow the progression once you’ve been diagnosed. For example, one can pursue lifestyle changes like dieting, exercise, avoiding smoking, and protecting your eyes from ultraviolet light. Consumption of retinal supplements that are composed of Lutein, Bilberry, Zeaxanthins, and other antioxidants are also vital to vision preservation.
Treatments for Wet AMD: Anti-VEGF Therapy
VEGF is an acronym for vascular endothelial growth factor. Currently, the most common and effective clinical treatment for wet Age-related Macular Degeneration is anti-VEGF therapy – which is periodic intravitreal (into the eye) injection of a chemical called an "anti-VEGF." In the normal life of the human body, VEGF is a healthy molecule which supports the growth of new blood vessels. In the case of macular health, though, VEGF is unhealthy. It promotes the growth of new, weak blood vessels in the choroid layer behind the retina, and those vessels leak blood, lipids, and serum into the retinal layers. The leakage (hemorrhaging) causes scarring in the retina and kills macular cells, including photoreceptor rods and cones.
An intraocular shot of an anti-VEGF drug inhibits the formation of new blood vessels behind the retina and may keep the retina free of leakage. An injection in the eye can be a disconcerting experience, and it may take several treatments to become accustomed to the procedure. However, the shot is usually not painful because the eye has been anesthetized. The procedure takes about fifteen minutes. Usually the appointment requires an hour. The effect lasts for a month or maybe more.
Researchers report high rates of success with anti-VEGF injections, including receding blood vessels behind the retina, a far slower progression of the disease, and, in some cases, moderate gains made in vision. In some parts of the world, anti-VEGF treatments have reduced the incidence of legal blindness by 50 percent. However, they have noted that injections of even small amounts of anti-VEGF drugs could -- though research is inconclusive -- have an effect on vascular function in the rest of the body. Strokes and hemorrhaging are two concerns, but because cardiovascular disease is already often associated with Age-related Macular Degeneration, any data available to date about strokes or hemorrhaging has been difficult to interpret.
Types of Anti-VEGF Drugs
Several anti-VEGF drugs are being developed to inhibit VEGF by trapping it or preventing it from binding with elements which will stimulate growth. Chemically synthesized short strands of RNA (nucleic acid) called "aptamers" prevent the binding of VEGF to its receptor. The various forms of anti-VEGF injections include ranibizumab (Lucentis, made by Genentech/Novartis), bevacizumab (off label Avastin from Genentech), and the recently Food and Drug Administration-approved aflibercept (Eylea/VEGF Trap-Eye from Regeneron/Bayer). Each of these chemicals works in a different way to inhibit blood vessel growth.
Side Effects of Intravetreal Injections
Side effects of intravetreal injections may include:
- Serious eye infection that may include eye pain, light sensitivity, vision changes.
- Increased eye pressure
- Retinal detachment
- Vitreous floaters