What is new in the treatment of age-related macular degeneration?
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Age-related macular degeneration (AMD) is a retinal disease affecting the area of sharpest vision, the macula. This area is responsible for central vision, needed for activities such as reading, cooking or watching television. In this article, we explain what is new in the treatment of age-related macular degeneration.
Currently, the subtype exudative or wet AMD is treated with multiple intravitreal injections of the medicines currently available, known as anti-VEGF agents. These are aflibercept, ranibizumab and brolucizumab. Repeated treatment regimens are tailored individually to disease activity, with injections needing to be repeated anywhere from monthly to every three or four months. New developments in this AMD subtype involve two new medicines: faricimab, available since the beginning of the year, and high-dose aflibercept (8 mg), likely to become available in the coming weeks. As demonstrated in clinical trials, these two new molecules will allow longer treatment intervals between injections because they are more potent medicines.
Reducing the number of injections may help improve the quality of life of patients and their carers, as well as reducing the likelihood of associated complications and improving adherence to treatment.
The possibility of sustained-release implants also continues to be studied. These are small reservoirs that release the anti-VEGF medicine continuously and in a controlled manner, surgically implanted in the patient's sclera. They could allow annual refilling, with the drawback that this would have to be done in an operating theatre.
As for the treatment of non-exudative or dry AMD, gene therapy continues to be studied as a way of slowing the progression of the areas of macular atrophy that characterise the disease. This gene therapy could be administered intravitreally, by injection like those used to treat exudative AMD, or subretinally, which would require retinal surgery.
Gene therapy represents one of the most promising frontiers in the treatment of dry AMD, although it is still at the research stage. Current and future clinical trials will be crucial in determining its safety, effectiveness and feasibility as a standard treatment.
If you would like more information about advances in AMD treatment, please contact us. At Castellote Eye Clinic we will provide any further information you need. And if you would like to learn more about caring for your eyes, please follow us on Facebook and Instagram.