Macular degeneration is the leading cause of vision loss in Australia, affecting one in seven Australians over 50. Unfortunately, over 15% of people over 80 have impaired vision (or are blind) from this disease. This article looks at the latest breakthrough treatments for 2020 and beyond.
Gold standard: Anti-VEGF Drugs
The mainstay of treatment for the wet (or more serious) form of macular degeneration is Anti-VEGF drugs. They include Lucentis, Eylea and Avastin.
These drugs were originally created for people with cancer, to prevent the tumour from making new blood vessels with which to feed itself. When injected inside the eye, these medicines prevent new blood vessels from forming under the macula. This type of vessel can leak easily and lead to loss of vision in Age-related macular degeneration (AMD).
Don’t be too put off by the sound of injections in the eye. The area is fully numbed prior to the procedure. You can read more about anti-VEGF therapy and what to expect HERE.
There are also other injectable drugs, which clear up bleeding inside the eye, such as triamcinolone, a corticosteroid, which can also be very effective at preventing vision loss from new blood vessels. As it is a steroid, it can have the side effect of causing cataract.
Drawbacks of therapy
Even though anti-VEGF therapy is very effective at controlling or even stopping the decline in vision from macular degeneration, it has its drawbacks: you have to have an injection every month for several months at a time, (often on and off for the rest of your life) to maintain the results. Many people fear injections and cannot easily get to treatment centres.
There is also the risk of getting a serious infection inside the eye or other sight-threatening complication from these injections, although this is rare.
The future: Implants and slow-release systems
One of the biggest breakthroughs in AMD treatment is the development of implants and slow release (or sustained delivery) systems for getting anti-VEGF drugs into your eye without the discomfort and risk of injections.
One of the most viable options under investigation is a non-biodegradable implant. These tiny implants are placed inside the eye during a surgical procedure, where they can then store and deliver the anti-VEGF medication over time. These tiny storage depots can be topped up without further surgery.
You can read more about these new therapies in an article published in Nature.
What about lens surgery for macular degeneration?
When you have your natural lens replaced, such as in cataract microsurgery, a new lens called an IOL is placed inside your eye. Surgeons are now trialling a special kind of IOL that can magnify things like small print or images like photos. More of your healthy retina is used when you have this kind of IOL, making it easier to see details if you have vision loss from macular degeneration.
This procedure does nothing to slow or stop the disease. It simply makes the best of the remaining vision and allows the healthy parts of your eye to fill in some of the gaps in your central vision due to this disease.
Stem cell treatment for macular degeneration
Stem cells are a type of cell that has the potential to become any kind of cell in your body – whether that be a heart cell, a skin cell or a retinal cell. Scientists and medicos are investigating ways to use these cells in AMD. Stem calls may be able to replace or heal damaged retinal cells. Implants containing these stem cells can be surgically placed in the eye. The cells can then migrate to the site of damage.
This is an exciting area and early results of clinical trials are promising. These novel therapies provide an optimistic outlook for the future for AMD sufferers.