Treatments for Wet Macular Degeneration

Injections: One option to slow the progression of wet AMD is to inject specific drugs into the eye. With wet AMD, abnormally high levels of vascular endothelial growth factor (VEGF) are secreted in your eyes. VEGF is a protein that promotes the growth of new abnormal blood vessels. Anti-VEGF injection therapy blocks this growth.

These were the first-line medications and are still used today.

Medications used to treat wet macular degeneration include:

• Bevacizumab (Avastin)

• Ranibizumab (Lucentis)

• Aflibercept (Eylea)

• Brolucizumab-dbll (Beovu)

There is a newer class of medications for wet age-related macular degeneration (AMD) that are anti-VEGF (vascular endothelial growth factor) drugs injected directly into the eye to block abnormal blood vessel growth and fluid leakage.

Breakthroughs focus on longer-lasting options, dual-action formulas, and implants to drastically reduce the traditional monthly or bimonthly treatment burden.

Dual-Action & High-Dose Injections

Faricimab-svoa (Vabysmo): A major FDA-approved advancement that targets two distinct disease pathways (VEGF and angiopoietin-2) to stabilize blood vessels and reduce inflammation. It allows dosing intervals of 3 to 4 months for many patients.  [1, 2]

Aflibercept (Eylea HD): A higher-dose (8 mg) version of the standard Eylea that effectively dries retinal fluid and can be administered every 12 to 16 months after initial monthly doses. [1, 2]

Brolucizumab (Beovu): An advanced anti-VEGF agent that requires fewer injections, allowing some patients to go 8 to 12 weeks between treatments. [1, 2]

Sustained-Release Devices

Susvimo (Port Delivery System): An FDA-approved refillable intraocular implant. It is surgically placed inside the eye and continuously releases a customized formulation of ranibizumab. Patients typically need as few as two refills a year instead of monthly injections.  [1, 2]

Emerging Treatments (Clinical Trials)

Gene Therapy: Highly anticipated gene therapies (e.g., ABBV-RGX-314, ixo-vec, and 4D-150) are in advanced clinical trials. The goal is to provide a “one-and-done” single administration that programs the eye to manufacture its own anti-VEGF proteins. [1, 2 ]

Tyrosine Kinase Inhibitors (TKIs): Experimental sustained-release implants and injections (like Duravyu and EYP-1901) are being investigated to potentially stretch treatment durability from 6 to 14 months. [1, 2]

If you are a candidate for any of these treatments, you may need monthly or longer interval injections.

Although an injection into the eye sounds quite frightening, it is usually very well tolerated by patients with very few, if any, complications.

Most patients describe the experience as being less painful and unpleasant than they anticipated.

Possible risks of eye injections include conjunctival hemorrhage, eye pain, floaters, increased eye pressure, infection, and eye inflammation. Some of these medications may increase the risk of a stroke.

Because treatment plans are highly personalized based on the disease stage and individual response, it is best to consult with your ophthalmologist or retinal specialist.

References:

American Academy of Ophthalmology 1 & 2

Genentech                                               1

Regeneron                                               1 & 2