Current Macular Degeneration Treatment Options

Macular Degeneration Treatment has been pitifully poor in the past. We do not yet have a Macular Degeneration cure, but the treatments are getting much better for maintaining vision and quality of life. Plently of people have been working on an exciting treatment breakthrough in recent years, called Lucentis.

Lucentis (TM)

Lucentis is the most recent and most exciting Macular Degeneration treatment available for Wet AMD.

What does it do?

The scientists have managed to isolate a particle called an Antibody Fragment (FAb)that binds to the VEGF-A molecule, rendering it unable to attach to the receptors on the walls of blood vessels.

Put simply, it stops the "Help Me!" signals of degenerating retinal cells getting through to the blood vessels. Therefore, you don't get the growth of new leaky blood vessels that make more of a mess of your macula. It is an effort to keep your macula dry.

How is it given?

It is administered by injection into the eye. I know this sounds scary when you think of a needle sticking into your eye...but those who have this treatment say it isn't that bad. Don't you just love anaesthetic? And the benefits are worth a little needle in the eye.

What are the benefits?

The Marina Study(1) showed 90% of patients maintained their level of vision (defined as losing no more than 15 letters on the chart) over the two years of the study. In the sham group (placebo) only 53% maintained the same standard of vision.

The Anchor Study(2) showed that 90% of patients maintained their vision compared to 66% of people who received the alternate treatment of Visudyne.

The really exciting part is that 76% of patients gained vision over the two years. 41% gained 3 or more lines of vision and 14% gained a whopping 6 lines of vision back!This is the first Macular Degeneration treatment to ever give back vision.

The down side is that it is not always a suitable treatment depending on the location and form of new blood vessels (Occult vs Classic).
Also, clinical trials are able to select subjects on strict criteria. In the real world, the doctors do not exclude your case from their treatment because you do not fit into strict criteria. Rather, they will discuss with you the available treatments and advise you on which is more likely to give you a better result for your particular case.

So in the real world we see a much greater spectrum of result, depending on a given person's starting point. Please do not blame the doctor if Lucentis(TM) doesn't work miracles for you.....this disease and the medicine and how often to give the injections are all under research to find out more. The good thing is that we finally have a treatment that does help many!

How long do you need to take the injections? For now, assume that the answer is "forever after". In the last few years we have found that those who discontinue treatment get a lot worse.

1.)Ranibizumab for neovascular age-related macular degeneration Topic: Results of the MARINA Study (year 1 and year 2) Authors: Rosenfeld PJ, Brown DM, Heier JS, et al, for the MARINA Study Group Journal: New England Journal of Medicine. 2006;355:1419-1431

2.)Ranibizumab versus verteporfin for neovascular age-related macular degeneration Topic: Results from year 1 of the ANCHOR Study Authors: Brown DM, Kaiser PK, Michels M, et al, for the ANCHOR Study Group Journal: New England Journal of Medicine. 2006;355:1432-1444

Visudyne(TM) drug treatment

Visudyne (verteporfin for injection) therapy was the first drug therapy available for wet Macular Degeneration treatment. It has been available since approx 2000. It is only suitable for those patients with a mainly "classic" pattern of new blood vessel growth.

Visudyne is injected into a vein in your arm. When the drug reaches the small blood vessels in the eye, the doctor will activate it using a low-energy laser. This produces a chemical reaction that causes the abnormal blood vessels to close. This doesn't cause any damage to surrounding healthy retinal tissue, unlike Photocoagulation.

This wet macular degeneration treatment slows down the progression of vision loss. In the clinical studies, patients had significantly less vision loss after 2 years than those in the placebo group. It is not indicated for "occult" wet MD or for dry MD.

Laser Photocoagulation

Laser photocoagulation has all but been replaced with the newer treatments available. It was used to cauterize the leaking blood vessels with a laser. Unfortunately, this method also destroys the surrounding and overlying retinal tissue. This results in scars and blindspots where the retina has been destroyed.

It was not ideal but at the time it was better to attempt to preserve what vision we could by sacrificing some at these areas of leakage. Thankfully the researchers have come up with new Macular Degeneration treatment breakthroughs.