Wet macular degeneration (AMD) treatment often involves intro-ocular or eye injections using anti-VEGF medications. VEGF stands for vascular endothelial growth factor. VEGF is a protein that the body makes that promotes blood vessel growth. Another term for new blood vessel growth is angiogenesis.  Wet AMD is aptly named because the macula – a very small spot in the center of the retina – gets “wet” as a result of these new, but abnormal vessels that leak blood and fluid. The goal of wet macular degeneration treatment is to “dry up” this area in the retina that is responsible for our detailed  and straight ahead vision. Another goal of wet AMD treatment is to prevent the new growth of these abnormal and fragile vessels.

This fairly new class of drugs, called anti-VEGF medications, is given as injections directly into the eye to help shrink existing abnormal blood vessels and to prevent the growth of new leaky blood vessels. There are four different medications that are used to treat wet macular degeneration. They are Macugen, Lucentis, Avastin and the most recent one is Eylea.

Macugen

The first anti-angiogenic or anti-VEGF medication used to treat wet AMD was Macugen (pegaptanid). It was FDA approved in 2004. This eye injection was normally given every 6 weeks for up to two years.  New anti-VEGF drugs have come on the market since 2004 that have shown to be more effective, so Macugen is not used as frequently for wet AMD. However, there are several clinical trials looking at the effectiveness of Macugen in the treatment of macular edema.

Lucentis

In 2006 Lucentis (ranibizumab) was FDA approved after several clinical trials. It is manufactured by Genentech, Inc. in California.  These monthly eye injections were shown to help maintain vision at 12 months in almost 95% of the participants in the three multicentered, randomized studies.  Sixty percent of patients who received the control treatment maintained their vision in the same time frame.

Avastin

Avastin is also an anti-VEGF therapy that was originally approved for use – not in patients with wet macular degeneration – but for patients who had colon cancer. Cancer tumors also develop new blood vessels that feed the tumor and cause it to grow. Anti-VEGF treatment prevents the growth of these blood vessels causing the cancer to “starve.”  What made this medication so appealing compared to Lucentis is the dramatic difference in cost.  Avastin is molecularely very similar to Lucentis, so physicians were administering Avastin to patients with wet macular degeneration in what is called off-label use. In other words this medication is FDA approved – but FDA approved for the treatment of cancer – not macular degeneration.  As a result there are clinical trials comparing Lucentis to Avastin in the treatment of wet macular degeneration.

Eylea

Eylea is the most recent anti-VEGF therapy on the market at the time of this writing. Recently FDA approved in November of 2011, the benefit to this eye medication is that it can be given less frequently. Less visits to the eye doctor and less eye injections are very appealing to most patients.

Knowing about the different medications used for wet macular degeneration treatment helps you to be an informed patient. Learn more about these injections, how they are given, possible side effects and current studies:

Anti-VEGF Therapy for Wet Macular Degeneration Treatment

Leslie Degner, RN, BSN

www.WebRN-MacularDegeneration.com