With our aging population and age related macular degeneration (ARMD) being one of the greatest causes of vision loss in older patients, you are likely to know someone who is affected by the disease. The causes of ARMD are not well known.
The last decade has seen an enormous advancement in the care of ARMD and we now see it as somewhat of a chronic disease that requires regular medication. Much like diabetes or hypertension, we cannot cure these diseases, but we can try to control them with medications.
Last month’s article discussed some of the future treatments that appear to be on the horizon and also the current state of treatment for non-exudative/dry ARMD. This article will review exudative/wet ARMD.
Exudative or “Wet” type macular degeneration is currently treated with medicine that is injected into the eye. These drugs have been very effective at trying to stabilize the bleeding from the disease and in many cases improve vision. The downside for many patients is that these medicines are, once again, a treatment not a cure. So the drugs have to be continuously injected into the eye. The current drugs on the market last approximately one month.
One advancement that we should see in the near future is a new drug called “brolucizumab” that has just finished clinical trials and should be approved by the FDA shortly for use. The advantage of this drug is that it appears to last longer than current drugs available – up to three months. This may reduce the total number of injections needed by a patient per year. We will have to see if the success in the trial setting carries over into the real world, but the early data looks promising and may give us a new option to help patients with the wet form of ARMD.
Other treatments for the wet type of ARMD that have been in the news and certain websites for patients with ARMD are surgeries to help “cure” the disease. Some surgeries revolve around implanting or treating with radioactive substances. These are not currently effective and are only in the testing phase, not used on patients routinely. There is a surgery that many patients ask about where the damaged retina is replaced by a section of healthy retina from another area of the patient. This surgery can be done, but the results have been very poor and is not a mainstay of treatment currently.
ARMD is a serious disease that has a tremendous impact on a patient and their families due to the disease effects and the treatment burden as it stands now. Fortunately, this is a very active area of research and many treatment options are being investigated. Unfortunately, there is no “Magic bullet” right now. The best treatment for exudative (wet) ARMD is sustained injections of drugs to treat the disease. Detailed discussions of what the future may hold should be had with your eye care provider. Currently, as in many cases of treatments, if it sounds too good to be true, it most likely is.