Many serious diseases of the retina used to be untreatable. Even for those treatable with laser therapy, outcomes were frequently poor. Therefore, many patients with conditions like macular degeneration, diabetic macular edema or retinal vein occlusion were expected to lose vision, often permanently.
However, “anti-VEGF” drugs are now available for treatment of these serious retinal diseases. These drugs are often effective not only in stabilizing vision, but are also able to improve vision if treatments are started before these diseases become too advanced.
There are currently 2 approved “anti-VEGF” drugs available: aflibercept (Eylea) and Ranibizumab (Lucentis). They work by reducing the growth of abnormal blood vessels in the retina and by reducing the swelling of the retina caused by leakage from these abnormal blood vessels. A third drug, Bevacizumab (Avastin), is available but is not approved for use in the treatment of eye diseases.
Both Eylea and Lucentis work very well for a range of serious retinal diseases like macular degeneration, diabetic macular edema and macula edema from retinal vein occlusion. In fact, they are so effective that they have now become the standard treatment for these conditions.
Both drugs are injected directly into the eyeball so that the drug can be delivered close to the retina for maximum benefit. Injections often need to be repeated to keep the disease under control. Whether to choose Eylea and Lucentis will depend on factors like individual responses to the medication and the condition being treated.
Injections of Eylea and Lucentis into the eye are done using a very small needle. There is minimal discomfort. However, injections have to be done correctly and carefully to ensure that important parts of the eye are not damaged in the process and to reduce the risk of serious eye infections.
A new drug, Brolucizumab (Beovu) is currently being registered with the health authorities and is expected to become available in the later part of 2020. It is expected to be more effective than the currently available drugs, with patients requiring fewer injections to keep their conditions stable.
This patient has wet age-related macular degeneration. Bleeding and swelling are seen in the central fixation point of the eye. Without treatment, severe and permanent loss of central vision is expected.
This cross-section scan of the macula (central fixation point of the retina) shows the swelling and distortion in the structure. If untreated, permanent damage to the structure of the macula will result in permanent visual loss.
The swelling of the macula has resolved after the injection of an anti-VEGF drug into the eye. Vision improved with normalization of the structure of the macula. Early treatment limits structural damage from wet age-related macular degeneration and reduces the risk of permanent visual loss. Injections may need to be repeated keep this disease under control.