Wet macular degeneration is also called:

  • Exudative Macular Degeneration or
  • Choroidal Neovascularization or Neovascular Macular Degeneration

Anti VEGF Process

Wet macular degeneration is the result of the formation of new, fragile and leaky blood vessels growing under the retina. The growth of these new blood vessels is called angiogenesis.

Vascular endothelial growth factor (VEGF) is secreted by cells that are oxygen deprived and stimulate the growth of these abnormal blood vessels. Healthy adults secrete very low levels of VEGF, while those who have health conditions such as cancer or age related macular degeneration secrete high levels of this protein.

This is what happens:

  • New blood vessels that are very weak and fragile start to grow in the choroid layer under the retina.
  • Fluid and blood leak from these weak blood vessels
  • Rod and cone cells are damaged by this fluid and blood
  • A macular or disciform scar is formed
  • There is loss of straight ahead or central vision

How do ANTI-VEGF drugs work?

When wet age-related macular degeneration (AMD) develops, weak abnormal blood vessels grow under the retina and lead to vision loss. The growth of these vessels is triggered by a protein called vascular endothelial growth factor (VEGF). The idea behind ANTI-VEGF drugs is to block the VEGF from stimulating the growth of these new blood vessels which damages the rod and cone cells by leaking blood and fluid. This slows the vision loss linked to wet AMD.Those that benefit from this type of treatment are patients who have active leaking blood vessels.

LUCENTIS, MACUGEN AND AVASTIN for Macular Degeneration

There are 3 ANTI-VEGF drugs used to treat wet macular degeneration:

  • MACUGEN was the first ANTI-VEGF therapy used to treat neovascular AMD. (generic name is pegaptanib)FDA approved in 2004
  • LUCENTIS (generic name is ranibizumab)FDA approved in 2006
  • AVASTIN (generic name is bevacizumab); not FDA approved for macular degeneration treatment but is used by ophthalmologists in what is called off-label use.(Avastin has been approved for treatment of colorectal cancer)

The cost of Avastin is much less than Lucentis.

Anti-VEGF Therapy

  • The eyelid and area is cleaned to prevent infection
  • A numbing agent is given to reduce pain
  • The ANTI-VEGF drug is administered by injection into the eye with a very fine needle

Usually a patient is given multiple injections over several months.

Side Effects of Anti-VEGF

  • Eye discharge
  • Headache
  • Eye pain or discomfort
  • Headache
  • Sensitivity to light
  • Eye infection
  • Increased eye pressure
  • Rarely, retinal Detachment, bleeding and cataract formation

How Well It Works

Anti-VEGF medicines can slow the vision loss that is linked to wet AMD.1 They may also improve vision for people with wet AMD.2 Because these medicines are relatively new, long-term effects are not yet known.

Side Effects

  • Changes in vision, or trouble seeing
  • Inflammation of different parts of the eye
  • Bleeding
  • Eye discharge
  • Eye pain or discomfort
  • Increased pressure inside the eye
  • Increased sensitivity to light
  • Headache
  • Painful urination
  • Ranibizumab (Lucentis) may raise the risk of stroke in elderly people, especially if they have already had a stroke

Many side effects may be caused by the actual injection procedure rather than the drug itself. For example, the injections have a risk of infection. Long-term effects of these medicines are not yet known.

What To Think About

You will likely get the injections on a regular basis, such as once a month.

Other types of anti-VEGF drugs are currently being studied, including some that may be injected into a vein (intravenously) rather than into the eye.

Anti-VEGF medicines may help stop vision loss in people who cannot benefit from other treatments such as laser photocoagulation or photodynamic therapy.