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About 200 million people worldwide suffer from age-related macular degeneration (AMD). The wet form of AMD is the most common cause of blindness in people over 55 in developed countries. According to prof. dr. hab. n. med. Jakub Kałużny, anti-VEGF drugs are the rescue, which can slow down the course of the disease and improve vision. The newest one is brolucizumab (Beovu®), which is an innovative anti-VEGF molecule.
What is AMD?
– AMD (Age-related Macular Degeneration) is age-related macular degeneration and one of the common causes of blindness. Genetic factors as well as the unhealthy lifestyle of the patient and comorbidities such as hypertension, diabetes, cardiovascular disease and overweight contribute to the development of AMD. Advanced disease comes in two forms. Atrophic AMD occurs in approximately 50% of cases. Here, visual acuity deteriorates gradually over the course of months and years. The wet form of AMD also accounts for approximately 50% of cases. It has a very severe course, and a significant loss of vision can occur even within a few weeks. In the final stage, permanent damage to the retina and loss of vision may occur, explains Prof. dr hab. med. Jakub Kałużny.
- Also read: Eye pain. Diseases that are manifested by pain in the eyeball
How do you recognize wet macular degeneration (AMD)?
– AMD causes a deterioration in central vision. The patient notices, inter alia, Difficulty reading, letters and lines in the center of the visual field are skewed, the picture is blurry and colors are less pronounced. As the disease progresses, there is a black or gray spot in the center of the field of view that obscures your vision. The disease progresses very quickly, so it is important to see a doctor and start treatment immediately, which will slow down its course.
- Find out more: WHO issues a vision report. Over a billion people have untreated visual disturbances
How to reduce the risk of developing AMD and other retinal diseases?
– It is obligatory to report for tests after the age of 50, especially if the parents suffered from this disease. If AMD is suspected, the doctor will order SOCT test (spectral optical coherence tomography) – explains prof. dr hab. med. Jakub Kałużny.
– It is also important to observe possible comorbidities, hygienic lifestyle and diet. The eyes are not favored by smoking, long sitting in front of a computer or smartphone screen, lack of exercise in the fresh air and excessive exposure to UV rays, without filter protection. A diet rich in fish fats, trace elements, lutein, zeaxanthin, zinc, selenium, etc. is important.
Are there any chances of stopping AMD?
– Unfortunately, we cannot heal yet age-related macular degeneration. It is important to detect the disease in its early stages so that anti-VEGF treatment is started before significant damage to the retina occurs. Doctors and scientists are still working on more modern drugs to help patients slow down AMD.
- Learn more about diseases of the blood vessels of the retina
What are the modern therapies for treating wet AMD?
– The newest and most effective treatment for the wet form of AMD is intravitreal injections. They are used with the use of preparations that inhibit vascular growth. These are anti-VEGF preparations. Their task is to inhibit the activation of VEGF receptors, a protein whose excess causes the growth of blood vessels – adds prof. dr hab. n. med. Jakub Kałużny.
What are intravitreal injections?
– Intravitreal injections slow down the course of AMD by stopping the growth of pathological vessels that form under the retina. It is a simple outpatient procedure that involves administering the active substance directly into the vitreous body of the eye. It is performed under local anesthesia in an operating room. The best known preparations used in this therapy are: Eylea, Lucentis and Avastin (i.e. aflibercept, ranibizumab, bevacizumab). At the beginning of May, the innovative Beovu® therapy (brolucizumab) was introduced to the Polish market.
From the very first dose, the preparation stops the disease progression – reduces neovascular changes, slows down the growth of endothelial cells and reduces the permeability of blood vessels. Brolucizumab is a new generation molecule with a very strong effect, thanks to which it is possible in some patients to extend the interval between drug administrations up to 3 months. The great advantage of all intravitreal injections is that they generally do not cause systemic side effects – such as could occur with oral or intravenous drugs.
How is wet AMD treated?
– Treatment based on intravitreal injections lasts about 2 years. During this time, the usual 3 loading injections are given – initially every 4 weeks (for drugs such as Eylea, Lucentis or Avantis). In the second year of treatment, it is possible to reduce the frequency of injections to one per quarter.
– The preparation of the new generation of Beovu® does not require so many injections in a long time. The innovative anti-VEGF molecule allowed for the introduction of a new dosing regimen. The first 3 doses of the drug, during the initial saturation stage, are administered at monthly intervals. Then the preparation is administered only once every 3 months. This is enough to ensure the maintenance of the correct anatomical parameters of the retina, as well as greater safety and comfort for patients – adds Prof. dr hab. n. med. Jakub Kałużny.
– Patients on treatment require monthly follow-up visits during the first year of treatment, during which, based on the OCT examination, the doctor decides on the date of administration and monitors the progress of the disease. Maintaining the continuity of treatment and strictly following the instructions of an ophthalmologist is a prerequisite for successful therapy.
The editorial board recommends:
- AMD – an age-related condition
- A silent thief of sight. It develops insidiously and gives no symptoms for a long time
- Do you see worse and worse? Check what could be the reason
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