Anti VEGF Therapy

Wet Macular Degeneration Treatment

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:

1) New blood vessels that are very weak and fragile start to grow in the choroid layer under the retina.

2) Fluid and blood leak from these weak blood vessels

3) Rod and cone cells are damaged by this fluid and blood

4) A macular or disciform scar is formed

5) There is loss of straight ahead or central vision

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. 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:

1) Macugen was the first anti-vegf therapy used to treat neovascular AMD. (generic name is pegaptanib)FDA approved in 2004

2) Lucentis (generic name is ranibizumab)FDA approved in 2006

3) 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). Several clinical trials are comparing the effects of Avastin to Lucentis. The cost of Avastin is much less than Lucentis.

Anti-VEGF Therapy

2) A numbing agent is given to reduce pain

3) 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

2) Headache

3) Eye pain or discomfort

4) Headache

5) Sensitivity to light

6) Eye infection

7) Increased eye pressure

8) Rarely, retinal Detachment, bleeding and cataract formation

Wet Macular Degeneration Research

Here are some current wet macular degeneration clinical trials that are recruiting:

1) Comparison of Age-Related Macular Degeneration Treatments Trials: Lucentis-Avastin Trial

"The purpose of the study is to evaluate the relative efficacy and safety of treatment of neovascular AMD with Lucentis on a fixed schedule, Avastin on a fixed schedule, Lucentis on a variable schedule, and Avastin on a variable schedule."

2) Bevacizumab (Avastin) and Photodynamic Therapy in Neovascular Age Related Macular Degeneration

"The purpose of this study is to determine if of combination therapy of intravitreal bevacizumab 4 days after the application of photodynamic therapy could improve the visual outcomes of patients with neovascular age related macular degeneration."

3)Intravitreal Bevacizumab for Age-Related Macular Degeneration

The purpose of this study is to determine whether intravitreal injection of bevacizumab is effective in the treatment of neovascular age related macular degeneration.

To find out how to search for clinical trials for wet macular degeneration click here: Clinical Trials

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Contact Leslie Degner, RN, BSN

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