Macular Degeneration and İnjection Treatment

Injection Treatment for Advanced Wet Age-Related Macular Degeneration

Currently, the most effective clinical approach for treating Advanced Wet Age-Related Macular Degeneration (AMD) is anti-VEGF therapy. This treatment involves periodic intravitreal injections of specialized chemicals designed to inhibit abnormal vessel growth. By targeting the underlying causes of vision loss, these injections help manage the progression of the disease and preserve central vision.

Common Anti-VEGF Medications

Several variants of anti-VEGF injections are utilized in modern ophthalmology, each working through different mechanisms to prevent blood vessel proliferation. The most prominent treatments include:

• VEGF Trap-Eye (Aflibercept): Recently approved by the FDA and produced by Regeneron Pharmaceuticals.
• Ranibizumab (Lucentis): Developed by Genentech for targeted eye treatment.
• Bevacizumab (Avastin): Used as an off-label treatment option from Genentech.

How VEGF Trap-Eye Works and Dosage Requirements

Vascular Endothelial Growth Factor (VEGF) is a naturally occurring protein that triggers the formation of new blood vessels. In patients with wet macular degeneration, this protein causes the growth of abnormal blood vessels in the eye, leading to scarring and significant loss of central vision. VEGF Trap-Eye works by inhibiting the binding and activation of VEGF receptors.

According to FDA-approved guidelines, the recommended administration for this treatment is as follows:

The Injection Procedure: What to Expect

Treatments are administered as an intraocular shot. While the idea of regular eye injections may require an adjustment period, the procedure itself is short and pain-free because the eye is thoroughly anesthetized. Regularity is key to the success of the therapy, ensuring the chemical levels remain effective within the ocular environment.

Safety, Risks, and Contraindications

While highly effective, injection treatments are not suitable for everyone. They are strictly not recommended for patients with:

• Ocular or periocular infections.
• Active intraocular inflammation.
• Known hypersensitivity to aflibercept or any of its excipients.

Intravitreal injections have been associated with serious conditions such as endophthalmitis (inflammation of internal eye tissues) and retinal detachments. Patients must report any sudden symptoms immediately. Furthermore, acute increases in intraocular pressure have been observed within 60 minutes of injection, requiring careful monitoring of the optic nerve head.

Potential Side Effects and Adverse Reactions

Serious adverse reactions occur in less than 0.1% of cases, including traumatic cataracts and endophthalmitis. However, more common reactions reported by patients include:

• Conjunctival hemorrhage
• Eye pain and increased intraocular pressure
• Vitreous detachment and vitreous floaters
• Development of cataracts

There is also a potential systemic risk of nonfatal stroke, nonfatal myocardial infarction, or vascular death that patients should be aware of.

Comprehensive Management of AMD

Beyond anti-VEGF injections, patients should explore other medical treatments and lifestyle changes. Monitoring your condition through sight tracking and maintaining close communication with your doctor are essential steps to ensure the best possible outcome for your vision health.

Op. Dr. Ahmet UMAY