In a new study of nearly 650 people with age-related macular degeneration (AMD), half still had 20/40 vision or better, typically good enough to drive or to read standard print,after five years of treatment with anti-VEGF drugs that are injected into the eye. The authors of the study, funded by the National Eye Institute (NEI), say those outcomes would have been unimaginable about 10 years ago, before the drugs' availability.
Results of the study were presented in May 2016 at the annual meeting of the Association for Research in Vision and Ophthalmology in Seattle.
"This is the most comprehensive study of anti-VEGF therapy for AMD to date," said NEI Director Paul A. Sieving, MD, PhD. "It points to the importance of long-term follow-up in studies evaluating disease treatments."
There are two types of late AMD—geographic atrophy, also known as dry AMD, and the more common neovascular AMD, also known as wet AMD. In wet AMD, fragile blood vessels grow under the retina and leak fluid. This usually starts in one eye, and is stimulated by a protein called VEGF. Just 10 years ago, people diagnosed with neovascular AMD were almost certain to develop severe vision loss in their affected eye and likely to lose vision in their other eye, too.
The new study looked at people with AMD who had regular treatment with the drugs Avastin and Lucentis, which are designed to block VEGF. After five years, 50 percent of them had 20/40 vision or better, 20 percent had 20/200 vision or worse, and the rest were in-between.
Ten years ago, the best available treatment for AMD was photodynamic therapy, in which an intravenous drug (injected into a vein) and laser seal off leaking blood vessels. Past studies have found that just one year after diagnosis, less than 15 percent of patients given this therapy alone retain 20/40 vision, and up to 40 percent decline to 20/200 vision. Without any treatment, less than 10 percent of patients retain 20/40 vision at one year, and up to 75 percent of untreated patients decline to 20/200 vision.