Wet Macular Degeneration Options

First-Line: Anti-VEGF Injections

Anti-VEGF (vascular endothelial growth factor) medications remain the mainstay of wet AMD therapy. These drugs block VEGF, a protein that stimulates abnormal blood vessel growth in the retina. Anti-VEGF medicines are injected directly into the eye, often with a frequency of every four to eight weeks at the start, which may be spread out as response allows.

Common Anti-VEGF Drugs:

Bevacizumab (Avastin)

Ranibizumab (Lucentis)

Aflibercept (Eylea)

Brolucizumab (Beovu)

Faricimab-svoa (Vabysmo) – Notable for its dual action that blocks two biological pathways and can extend injection intervals up to 16 weeks.

𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐀𝐝𝐯𝐚𝐧𝐜𝐞𝐬:

Longer-acting formulations (such as higher-dose Eylea, Beovu, and Vabysmo) mean some patients require fewer injections.

Susvimo (Port Delivery System): An implantable reservoir that gradually releases ranibizumab, requiring refills only every six months in some cases.

𝐋𝐚𝐬𝐞𝐫 & 𝐋𝐢𝐠𝐡𝐭-𝐁𝐚𝐬𝐞𝐝 𝐓𝐡𝐞𝐫𝐚𝐩𝐢𝐞𝐬

𝐏𝐡𝐨𝐭𝐨𝐝𝐲𝐧𝐚𝐦𝐢𝐜 𝐓𝐡𝐞𝐫𝐚𝐩𝐲 (𝐏𝐃𝐓): Involves injecting verteporfin (Visudyne) and activating it using a laser to seal off leaking vessels. PDT is less commonly used now but may help in selective cases where anti-VEGF is insufficient or as combination therapy.

𝐋𝐚𝐬𝐞𝐫 𝐏𝐡𝐨𝐭𝐨𝐜𝐨𝐚𝐠𝐮𝐥𝐚𝐭𝐢𝐨𝐧: Uses a focused laser to cauterize abnormal vessels. It is reserved for select cases due to the risk of damaging surrounding retinal tissue, which may result in permanent vision loss.

𝐂𝐮𝐭𝐭𝐢𝐧𝐠-𝐄𝐝𝐠𝐞 𝐓𝐡𝐞𝐫𝐚𝐩𝐢𝐞𝐬

Gene Therapy: In clinical trials in 2025, gene therapy delivers DNA to retinal cells so the eye naturally produces anti-VEGF medication, potentially reducing or eliminating the need for frequent injections. This is a promising future option that could offer longer-lasting effects from a single administration.

𝐒𝐮𝐬𝐭𝐚𝐢𝐧𝐞𝐝-𝐑𝐞𝐥𝐞𝐚𝐬𝐞 𝐃𝐫𝐮𝐠 𝐈𝐦𝐩𝐥𝐚𝐧𝐭𝐬: Tiny devices implanted in the eye to provide prolonged medication delivery are making injection schedules less frequent.

𝐒𝐭𝐞𝐦 𝐂𝐞𝐥𝐥 𝐓𝐡𝐞𝐫𝐚𝐩𝐢𝐞𝐬: Early research suggests potential for restoring vision, but these options are still experimental.

Topical Treatments: Eye drop forms of anti-VEGF and neuroprotective agents are in development, not yet widely available but could offer non-invasive treatment alternatives in the future.

𝐑𝐞𝐡𝐚𝐛𝐢𝐥𝐢𝐭𝐚𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐒𝐮𝐩𝐩𝐨𝐫𝐭

Low Vision Rehabilitation: Since wet AMD doesn't cause total blindness, specialized rehabilitation can teach adaptive skills, use of magnifiers, and electronic devices to maximize remaining vision and independence.

𝐕𝐢𝐭𝐚𝐦𝐢𝐧𝐬 𝐚𝐧𝐝 𝐍𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧: AREDS 2 supplements (lutein, zeaxanthin, vitamins C and E, zinc, copper) may help some patients prevent progression from intermediate AMD to advanced stages.

When to Start Treatment

Rapid treatment is crucial; therapy should be started as soon as possible after diagnosis to minimize permanent damage to the macula and preserve as much central vision as possible.

𝐒𝐨𝐮𝐫𝐜𝐞:

Mayo Clinic – Wet Macular Degeneration Treatment:

https://www.mayoclinic.org/diseases-conditions/wet-macular-degeneration/diagnosis-treatment/drc-20351113

National Eye Institute – Wet AMD Treatments:

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration/treatments-wet-amd-advanced-neovascular-amd

AAO – New Treatments for Macular Degeneration:

https://www.aao.org/eye-health/tips-prevention/promising-new-treatments-amd

Cleveland Clinic – Macular Degeneration Treatment:

https://my.clevelandclinic.org/health/diseases/15246-macular-degeneration

WebMD – Wet AMD Treatment:

https://www.webmd.com/eye-health/macular-degeneration/wet-amd-treatments

Importance of Early Detection in Wet AMD Treatment

Detecting wet macular degeneration early plays a critical role in managing vision loss. Regular eye examinations are essential, particularly for individuals at higher risk due to age or family history. The earlier the diagnosis is made, the sooner treatment can commence, which is crucial in preventing irreversible damage to the macula. Symptoms such as blurred vision, dark spots, or distortions should prompt immediate consultation with an eye care professional. By prioritizing early detection, patients can benefit from timely interventions, leading to improved outcomes and a better quality of life.

Lifestyle Modifications to Support Eye Health

In addition to medical treatments, making lifestyle changes can significantly impact eye health for individuals with wet AMD. A balanced diet rich in antioxidants, such as leafy greens, fish, and nuts, can provide essential nutrients that support retinal health. Regular physical activity not only helps maintain overall well-being but also reduces the risk of developing related conditions, such as cardiovascular disease, which can exacerbate eye issues. Moreover, protecting the eyes from harmful UV rays by wearing sunglasses and avoiding smoking can further enhance eye health and potentially slow the progression of AMD.