Home Blog Breakthrough in AMD Treatment: A Ray of Hope for Patients

Breakthrough in AMD Treatment: A Ray of Hope for Patients

Posted on 17 January 2024
by Ms Stacey Strong in

Blog

Age-related macular degeneration (AMD) is a progressive eye condition that affects the macula, a crucial part of the retina responsible for central vision. It is the central part of the retina responsible for clear, sharp vision needed for activities like reading and driving. It’s a leading cause of severe vision loss among older adults. Fortunately, recent advancements in medical research have paved the way for a new treatment approach, offering hope and improved outcomes for those affected by AMD.

AMD is primarily attributed to aging, genetics, and environmental factors. The aging process often leads to the accumulation of waste products and cellular damage in the macula. Genetics play a significant role, with certain genetic variations increasing the risk of developing AMD. Lifestyle factors like smoking, poor diet, and excessive sun exposure can exacerbate the progression of AMD.

Early stages of AMD might not exhibit noticeable symptoms. However, as the disease progresses, individuals may experience:

Blurred or distorted central vision.
Difficulty seeing clearly in low light.
Decreased colour brightness or intensity.
Straight lines appearing wavy or distorted.

There are two main types of AMD: dry AMD and wet AMD.

1. Wet AMD

Wet AMD (Neovascular AMD): Wet AMD is characterised by the growth of abnormal blood vessels (choroidal neovascularisation) beneath the retina, leading to vision loss. Treatment often involves anti-VEGF (vascular endothelial growth factor) eye injections to block the growth of these blood vessels and reduce the progression of vision loss. Multiple injections are used until the condition is stable or improved.

Anti-VEGF Eye Injections: Anti-VEGF treatments involve injecting medications directly into the eye to block the effects of VEGF and reduce the growth of abnormal blood vessels in the retina.
Further Anti-VEGF Eye Injections: Additional anti-VEGF eye injections are needed over time to maintain vision and prevent the growth of new blood vessels.
Port Delivery System: A port delivery system is a device that can be implanted in the eye to provide continuous, slow release of anti-VEGF medication into the eye, reducing the need for frequent eye injections.
Gene Therapy: Gene therapy is being explored as a potential treatment for wet AMD, aiming to deliver genes that can inhibit the growth of abnormal blood vessels.
Complement Cascade: Research is also focusing on understanding and targeting the complement cascade, a part of the immune system that is involved in the development of AMD.
Stem Cells: Stem cell research is being conducted to explore the potential of using stem cells to replace damaged retinal cells in AMD patients.
Surgical Procedures: Some surgical procedures may be used in severe cases of wet AMD to remove abnormal blood vessels or blood that has leaked into the retina.

old woman with grey hair checking her eyes

2. Dry AMD

Dry AMD (Non-Neovascular AMD): Dry AMD is characterised by the gradual breakdown of cells in the macula. Currently, there is no cure for dry AMD, but certain treatments and lifestyle changes may help slow its progression and manage its effects. Currently eye injections with anti-VEGF do not help dry AMD. In the next 5 years we expect to see many quantum advances in the treatment of dry AMD.

Lifestyle Modifications: These include a healthy diet, quitting smoking, wearing sunglasses, and managing other health conditions like high blood pressure and cholesterol.
Drug Application and Research: Various drugs and light treatments are being researched and tested to treat dry AMD, including medications targeting specific pathways involved in the disease, and low level light treatments.

Geographic Atrophy (GA):

GA is an advanced form of dry AMD characterized by large areas of cell loss in the macula.

Treatment Options: There are ongoing clinical trials and research exploring potential treatments for GA, including drugs, light treatments and therapies that aim to slow down or stop its progression.

Healthcare and Regulatory Bodies

Healthcare Products Regulatory Agency (MHRA): A regulatory body in the UK responsible for ensuring the safety, quality, and efficacy of healthcare products.
National Institute for Health and Care Excellence (NICE): An organisation that provides guidelines and advice to improve health and social care in the UK.
The Macula Society is a charity which supports research in AMD and provides a patient focus and advice.

Clinical Trials

Many of the treatments mentioned are or have been subjects of clinical trials, which are essential in evaluating the safety and efficacy of new treatments for AMD.

Patient Experience

Regular hospital visits and the treatment burden of injections and procedures can impact the patient’s quality of life, emphasising the need for more convenient and effective treatments to maintain vision and improve patients’ lives.

Low vision assessment

A dedicated Optometrist will carry out Low Vision Assessment and advise on magnifiers and other devices to help maximise vision in patients with AMD.

In summary, ongoing research and advancements in treatment options, including anti-VEGF therapies, gene therapy, stem cell research, light treatments and drug development, offer hope for improving vision and managing AMD, a condition that can have a significant impact on an individual’s life and well-being.

Recent Breakthroughs in AMD Treatment

Recent breakthroughs in AMD treatment have revolutionised the management of this condition, providing more effective options to slow down disease progression and preserve vision.

Anti-VEGF Therapy: Anti-VEGF (vascular endothelial growth factor) drugs are administered via injections directly into the eye. These drugs help reduce abnormal blood vessel growth and leakage in the retina, which is a hallmark of AMD. By controlling this abnormal growth, anti-VEGF therapy can slow down vision loss and, in some cases, improve vision.
Photodynamic Therapy (PDT): PDT involves injecting a light-sensitive drug into the bloodstream, which is then activated by a laser aimed at the retina. The activated drug selectively damages abnormal blood vessels, helping to slow down the progression of AMD.
Retinal Laser Therapy: Laser therapy involves using a laser to destroy or seal off abnormal blood vessels in the retina. This can help reduce leakage and minimise damage to the macula.
Retinal Implants and Devices: Research is ongoing in the development of retinal implants and devices that can restore vision in individuals with advanced AMD. These devices can bypass damaged parts of the retina, transmitting visual information to the brain and potentially improving vision.
Light treatments to the macula show promise in arresting dry AMD.

The discovery of new treatment modalities for AMD represents a significant advancement in the field of ophthalmology. These treatments offer hope to individuals suffering from AMD, providing improved options for managing the disease and preserving vision. Continued research and development in this field hold promise for even more effective treatments and ultimately enhancing the quality of life for those affected by AMD. If you suspect you may have AMD or are at risk, consult an eye care professional for a comprehensive evaluation and appropriate treatment options.

older woman patient in an eye doctor's chair

Facts about new treatments and advancements in managing AMD

Extended Dosing Intervals: With improved formulations and efficacy of anti-VEGF drugs, treatment intervals have extended, reducing the burden of frequent injections for patients. Extended dosing intervals, such as treat-and-extend regimens, enhance patient compliance and comfort.
Sustained-Release Drug Delivery Systems: Researchers are exploring sustained-release drug delivery systems, including implantable devices and sustained-release injections, to deliver medication over a more extended period. These systems can reduce the need for frequent injections and improve treatment outcomes.
Gene Therapies and Genome Editing: Experimental gene therapies and genome editing techniques are being studied for AMD treatment. These approaches aim to target and modify specific genes associated with AMD, potentially providing a more permanent and precise treatment.
Stem Cell Therapy: Stem cell research holds promise for regenerating damaged retinal cells in AMD. Scientists are investigating the use of stem cells to replace or repair damaged retinal tissue and restore vision in individuals with AMD.
Complementary Therapies: Nutritional supplements, such as vitamins and minerals (e.g., lutein, zeaxanthin, vitamin C, vitamin E, zinc, and copper), are recommended for certain AMD patients to help slow disease progression and reduce the risk of severe vision loss.
Artificial Vision Devices: Advanced technologies like electronic retinal implants and visual prosthetic devices are being developed to restore vision in individuals with advanced AMD. These devices use artificial means to stimulate the remaining healthy cells in the retina.
Telemedicine and Remote Monitoring: Telemedicine has become an essential tool for monitoring and managing AMD, especially during the COVID-19 pandemic. Remote monitoring allows healthcare providers to track patients’ progress and adjust treatment plans accordingly.
Clinical Trials and Research: Ongoing clinical trials and research studies are continuously exploring new treatment options and potential breakthroughs in AMD management. Patients are encouraged to participate in clinical trials to contribute to the advancement of AMD treatments.

It’s important to consult with an ophthalmologist to determine the most appropriate treatment plan based on the specific characteristics of AMD and individual patient needs. If you or your relative may suffer from AMD, please contact Clinica London on +44 207 935 7990 to book an appointment.

You will need to see one of the four Consultant Ophthalmologists who specialise in Retina and macular disorders.

The AMD Consultation

This will involve having your pupils dilated for fundal retinal and macula examination. Diagnostic tests are done in our out-patient EyeDOC (Eye Diagnostic and Orthoptic Centre) and will include an OCT (Ocular coherence tomography) of your retina in order to analyse the health of the layers of the macula.

If it is necessary to see minute blood vessels, dye tests called a Fundus Fluorescein Angiography and Indocyanine Green Angiography, will also be organised. Once the diagnosis and degree of AMD has been evaluated, the Consultant Ophthalmologist will discuss and carry out the treatment, whether it be an Anti VEGF eye injection, light treatment or delicate laser treatment.

At Clinica London we have four Ophthalmic Specialists who assess and treat AMD; they are:

We also have a dedicated Low Vision Optometrist, Ms Hannah Dunbar, who sees patients for optical devices to assist their low vision, on referral from one of the above consultants.