Treatments for Macular Degeneration

Beovu is also prescribed as an injection to be given in the vitreous of the eye after it has been numbed. It is the only anti-VEGF agent recommended up to three-month dosing intervals in eligible patients. The treatment with other anti-VEGF agents is typically given at every 4-6 weeks frequency.

After numbing the eye, the doctor injects Eylea into the clear, jelly-like substance (the vitreous) that fills the eye from the lens back to the retina and then monitors the patient’s progress. After an initial three-month period of injections every four weeks, Eylea can be administered every eight weeks. In comparison, treatments with the other angiogenesis inhibitors are normally given every four weeks (Lucentis and Avastin) or every six weeks (Macugen). The actual number of injections needed is determined by the physician, taking the individual patient’s disease status and response to treatment into consideration.

Lucentis is also injected into the vitreous portion of the eye after it has been numbed. Injections are given regularly over a period of time. The frequency and actual number of injections needed are determined by the physician and the individual patient’s disease status and response to treatment.

Findings from international studies announced in 2012 indicate that an injection every four weeks may be optimal. The most commonly reported side effects of Lucentis include hemorrhage of the conjunctiva, floaters, eye pain, increased eye pressure, and inflammation of the eye. Rare but serious adverse events include endophthalmitis, retinal detachment, retinal tear, increased eye pressure, and traumatic cataract.

Macugen is also injected into the vitreous portion of the eye that has been numbed. It is usually administered every six weeks. The actual number of injections needed is determined by the physician, taking the individual patient’s disease status and response to treatment into consideration. Macugen is still available for treatment of wet AMD, but is not used as often as other injectable angiogenesis inhibitors. Common side effects of Macugen include inflammation of the eye, blurred vision, other changes in vision, cataracts, bleeding in the eye, swelling of the eye, eye discharge, irritation or discomfort of the eye, and “spots” in vision. Injection can also make the eye susceptible to infection for a period of time.

Avastin is an FDA-approved cancer therapy drug manufactured by the same company that makes Lucentis. Avastin has been used by doctors as an off-label treatment for AMD. Both drugs are similarly administered. However, Avastin is much less expensive, and many doctors believe these drugs are equally effective against macular degeneration. The National Eye Institute of the National Institutes of Health conducted clinical trials (Comparison of Treatments Trials, or CATT) to study the relative efficacy and safety of Avastin and Lucentis.

SUSVIMO will be an alternative to individuals who have responded to at least two intravitreal eye injections of anti-vascular endothelial growth factor (anti-VEGF). It is a continuous delivery system, a grain of rice-sized device implanted in the eye, which will require refills of anti-VEGF far less frequently than many currently receive injections.

The SUSVIMO implant has been associated with a 3-fold higher rate of endophthalmitis than monthly intravitreal injections of ranibizumab. The implant and/or implant-related procedures have been associated with endophthalmitis, retinal detachment, implant dislocation, septum dislodgement, vitreous hemorrhage, conjunctival erosion, conjunctival retraction, and conjunctival blebs.

* As of Oct. 24, 2022, this product is currently under voluntary recall due to a manufacturing problem with the device.

VABYSMO targets both VEGF and another related protein called Angiopoietin-2 (Ang-2). It will be administered by intravitreal injection every 4 weeks for the first 4 doses. After this patient will be evaluated 8 and 12 weeks later to adjust the frequency of injection for each patient.

Intravitreal injections have been associated with endophthalmitis, retinal detachments, and an increase in eye pressure. The most common adverse reaction (≥5% of patients) reported in patients receiving VABYSMO was conjunctival hemorrhage.