New treatment for age related macular degeneration at Duchy
There is a new treatment available for wet age-related macular
degeneration at Duchy Hospital. It is not appropriate for patients
with dry macular degeneration.
What is Wet Macular degeneration
About 10% of people with AMD develop the "wet" form of the
disease. This occurs when abnormal blood vessels develop underneath
the macula. These blood vessels leak fluid and blood, and
eventually promote scar tissue formation. Wet AMD can progress
rapidly and cause serious damage. If it's caught early, however,
laser surgery and injections may be able to prevent extensive
Information about choice of drugs
Recent scientific advances have shown that abnormal retinal
blood vessels in this condition can be treated by drug injection
into the vitreous gel in the eye. Several injections are likely to
There are 3 treatments available:
1. Lucentis - ranibizumab. This drug is licensed in the USA and
due to be licensed in the UK shortly. It has been found to be
effective in all types of wet macular degeneration. Results from
drug trials showed significant improvement in vision and prevention
of severe visual loss.
2. Macugen - pegaptanib sodium. This drug has some effect on wet
macular degeneration, but does not seem to be as effective as
Lucentis. It reduces the likelihood of visual loss, but only 6% of
people treated showed a major improvement.
3. Avastin - bedacizumab. This is a drug which was developed for
colon cancer. It has a very similar structure to Lucentis, and was
used because promising results were obtained with Lucentis. There
have been some clinical trials with this drug and it has been used
for several thousand patients over the last few years and seems to
have similar results to Lucentis. Avastin is not licensed for use
in the eye, but can be used "off label".
Risks for intravitreal injections.
These drugs are injected into the vitreous gel, through the
sclera, "the white of the eye", under local anaesthetic. This is a
standard way of delivering drugs to the retina and should be
relatively painless, but is not entirely without risk. The most
side-effect of these injections could be an infection in the
The risk of this is thought to be 1 in 1000, the infection can
be treated, but it could lead to loss of sight.
Other risks include floaters or black spots for a few days, or a
transient increase in pressure in the eye. Retinal tears or
detachment or cataract induced by the treatment are rare, but could
require surgery. There is also a small risk of inflammation in the
eye following the injection, which can be treated with drops.
Low levels of the drugs can reach the bloodstream after
injection into the eye. Trials of Macugen and Lucentis have shown
no adverse effect to the body after two years of follow up, but no
such trial has been undertaken for Avastin.
There is a small chance of an allergic reaction to the drug,
which could vary from a mild to a severe reaction, with breathing
difficulties which can be treated, but could very rarely result in
As with any new drug, there may be unknown and potentially
serious sight and life-threatening side effects.
For more information contact our Enquiry Handling team on