Wet Macular Degeneration Treatment & Surgery

Wet macular degeneration treatment options are Angiogenesis Inhibitors, Laser Photocoagulation and Photodynamic Therapy.

Common macular degeneration treatments

• Angiogenesis Inhibitors - Lucentis (ranibizumab injection) and Macugen (pegaptanib sodium injection).
• Laser Photocoagulation
• Photodynamic Therapy

Angiogenesis Inhibitors

The two most common angiogenesis inhibitors are Lucentis (Generic name: ranibizumab injection) and Macugen (Generic name: pegaptanib sodium injection). Angiogenesis inhibitors are effective for wet age related macular degeneration (abnormal growth of fragile blood vessels eventually damage macula).

How Angiogenesis Inhibitors works? It is an antibody fragment which can binds to and stops the activity of human vascular endothelial growth factor (VEGF), VEGF is a protein believed to responsible for the formation of these fragile blood vessels. Angiogenesis Inhibitors (Lucentis or Macugen) is injected into the vitreous portion of the eye (the clear jelly like substance between the lenses back to the retina). In macular degeneration, VEGF is continually produced, so routine administration of Lucentis over a period of time is required.

Possible side effects of Lucentis: hemorrhage of the conjunctiva, eye pain, increased eye pressure and inflammation of the eye. Other rare side effects include severe inflammation of the interior of the eye, retinal detachment, retinal tear, increased eye pressure and traumatic cataract.

Possible side effects of Macugen: eye inflammation, blurred or changes in vision, cataracts, eye bleed, eye swelling, eye discharge, irritation or discomfort in the eye and spots in the vision.

Laser Photocoagulation

Laser photocoagulation was the first treatment used for wet macular degeneration. It is an outpatient procedure performed by first numbed the eye and the abnormal leaky blood vessels are heated, sealed and destroyed using high energy lasers. This can help prevent or at-least slow further damage, but it results in a permanent blind spot. Successful laser photocoagulation is a one time treatment, but if new blood vessels grow, it needs to be repeated.
Possible side effects: mild pain during and shortly after the procedure, relieved by taking nonprescription pain medication. Reduced vision and retina scarring may also occur.

Photodynamic Therapy (PDT)

Photodynamic therapy using Visudyne (Generic name: verteporfin) is used for the treatment of wet macular degeneration characterized by the new growth of fragile and abnormal blood vessels or neovascularization. PDT is more effective treatment if the area of abnormal blood vessel growth and bleeding is in the fovea, at the center of the macula. Photodynamic therapy (PDT) is performed by injecting Visudyne, a light sensitive drug into a vein in the arm. The drug circulated in the bloodstream and is absorbed by the fragile blood vessels growing underneath the macula. A low intensity, non thermal or cold laser is shining at the retina for a little over a minute. This activates Visudyne to destroy the abnormal blood vessels and inhibit the neovascularization. PDT has an advantage of using cold laser, which does not damage the retina or other cell layers beneath the abnormal vessels. PDT helps to stabilize the vision, but it will not restore lost vision or improve vision. Treatments are needed for every 3 months and repeated many times to prevent re-growth of the abnormal vessels (approximately 6-7 treatments over 2-3 years). PDT treatment takes about 20 minutes and it is painless.

Because the drug is light activated, patients are advised to avoid exposing their eyes or skin to sunlight or bright light for up to five days after treatment.

Possible side effects of PDT: headache, injection site reaction, and blurred or reduced vision.