Harvard Men's Health Watch

Anti-VEGF drugs may maintain vision of those with wet AMD

In the Journals

A new study suggests a drug that counters a special protein may help people with the wet form of age-related macular degeneration (AMD) maintain their vision enough to legally drive or read small print, like the classified ads in newspapers, for at least five years.

With wet AMD, fragile blood vessels grow under the retina and leak fluid. This process, which often begins in one eye, is stimulated by a protein called VEGF, which also helps maintain the abnormal blood vessels. With anti-VEGF drugs, the leakage from the abnormal vessels slows or stops, and in some cases the vessels regress.

Research published online May 2, 2016, by the journal Ophthalmology examined about 650 people with wet AMD, half of whom had 20/40 vision or better. State drivers' licenses generally require 20/40 vision in at least one eye. Vision of 20/200 in both eyes is considered legal blindness for the purpose of federal disability benefits.

In the study, subjects were given one of the anti-VEGF drugs Avastin (bevacizumab) or Lucentis (ranibizumab). The assigned drug was injected into the jelly-like substance that fills the back of the eye on a monthly or as-needed basis (seven to nine times per year, on average).

After two years, about 70% had 20/40 vision or better, and only 5% had 20/200 or worse. On average, both drugs improved visual acuity by one to two lines on a vision chart. The subjects continued treatment as needed for the next three-and-a-half years, but the vast majority received only an average of four to five injections per year. Still, even with fewer treatments, at the follow-up, 50% still had 20/40 vision or better, and 20% had 20/200 vision or worse. The rest were in between.