Age-related macular degeneration (AMD) is the leading cause of visual disability chez over 50s. A common pathology – it affects around 8% of the French population – whose frequency increases with age: it affects 1% of people aged 50 to 55, around 10% of those aged 65–75 and 25 to 30% of over 75 years old, indicates Inserm.
Most often, only one eye is affected at the beginning of the disease, but the vision centrale is necessarily affected because this pathology is due to damage to the macula which is located in the center of the retina.
There exists two forms of AMDdry AMD (atrophic form), the most common since it concerns 90% of cases, and wet AMD (neovascular form known as exudative). These two forms sometimes occur at the same time or one evolves towards the other (dry AMD evolves towards a wet form in 10% of cases), they produce the same effects (central vision is impaired) but do not benefit the same treatments.
The injections must be renewed regularly and require strict monitoring after each procedure (under local anesthesia) because of risk of complications.
In reality, there is currently no (or few) medication or treatment capable of treating Dry AMD. In its less advanced form, vitamin and trace element supplementation can be beneficial, as can stopping smoking.
Therapeutic tools are more developed for wet AMD (generally more serious) but we nevertheless cannot cure it, we can only just slow down your progress.
“To date, only exudative AMD can benefit from active treatments, which must start, if possible, less than 10 days after diagnosis. we learn on the Macula Days website, dedicated to AMD.
Wet AMD: what treatments are available?
The therapeutic protocol for the treatment of wet AMD is based around injections directly into the eye (we speak of intravitreal injections) of drugs belonging to biotherapies (ranibizumab (LUCENTIS) or aflibercept (EYLEA), more rarely bevacizumab (AVASTIN)). Depending on the patient’s profile and the progress/form of the disease, the laser, in combination with medications or alone, may be suggested by the doctor. But these injections must be renewed regularly and require strict monitoring after each procedure (under local anesthesia) because of risk of complications (infection, inflammation, tear or detachment of the retina).
Dry AMD: new treatment options?
For the dry form, a new treatment (Syfovre) was approved in the United States in 2023, an injection formulated more specifically for advanced forms of the disease. Due to scientific support considered insufficient and especially high risks of complications, theEuropean Medicines Agency for its part issued a negative opinion on its marketing with us last July.
Without a valid treatment currently on the market, patients often have to make do developments to limit as much as possible the discomfort and loss of autonomy when the illness becomes truly debilitating. Tools to facilitate reading and/or driving (when this is still possible) can help (magnifying glasses, glasses, new technologies, etc.).
Eye drops, less invasive, less risky and more effective than injections?
Under these conditions, a simple collyre which would make it possible to treat dry AMD would be an extraordinary advance for all patients. This is indeed the type of solution proposed by Korean researchers. Tested on mice with dry AMD, the eye drops showed effective pto erase the signs of AMD and restore the retina.
Bonus, the form of the medication – eye drops – allows “better compliance with treatment while reducing complications and costs associated with repetitive invasive treatments” indicates the press release from the Korean Institute (KIST) which developed the eye drops.
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