2024-02-28 12:45:59
According to Health Insurance, between 25 and 30% of people aged over 75 suffer from age-related macular degeneration, AMD. Chronic eye disease, it affects the central area of the retina and progressively impairs visual abilities. An antibody, developed to treat the wet form of AMD, is now available to more patients. Explanations.
Dry AMD and Wet AMD
Age-related macular degeneration, AMD, is a chronic eye disease. The part of the eye affected is the central area of the retina, at the macula. The disease is age-related and appears from the age of 50. As age advances, the proportion of people affected increases. Generally, the disease develops in one eye, then the other may be affected later. AMD is today the main cause of low vision in the elderlywith progressive loss of visual ability in the center of the field of vision.
Specialists distinguish several forms of AMD, all of which begin with an early dry age-related maculopathy, ALD. In some people, MLA remains stable throughout life, but in others it progresses into three distinct forms:
Atrophic or dry AMDmost common from age 65; Wet or exudative AMD ; Mixed shapes.
Although currently no treatment exists for dry AMD, therapeutic options are available to combat the progression of wet AMD.
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Antibodies targeting retinal vessels
In wet AMD, the disease is characterized by the abnormal development of blood vessels in the macula. These small, fragile blood vessels leak serum and/or blood, blurring vision and causing intraretinal hemorrhages. To fight against this form of AMD, ophthalmologists rely on biotherapies, i.e. antibodies targeting abnormal small vessel growth factors (anti-VEGF).
Among the antibodies developed, there is le brolucizumabwhich with other antibodies of the same family, now constitutes first-line treatment for wet AMD. Thanks to this treatment, the progression of the disease is slowed and vision maintained or even improved. On the other hand, these antibodies do not definitively cure the disease. Recently, brolucizumab has received High Authority of Health a favorable opinion for an extension of indication. In practice, this opinion allows a larger number of patients to benefit from this expensive biotherapy.
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Combining biotherapy with dynamic phototherapy
The brolucizumab antibody is administered directly to the eye, when an intravitreal injection, carried out by the ophthalmologist. The injection is performed under local anesthesia. During the first three months, the patient receives one injection per month. Then the effectiveness of the treatment is evaluated by the doctor to determine the benefit of continuing the injections or not.
When biotherapy is not effective enough to slow the progression of wet AMD, the ophthalmologist can suggest that the patient combine intravitreal injections with dynamic phototherapy. This technique is based on the venous administration of a dye, verteporfin, which attaches to the abnormal vessels of the retina. After administering the dye, the eye is exposed to infrared laser light, which causes blood clots to form in the stained abnormal vessels. The affected vessels will stop their growth and gradually regress.
Faced with AMD, early screening and diagnosis are essential to implement treatments for wet AMD.
Read also – AMD: What recommendations in 2022?
Estelle B., Doctor of Pharmacy
Sources
– BEOVU (brolucizumab) – Age-related macular degeneration (AMD). www.has-sante.fr. Accessed February 19, 2024.
– Your information booklet about your treatment with Beovu® (brolucizumab). ansm.sante.fr. Accessed February 19, 2024.
– Age-related macular degeneration (AMD). www.ameli.fr. Accessed February 19, 2024.
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