Age-related macular degeneration (AMD) is one of the primary causes of irreversible vision loss among Americans over 60. Early symptoms may include the accumulation of drusen and geographic atrophy; later stages often show abnormal blood vessel growth that compromises vision.

Here are a few of the latest advances in this area of therapy.

1. Avacincaptad Pegol

Avacincaptad Pegol has been proven to slow the progression of geographic atrophy (GA) among patients suffering from dry age-related macular degeneration, an advanced form of the disease which could eventually lead to blindness if left untreated. It works by suppressing C5 protein activity which is believed to be overactive in GA as well as other conditions like diabetic retinopathy.

In the GATHER1 study, Avacincaptad pegol (Zimura, Iveric Bio) significantly slowed geographic atrophy growth across central and noncentral retinal areas and all four quadrants of retina. Geographic atrophy serves as an indicator of severity in eye conditions; thus these two studies could provide valuable guidance in designing treatments to manage it effectively.

Many individuals living with age-related macular degeneration develop wet or neovascular AMD, in which abnormal blood vessels grow under the retina and leak fluid, resulting in rapid visual loss that is more difficult to treat than dry AMD. Laser therapy may help destroy new blood vessels and protect macula from further damage while other therapies such as photodynamic therapy and anti-VEGF injections are being investigated to possibly delay its onset.

Avacincaptad pegol is currently under FDA priority review to treat GA secondary to dry AMD. If approved, Avacincaptad will become the first ever therapeutic option available for this condition. A single daily pill of Avacincaptad can be taken by mouth. Future development may include topical formulation. REACH Market Research conducted a survey with 25 ophthalmologists who specialize in treating GA patients and reported caring for anywhere between three and thirty GA patients each. According to the report, most physicians would likely prescribe an improved version of pegcetacoplan and avacincaptad pegol with similar safety and dosing frequencies but increased efficacy compared with these medications; the company is currently waiting on results of its phase 3 clinical trials DERBY and OAKS before proceeding with FDA approval.

2. CT1812

Age-related macular degeneration afflicts the macula, the central region of retina at the back of eye responsible for sharp, straight forward vision. It is the leading cause of irreversible blindness among Americans over 60 and damages light-sensitive cells called photoreceptors, eventually leading to progressive loss of central vision. There are two advanced forms of macular degeneration; dry and wet; one is marked by abnormal blood vessels that leak fluid out onto retina, creating distortions or blurriness in vision; whereas wet form features abnormal blood vessels which leak fluid out onto retina and distorting vision while distorting or distorting vision altogether.

Treatment for wet macular degeneration typically entails injecting drugs that inhibit new blood vessel formation, such as VEGF inhibitors. Although injections typically need to be repeated once or twice monthly in order to be effective, gene therapy could potentially provide one-time solutions with significant reduction in injection frequency and side-effects.

Recent research indicates that G6501, an allogeneic retinal pigment epithelial (RPE) cell suspension from Cognition, reduced geographic atrophy (GA) rates among dry AMD patients when administered as a single injection. Cognition intends to develop it for use against other conditions as well.

Pegcetacoplan can not only slow the progression of GA, but it is also capable of protecting against additional cell damage and improving visual performance. Recently approved by the FDA as a treatment option for geographic atrophy in patients suffering from dry macular degeneration.

Pegcetacoplan works by inhibiting the complement system, a protein responsible for identifying and killing pathogens and dying cells. The drug has undergone multiple clinical trials and been found to be both safe and effective for those living with geographic atrophy.

Retinal specialists can identify early signs of macular degeneration through regular exams and help patients adopt healthy lifestyle practices to prevent further vision loss. Furthermore, retina specialists may refer patients to ophthalmologists for cutting-edge treatment breakthroughs like pegcetacoplan or experimental therapies; in time experts hope to discover cures for other eye diseases which affect older Americans; until that day arrives we will continue making strides toward improving quality of life for people living with macular degeneration.

3. Aflibercept

People suffering from wet AMD (neovascular AMD), often referred to as advanced, neovascular macular degeneration, typically receive regular or twice-monthly eye injections of so-called anti-VEGF drugs to slow the growth of blood vessels that leak fluid and cause vision loss. Unfortunately, however, even these medications cannot stop progression of the disease and many eventually lose central vision altogether.

Researchers are exploring strategies for combatting visual decline by blocking key genes. In an experimental mouse model similar to wet AMD, scientists employed nanoparticles with RNA interference capability to reduce expression levels of angiopoietin-like 4 and VEGF within its retina pigment epithelium layer.

Researchers found that their treatments reduced levels of proteins found in eyes, leading to reduced cellular changes associated with neovascularization and macular oedema. Their results, published in PLoS One journal, represent an important step toward developing targeted treatment methods for wet AMD.

Researchers conducted a large, double-masked trial to assess if Aflibercept could serve as an effective alternative to Avastin for treating wet AMD. They recruited 106 treatment-naive patients with active subfoveal choroidal neovascularization secondary to Neovascular AMD who were randomly assigned either Aflibercept (n=106) or Ranibizumab (Lucentis; n=106) as three monthly dosing regimens; their primary outcomes being best-corrected visual acuity and anatomic measures.

Results demonstrated that Aflibercept was equally as effective as Ranibizumab for stabilization and improvement of macular oedema and visual acuity at 44 weeks, as well as improving anatomic measures of disease progression. Furthermore, this study demonstrated a low risk of serious side effects between both drugs. This support the use of Aflibercept as a bevacizumab alternative with potentially lower costs for wet AMD treatment.

4. Xiflam

Retinal diseases have seen increasing focus on understanding their source, evidenced by Angiogenesis, Exudation and Degeneration 2022 virtual conference (held February 11-12th) which featured presentations from leading retinal specialists.

Treatment of macular degeneration begins on a cellular level. This involves detecting geographic atrophy – one key measure to determine if wet age-related macular degeneration will develop and stop its further progression – in order to detect geographic atrophy as early as possible and stop its progress.

An effective treatment for the condition could involve targeting a protein involved in this process through vaccination; however, its complex structure and production within the eye makes this an difficult endeavor to undertake.

However, there are encouraging signs that an end could soon be in sight. InflammX Therapeutics are developing an anti-inflammatory medication known as Xiflam that blocks pathogenic channels on cells known as connexin hemichannel – one key element in an autoinflammation pathway known as the inflammasome.

Research conducted as part of this initiative could produce an oral medication to prevent macular degeneration and diabetic retinopathy progression. Now in phase 2b clinical trials, the company will test if its drug is safe and effective.

Other promising treatments are being explored for wet macular degeneration. Current therapies target vascular endothelial growth factor (VEGF), which promotes abnormal formation of blood vessels that allow fluid leakage into the macula. Unfortunately, most require regular repeat injections into both eyes and are therefore not suitable for everyone.

Researchers are exploring sustained delivery systems for ocular drugs that would allow users to replace frequent eye drops with one gel patch instead. One such development effort comes from New Zealand-based spinout TheiaNova, supported by Bridgewest Ventures and Auckland UniServices with funding through Callaghan Innovation’s technology incubator programme, to treat keratoconus; an eye disease caused by irregular growth of cornea. Their Nexagon drug recently achieved high rates of corneal epithelial cell recovery among those experiencing severe PCED from chemical and thermal injury as per recent trials results from TheiaNova’s Nexagon drug trial results – providing patients with fast relief.