Aflibercept, an anti-VEGF injection, is designed to treat Wet Macular Degeneration. This condition is marked by abnormal blood vessels that leak fluids under the retina causing scarring and eventual vision loss. Aflibercept stops any further bleeding by stopping further damage to macula cells.

VEGF Inhibitor

Vascular Endothelial Growth Factor (VEGF) is a protein in our bodies that promotes blood vessel growth to deliver nutrients and oxygen to cells. When applied directly to eyes, VEGF helps form new blood vessels to prevent leakage of fluid and retinal damage due to macular degeneration – known as macular edema which limits vision loss centrally. Drugs known as VEGF inhibitors block its action within eyes to treat vision loss caused by specific forms of macular degeneration.

VEGF inhibitors may help improve vision in those suffering from wet age-related macular degeneration by decreasing or stopping fluid leakage and scarring in the macula. Furthermore, these medications may also help stabilize eyes that have retinal detachments by limiting further fluid leakage and retinal pigment epithelial cell degradation.

Anti-VEGF therapy is widely utilized to treat both wet and dry macular degeneration in the United States, with more than half of patients being treated for wet AMD benefiting from its administration. The Food and Drug Administration has approved several agents for intravitreal injection including ranibizumab (Lucentis), which targets VEGF isoforms and their smaller bioactive cleavage products; as well as bevacizumab (Avastin), which blocks VEGF-A and its cognate receptors.

Aflibercept (Eylea), a novel drug developed through recombinant technology, has shown promise in decreasing the frequency of injections required to maintain effective therapy for wet AMD. This agent is composed of a recombinant fusion protein consisting of the extracellular domain of human VEGF receptor 1 fused to an Fc portion of human IgG1 for intravitreal injection as an iso-osmotic solution and acts as an effective soluble decoy receptor that binds and inhibits activity of cognate receptors such as VEGF-A or VEGF-R1 in eyes.

Two randomized clinical trials, known as View 1 and View 2, demonstrated the efficacy of EYLEA injections every two months as being as effective in treating wet AMD as Lucentis injections every month. Furthermore, every two monthly injections provided the same result in terms of reduced visual acuity loss reduction as monthly ones.

These results are drawn from subgroup analysis of the PIER study, in which 527 treatment-naive diabetic macular edema patients due to retinal vein occlusion were followed for 36 months with dosing schedules based on assumptions that those only suffering dry disease would benefit from quarterly treatments while those suffering wet disease could also be administered monthly doses, though monthly dosing did not offer additional advantages.

Anti-VEGF Injection

VEGF (vascular endothelial growth factor) is a naturally-occurring protein in our bodies that promotes new blood vessel growth, but can also cause abnormal vessel growth in the retina and macular degeneration, low vision or blindness. Anti-VEGF drugs are available as treatments for macular degeneration and related conditions by inhibiting VEGF production and blocking its formation; some can be taken orally while intravitreal injection is administered by an eye doctor with different dosage requirements depending on age or gender; adult dosage will differ between adults vs children in terms of dose requirements for adults compared with their counterparts.

VEGF inhibitors are the standard of care for wet age-related macular degeneration (wAMD), which can lead to permanent vision loss. Monthly or bimonthly injections of agents such as Aflibercept, Ranibizumab and Bevacizumab may slow the progression of AMD and restore vision in many advanced neovascular AMD cases. Sometimes they can even be combined with photo-sensitizing agents in order to target abnormal blood vessels in the eye that contribute to macular degeneration.

Researchers are exploring ways to alleviate the burden of treatment on patients, including personalized OCT-guided dosing and novel delivery methods. Unfortunately, clinical trials that led to monthly or bimonthly injections as the standard of care for neovascular wet AMD may make this difficult to accomplish.

Results of a preliminary study indicate that people living with wet AMD may be able to temporarily forgo injections. Published in Ophthalmology, this research involved 106 participants taking anti-VEGF medication to stop macular degeneration from worsening; those able to discontinue anti-VEGF treatments maintained or improved visual acuity even without medication.

Researchers emphasize that this study was only an initial step and more research needs to be conducted in order to establish when people may safely stop treatment. They cautioned that only limited data was included from people participating in this initial phase; year two results of VIEW (VEGF Trap: Investigation of Efficacy and Safety in Wet AMD) program will be presented at forthcoming medical conferences.

Side Effects

Eylea (aflibercept) is an injectable drug designed to treat wet macular degeneration, diabetic retinopathy and retinal vein occlusion. It works by blocking VEGF – a protein responsible for blood vessel growth – while in combination with photodynamic therapy or retinal laser treatments it may prevent or even reverse vision loss in wet macular degeneration patients.

Wet macular degeneration, which occurs less frequently than dry macular degeneration and involves blood vessels under the retina that leak fluid, can progress quickly, leading to permanent blindness within days or weeks if left untreated. Signs of wet macular degeneration include sudden blurring in central vision or changes in color intensity or formation of blind spots that invite invitations.

Bevacizumab, ranibizumab and aflibercept are all medicines designed to stop abnormal blood vessel formation by blocking VEGF, which fuels it. These revolutionary drugs have changed how patients with this condition are treated and saved the sight of thousands who would otherwise have experienced legal blindness without them.

Anti-VEGF agents typically cause systemic side effects when administered intravitreally, including conjunctival hemorrhage, eye pain, retinal hemorrhage, cerebral vascular accidents (such as cerebral vascular accidents), myocardial infarction ( MI ), stroke and deep vein thrombosis/pulmonary embolism.

Eylea 8mg provides wet AMD, DME and DR patients with an effective treatment that requires fewer injections per year than its previous 2mg formulation. With longer treatment intervals available under this new formula, patients require less injections throughout the year than previously. This will greatly decrease the time needed for treatment at an ophthalmologist, and may lower risks such as endophthalmitis and retinal detachment that could occur with regular injections. These risks can further be minimized using aseptic injection techniques recommended by physicians as well as following ophthalmologist advice regarding care. It’s also advised that any signs of endophthalmitis or retinal detachment be reported immediately to their healthcare provider.

Precautions

Macular degeneration is a progressive breakdown of the macula that results in central vision loss. It is the leading cause of blindness among Americans over fifty and typically affects those living in their 50s and older, typically manifesting with blurry or dim central vision, loss of fine detail in objects, difficulty with facial recognition and trouble with color recognition – it occurs most commonly in retinas containing photoreceptor cells that allow us to detect fine details, colors and details; macular degeneration affects only central vision which enables reading, driving and recognising faces without difficulty.

Macular degeneration comes in two varieties; dry and wet. Wet macular degeneration is caused by abnormal blood vessels growing beneath the retina which leak fluids and blood into the macula causing distortion to central vision.

Aflibercept (Eylea) is a soluble fusion protein that binds and blocks the action of vascular endothelial growth factor, preventing it from stimulating new, fragile, permeable blood vessels associated with wet age-related macular degeneration. Administered through intravitreal injection and approved for sale in the UK for treating wet AMD, Aflibercept is considered FDA-approved treatment.

Current treatments for wet macular degeneration include photodynamic therapy with verteporfin and laser-induced photocoagulation. The goal of this is to kill off blood vessels responsible for excess neovascularization that causes scarring and permanent vision loss, with scarring being permanent as a result. Furthermore, research conducted through AREDS study demonstrated that high dose combinations of vitamins C & E, beta-carotene, zinc & copper significantly slowed progression into advanced age-related macular degeneration.

Patients suffering from active macular degeneration should undergo regular slit lamp exams and photographs with the intent of assessing visual acuity, the presence of new macular hemorrhages or retinal changes, as well as compliance with diet recommendations. If they don’t respond to PRN treatments with Aflibercept, a Treat and Extend regimen is often offered instead; any significant change should be reported immediately to their physician.