What You Should Know About NHS Macular Degeneration Treatment

Macular degeneration affects the macula of your eye, used for central vision. This occurs when blood vessels under your retina start leaking fluid into this region, blurring or distorting it and leading to blurred or distorted vision.

Faricimab, an affordable and safe treatment for wet age-related macular degeneration, works similarly to existing drugs such as Aflibercept and Ranibizumab which have already been recommended by NICE.

1. Transpupillary thermotherapy

If you suffer from wet age-related macular degeneration, transpupillary thermotherapy could be an option to consider as part of treatment. This laser procedure uses light energy to damage blood vessels leaking fluid and leading to vision loss in macular degeneration patients. Unfortunately, its long-term effectiveness remains unknown since studies that examined it only included small samples and did not follow participants for very long.

Treatment works by heating the area around your retina (the part of your eye that helps you see straight ahead). This process can be performed outpatient at either a local hospital or specialist clinic, though you might also use special equipment in your own home for this process. Your doctor will give you instructions that will keep the eye safe from further damage, such as not to rub or touch it frequently as this can increase damage. Shields might also be given out so as to help stop your eye drying out, while tips might include how to keep bright lights at bay (such as using mobile phones or laptops in dimly-lit rooms). In particular, it may be advised not to expose yourself too frequently as bright light exposure increases risk for hemorrhaging haemorrhages more likely than exposure from dim light alone.

NICE also recommends anti-VEGF injections like Aflibercept or Ranibizumab; you should continue with these therapies if they work for you and if deemed suitable by an NHS clinician.

Wet AMD can lead to permanent loss of central vision. This occurs when blood vessels in the macula burst, leaking fluid into the center of your retina and blurring your central part of vision – making reading or driving difficult and leading to pathological myopia (short sightedness). Over time, you might notice your central vision becoming increasingly blurry over time and worsening with age; medicine may help around 30-40% of those affected, though vision may continue to decline regardless.

2. Anti-VEGF injections

Age-Related Macular Degeneration (AMD), particularly wet AMD – which affects central vision – causes blood vessels to expand abnormally and leak fluid, shrinking the macula (an area on the retina on the inside back surface of your eyeball) and leading to blurry central vision. Treating leaky blood vessels requires monthly injections of anti-VEGF medications into each eyeball; however, returning for these injections may prove challenging and cause patients to miss them altogether resulting in decreased vision quality and worsened vision quality over time.

Ranibizumab is currently the only approved treatment option for wet AMD, and has proven itself effective at slowing or stopping its progression, and even helping restore some vision in people who had lost it. Unfortunately, however, its price makes it out of reach for many patients; NHS doctors should instead prescribe bevacizumab, a cheaper version which has also proven just as effective and safer; doing this would save substantial sums that could then be reinvested back into other frontline services for patient care.

Recent research has demonstrated that some patients can be weaned off monthly injections. By studying eye fluid samples taken from their patients, researchers identified specific proteins which indicate whether or not someone is responding positively to anti-VEGF therapy; in particular, higher levels of one protein (Apolipoprotein B100) correlate with better response to this drug therapy; this finding opens the way to developing other biomarkers which predict patient response as well as new treatments for wet AMD.

This exploratory sequential mixed methods study used interviews and questionnaires with individuals who have neovascular AMD. Next, quantitative measures such as questionnaires and electrophysiology measurements were implemented in order to understand pain perception, impact and associated outcomes associated with intravitreal anti-VEGF injections for treating neovascular age-related macular degeneration.

3. Laser treatment

Macular degeneration can damage the central part of your retina (macula), significantly impairing vision. When this occurs, laser treatment may provide relief by helping prevent further macula damage while slowing the rate of vision loss or improving quality. Argon-green laser photocoagulation therapy for macular degeneration uses small blood vessel destruction that leak fluid into macula to decrease macular oedema (one cause of permanent vision loss in wet age-related macular degeneration), helping preserve reading vision while protecting reading vision.

The SMDS study demonstrated that low-intensity laser photocoagulation treatment could slow the progression of severe visual loss among people suffering from senile macular degeneration and an associated choroidal neovascular membrane outside of the central macula, yet did not completely prevent further vision loss. While some individuals experienced immediate improvement while others saw little change overall, few individuals saw any significant restoration in lost vision.

Photodynamic therapy may also provide relief, with verteporfin injection into the eye providing coverage to where new blood vessels exist and sticking to their surfaces. A light is then shone upon it for 90 seconds in order to activate this drug and destroy those new blood vessels and slow vision decline.

If you’re eligible for this treatment, a thorough assessment must take place first. Before the procedure, eye drops are administered to dilate your pupils, and someone will need to drive you home afterward. Your vision might appear blurry or there may be temporary floaters following treatment but these should subside over time.

Micro-pulse laser photocoagulation, another cutting-edge form of laser surgery being offered as part of NHS medical treatments for wet macular degeneration, may provide faster and less painful relief than argon-green laser therapy.

4. Surgery

Macular degeneration typically results from changes to the area underneath it – known as the choroid layer – where blood vessels have problems. Fluid leaks into this space and causes scarring which eventually results in vision loss; this is known as wet macular degeneration. Radiotherapy offers one possible treatment option, where new blood vessels form underneath the macula before being destroyed with radiation beams; this should slow down sight loss over time but cannot promise instant improvements for patients.

An investigation conducted and published today in The BMJ suggests that doctors should be given access to an alternative cheaper drug which is equally safe and effective at treating wet age-related macular degeneration (AMD), called bevacizumab, that could save the NHS an estimated PS102m annually. At present only ranibizumab is licensed for this condition, although trials conducted by public funds show its equivalent bevacizumab could provide equal results and save taxpayer money as it costs less per dose.

bevacizumab works similarly to ranibizumab and has been proven safe and effective, but without patent protection it could be purchased at lower cost by other pharmaceutical companies, enabling more time for doctors to treat people in need of help.

University Hospitals Coventry & Warwickshire ophthalmic specialists are now offering a new service for patients suffering from Neovascular Wet AMD (AMD). This condition occurs when blood leaks through abnormal blood vessels growing beneath the retina, damaging overlying tissue and blurring central vision. The service targets individuals who have already received anti-VEGF injections but their vision has still not improved enough for laser surgery surgery to be considered an option.

Even so, NHS resources have come under increased strain and it has had to reduce some services it offers – including sending patients out for certain procedures to private providers; roughly half of NHS-funded cataract operations now take place through independent providers.