Age-Related Macular Degeneration (AMD)

In age-related macular degeneration, the nerve cells are destroyed in the macula – the point of sharpest vision on the retina. This is caused by deposits beneath the retina as a result of local disturbances in retina metabolism.

Age-related macular degeneration – the most common cause of blindness in people over 65 

As you grow older, you become more experienced, knowledgeable, wise and farsighted. However, an estimated 170 million people live with age-related macular degeneration (AMD) globally¹, which is the most common cause of severe visual impairment and blindness among people over the age of 65 in developed countries.² 

As societies continue to age, the incidence of age-related macular degeneration is projected to increase even further to 288 million people worldwide by 2040, with women more frequently affected than men.

Vision loss significantly impacts a patient’s daily life and is linked to loss of independence, falls, injury, and negatively impacts cognition, mental health, and employment status.³ 

The initial symptoms of macular degeneration

In most cases, the first sign of age-related macular degeneration begins when straight lines suddenly look bent. Further indications of macular degeneration can emerge when reading. For example, when a patient fixes his/her eyes on text, letters can become blurred, and only an indistinct blob can be seen. 

Over time, this blob can grow in size, resulting in sufferers being able to see a clock, but not the time, or they can recognize a person's outline but not his/her facial features. The disease usually starts in one eye, but the second is highly likely to be affected later. 

Different forms of the disease

"Dry" age-related macular degeneration (AMD) is the most common form of the disease. It progresses slowly, so that the patients' loss of vision remains limited. The "wet" form of macular degeneration (wet AMD), which accounts for about 10 percent of all AMD cases², causes much more serious restrictions to vision. It is caused by tissue fluid and blood seeping from pathologically changed blood vessels into the macula, leading to edemas (swellings caused by fluid accumulations). 

In addition, new, diseased blood vessels form in the choroid under the retina. As a result, the nerve cells of the retina gradually die off, and central vision can be lost in just a few years. If there is hemorrhaging, sight may be fully lost immediately. Measuring the thickness of the retina can indicate how active the disease is.

An active substance against wet AMD

Medicines that inhibit the vascular endothelial growth factor (VEGF) are commonly used today in the treatment of wet age-related macular degeneration (wet AMD). VEGF is a naturally occurring protein in the body. Its normal role in a healthy organism is to trigger the formation of new blood vessels (angiogenesis) which supports the growth of the body's tissues and organs. However, it is also associated with the growth of abnormal new blood vessels in the eye, which exhibit abnormal increased permeability that leads to edema. 

Anti-VEGF therapy aims to slow the abnormal growth of new blood vessels in the eye. These therapies, which are injected into the eye, can cause existing edemas (swelling) and new, pathologically formed blood vessels in the choroid to recede. This means photoreceptor cells that have not yet been completely destroyed, can be saved which can stop progressive blindness, and even improve visual acuity in some patients.

Conventional anti-VEGF treatments require frequent visits to the hospital or an office-based ophthalmologist to receive injections, which can place a significant burden on patients and their carers. The frequency of injections can also present challenges to long-term treatment compliance, which can negatively impact patient outcomes. 

Treatment options that offer extended treatment intervals have the potential to substantially alleviate the burden of disease. Extended intervals mean fewer injections, fewer hospital visits which addresses an important patient need, allowing patients to spend more time doing things that are important to them.

Bayer is committed to advancing treatment options that benefit patients in need.

Sources:

[1] Khachigian LM, et al. J Transl Med 2023;21:133.

[2] Morris B, et al. Postgrad Med J 2007;83:301–307.

[3] Welp A et al., editors. Vision for Tomorrow. Washington (DC): National Academies Press (US); 2016 Sep 15