Optimal Management of Age-Related Macular Degeneration

Usha Chakravarthy, DO, PhD


March 21, 2023

The treatment of neovascular age-related macular degeneration (AMD) has been transformed by the use of vascular endothelial growth factor (VEGF) inhibitors.

Although these medications can offer impressive initial gains in visual acuity, those gains may be lost over time, and patients require frequent monitoring and retreatment. In many cases, eyes also progress to atrophy and fibrosis.

Prof Usha Chakravarthy, from Queens University of Belfast, Belfast, Northern Ireland, explains that some drugs may offer neuroprotection and reduce rates of atrophy.

She describes newer therapeutic options that include slow-release delivery systems to extend the interval between treatments as well as novel medications that have a more durable effect. Among the novel medications is the bispecific antibody faricimab (Vabysmo), which inhibits both VEGF and angiopoietin-2.

Prof Chakravarthy concludes with a look at the emerging option of gene therapy, in which cells are engineered to produce VEGF antagonists, which would potentially reduce the need for retreatment.


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