Give wet AMD drug early to keep sight for longer
New study finds it's better to start treatment when sight test scores are under 6/12
A nationwide clinical study has found that people treated for one form of age-related macular degeneration (AMD) do significantly better if treatment starts sooner than current guidelines recommend.
AMD is a condition that affects the central area of vision (the macula), which we use for reading, driving or recognising faces. Around 1 in 5 people with AMD develop ‘wet’ AMD, in which unhealthy new blood vessels grow under the macula. Blood and fluid leak from these vessels, causing damage to the tissue.
Stop unhealthy blood vessel growth
Wet AMD is treated with regular eye injections of treatments such as Lucentis (the brand name for the drug ranibizumab), Avastin or Eylea. They slow down sight loss by helping to stop new unhealthy blood vessels from growing.
Current guidelines recommend that UK National Health Service (NHS) treatment for wet AMD should start when people score more than 6/12 on tests of clear vision. A score of 6/12 means that while someone with standard vision could read a test chart from 12 metres away, you would have to stand closer, at 6 metres away, to read the same thing. A score of 6/24 means someone with standard vision could stand even further away (24 metres from the chart) while you stayed 6 metres from it.
Better than 6/12 is better
But results from the study, which was published in the British Journal of Ophthalmology, show that treating people when their vision is better than 6/12 leads to much less sight loss than starting later on.
“This study of over 11,000 people receiving Lucentis for wet AMD at 14 centres around the UK makes the important finding that it really matters when you start treatment,” said Dr Dolores M Conroy, Director of Research at Fight for Sight. “We already knew that ranibizumab can slow the progress of sight loss from wet AMD. Now we know that if you start treatment when visual acuity is still relatively good, you can maintain consistently better vision for longer.
“The results should be able to inform future policy decisions about funding criteria for treatment. Finding out what factors affect AMD progression is an important priority for research as identified by the Sight Loss and Vision Priority Setting Partnership.”