What is wet macular degeneration?
Wet macular degeneration occurs when abnormal blood vessels (known as choroidal neovascularization) grow under the macula. These new blood vessels may then bleed and leak fluid, causing the macula to bulge or lift up from its normally flat position, thus distorting or destroying central vision. It is called wet because of the fluid the leaks from the abnormal blood vessels. Patient with wet macular degeneration usually develop rapid vision loss over the course of weeks or months. Straight lines may look wavy because the macula is no longer smooth. Below is a discussion of various manifestations of wet AMD. Click the button to learn more about the treament of wet AMDTreatment of Wet AMD
What is a Choroidal Neovascular membrane?
Choroidal neovascular membranes are new blood vessels that grow beneath the retina and disrupt vision. These blood vessels grow in an area called the choroid, the area between the retina and the sclera (the white part of your eye). The choroid supplies oxygen and nutrients to the eye. These blood vessel growths break through the barrier between the choroid and the retina. Although one would think that more blood vessels supplying nutrients to the eye would be good, it is not. The new blood vessels grow out with scarring. Also, they leak more than normal retinal blood vessels. Finally they can bleed and blood is very harmful to the retina. Rarely patient maintain good vision with choroidal neovascular membranes (about 10 or 20 percent). Most people lose central vision rapidly who develop choroidal neovascular membranes unless they are treated.
What is a Disciform Scar?
Untreated, a person with a choroidal neovascular membrane will usually develop a submacular scar like the one in the photo. The scars are white because the are composed mostly of fibroblasts. Subretinal scars cause degeneration of the overlying retina and loss of vision. The scars are circular or disc shaped and therefore are called disciform scars. They cause vision loss because they block the transport of nutrients from the supporting tissue under the retina (the retinal pigment epithelium) which is vital to the survival and function of the retina. Unfortunately, once the retina has been permanently damaged by a submacular scar it cannot be resurrected. Retinal tissue does not regenerate. It cannot be replaced. Research is being pursued all over the world trying to find a way to fix damaged retinas, but nothing, at the moment (January 2015) is close to being effective.
What is Subretinal Fluid?
A hallmark of wet AMD is subretinal fluid. This comes from leaking abnormal blood vessels under the macula. Their is not a firm attachment between the retina and the underlying retinal pigment epithelium. The retina is held in place against the underlying retinal pigment epithelium by a pump in the retinal pigment epithelium. This pump removes naturally occurring fluid in the subretinal space and keeps it dry. The leakage from a choroidal neovascular membrane overwhelms the natural pump in the retinal pigment epithelium and subretinal fluid accumulates. The subretinal fluid distorts the retina causing patients to see things as wavy instead of straight. It also decreases the supply of oxygen and nutrients to the retina and makes the vision blurry. Subretinal fluid is best dectected using optical coherence tomography. The photo shows a dark area under the retina where subretinal fluid has accumulated. The effect (or lack of effect) of treatments for wet macular degeneration is usually evaluated by monitoring the optical coherence tomography scan for subretinal fluid.
What is a Pigment Epithelial Detachment?
Most patients with wet AMD develop a retinal pigment epithelial detachment. The retinal pigment epithelium is a layer of cells under the retina that supports the retina. In the OCT image it is the bright white line closest to the bottom of the picture with RPE on top of it. (there are two lines, the line on the bottom is the RPE, the line on the top is the back of the retina). When fluid or lipid (fatty material) or blood vessels accumulates under the retinal pigment epithelium the retinal pigment epithelium is pushed up. The bump in the retinal pigment epithelium is called a pigment epithelial detachment. These are common in wet AMD. Treatment does not always cause the retinal pigment epithelial detachment to flatten. Vision can be excellent over a retinal pigment epithelial detachment. The distortion of the overlying retina will often cause distortion in the vision. Retinal pigment epithlial detachments do not compromise the ability of the retinal pigment epithelium to nurish the retina. Finally, you can develop a retinal pigment epithelial detachment without wet AMD. These retinal pigment epithelial detachments have lipid (fatty) material in them but no blood vessels. About 90 percent of retinal pigment epithelial detachments are associated with wet AMD and abnormal blood vessel growth.
What is a Polypoidal Choroidal Vasculopathy (PCV)?
Polypoidal choroidal vasculopathy is a subtype of wet AMD that is caused by a mature vascular complex under the retina. It is characterized by a branching vascular network with one or more polyps at the termini of the vessels. The branching vascular network and the polyp(s) are best seen with indocyanine green angiography. There is some evidence the polypoidal choroidal vasculaopathy (PCV) is less response to anti-VEGF injection therapy than other forms of wet AMD. In many cases photodynamic therapy is helpful in treating PCV.
What is a Submacular Hemorrhage (Blood)?
Submacular hemorrhage (blood) is one of the most feared complications of wet AMD. The blood is toxic to the overlying retina and causes immediate severe vision loss. The photo shows blood in a patient whose vision dropped from 20/30 immediately to 20/1600 (no longer able to see even the big letters on the visual acuity chart). Fortunately, submacular hemorrhage is rare and occurs in only about 1 percent of patient with wet AMD. Once there is a submacular hemorrhage, vision almost never returns to what it was before the bleed. Treatment of wet AMD helps reduce the amount of vision loss. Surgery for submacular hemorrhage is controversial and may not be helpful. Visual recovery in someone with a submacular hemorrhage is very very slow. It usually takes about 6 months for the blood to absorb and then another 6-12 months for the overlying retina to heal. Vision usually improves some as the blood absorbs but not much. Most patients recover enough vision to see the big letters on the visual acuity chart but not enough vision to read.
Wet Macular Degeneration NEWS
Below are current articles from a Google News Feed on Wet Macular Degeneration
US Wet Age-Related Macular Degeneration Market and Competitive Landscape 2018 - ResearchAndMarkets.com
Business Wire (press release)
US Wet Age-Related Macular Degeneration Market and Competitive Landscape - 2018 provides comprehensive insights into Wet Age-Related Macular Degeneration pipeline, epidemiology, market valuations, product sales, market forecast, product forecasts ...
A Report On Growing Age Related Macular Degeneration (AMD) Market By Wet and Dry Eye, Age, Treatment and Top ...
By type, the market is segmented into wet age-related macular degeneration (Wet AMD) and dry age-related macular degeneration (Dry AMD). Wet AMD accounts for more than 50% of the total market and is expected to grow at the highest CAGR of 7.6% ...
Adverum Bio's gene therapy ADVM-022 shows positive action in preclinical wet AMD study
Results from a preclinical study evaluating Adverum Biotechnologies' (ADVM -0.4%) gene therapy ADVM-022 in a non-human primate model of wet age-related macular degeneration (wet AMD) showed an encouraging treatment effect. The data were ...
Adverum Biotechnologies Announces Data Presented at the European Society of Gene and Cell Therapy (ESGCT)
Novartis challenges court ruling allowing use of Avastin in wet AMD
Novartis is appealing against a High Court ruling that it is lawful for the NHS to prescribe Roche's Avastin (bevacizumab) in an unlicensed use in wet age-related macular degeneration (AMD), instead of pricier approved drugs. Novartis's Lucentis ...
Phase 3 trials to focus on Port Delivery System for AMD, faricimab for DME
Genentech and Roche announced the initiation of three large phase 3 clinical trials evaluating the Port Delivery System with ranibizumab to treat wet age-related macular degeneration and faricimab to treat diabetic macular edema, according to company ...
The Durango Herald
Southwest Retina opens research center to conduct clinical trials
The Durango Herald
Patients with wet macular degeneration can be successfully treated with monthly injections that can preserve and sometimes improve vision. Wet macular degeneration is caused by leaking blood or fluid, and it can cause blurry vision, blind spots and ...
UK High Court OKs Avastin off-label use in wet AMD
Twelve clinical commissioning groups in the north of England have won the right to used Roche's Avastin off-label in the blinding condition wet age-related macular degeneration (AMD). The contested policy, which the U.K. High Court has now ruled as ...
CCGs win right to offer patients Avastin for wet AMD
Novartis, Bayer consider appeal as court says Avastin can be used in AMD
High Court rejects Novartis, Bayer's bid to outlaw off-label Avastin
Brolucizumab meets secondary endpoints for fluid resolution in wet AMD
According to a press release from Novartis, this is noteworthy because “it provides insight into the effect of maintenance treatment, an important clinical focus for a chronic disease like [neovascular age-related macular degeneration].” The data were ...
Regenxbio completes dosing in phase 1 trial of gene therapy for wet AMD
The multicenter, open-label, multiple-cohort clinical trial is assessing the safety and tolerability of RGX-314 as a one-time therapy for patients with previously treated wet AMD and is being completed at seven retinal surgery centers across the United ...
Malaria Drug Amodiaquine Improves Blood Vessel Growth in AMD
Traditional therapies for AMD and DR are anti-vascular endothelial growth factor (VEGF) treatments, which prevent blood vessel growth. Unfortunately, up to 30% of patients don't respond to anti-VEGF therapy and their AMD continues to progress.
Mediterranean diet prevents a leading cause of blindness, study suggests
There are two kinds of AMD -- dry and wet. The dry type affects about 80 to 90 percent of people with AMD. In dry AMD, small white or yellowish deposits, called drusen, form on the retina, causing it to deteriorate over time. In the wet form, blood ...
Tullahoma News and Guardian
REGENXBIO completes fourth cohort dosing in Phase I trial of RGX-314 for wet AMD
REGENXBIO (NASDAQ:RGNX) has completed dosing of the fourth cohort of six patients in a Phase I clinical trial evaluating RGX-314 for the treatment of wet age-related macular degeneration (wet AMD or nAMD). A total of 24 subjects have been dosed in the ...
REGENXBIO Announces Completion of Dosing of Fourth Cohort in Phase I Clinical Trial of RGX-314 Gene Therapy for ...
Regenxbio (RGNX) Reports Complete Dosing of Fourth Cohort in Phase I Clinical Trial of RGX-314 Gene Therapy for ...
RGX-314 Gene Therapy for Neovascular AMD Trial - Full Text View - ClinicalTrials.gov
Why everyone over 50 needs a retina eye exam
There are two basic types of macular degeneration, wet and dry. Wet AMD refers to degeneration in which the blood vessels in the eye are leaking. The medications help reduce or stop the leaking. Dry AMD needs to be monitored in order to ensure it has ...
BLOG: Putting technology to work for you: Monitoring AMD patients
The ForeseeHome monitoring device (FSH, Notal Vision) is, I believe, a “flagship” product for the use of telemedicine and artificial intelligence in the early detection of wet AMD. The device uses preferential hyperacuity perimetry, capable of ...
WMRA Public Radio
Has UVa Found a Cure for Macular Degeneration?
WMRA Public Radio
Macular degeneration is the leading cause of vision loss, affecting two million Americans over 40, with 7 million more at risk of developing the disease, according to the Centers for Disease Control and Prevention. Jayakrishna AMBATI: Actually if you ...
Opthea to Host Wet AMD and Diabetic Macular Edema Key Opinion Leader Forum in New York City
GlobeNewswire (press release)
MELBOURNE, Australia, Sept. 24, 2018 (GLOBE NEWSWIRE) -- Opthea Limited (ASX:OPT), a developer of novel biologic therapies for the treatment of eye diseases, is pleased to announce that it will host a symposium focused on next generation treatments ...
Louisville Business First
Apellis shares plunge after incident in two clinical trials
Louisville Business First
One of the APL-2 trials is a Phase III trial in treating geographic atrophy (GA), and the other is a Phase II trial in treating wet age-related macular degeneration (AMD). These diseases result in blindness, and there currently is no FDA-approved ...
Macular degeneration biotech Kodiak Sciences sets terms for $126 million IPO
Kodiak Sciences, a phase 1 biotech developing anti-VEGF inhibitors for wet AMD, announced terms for its IPO on Monday. The Palo Alto, CA-based company plans to raise $126 million by offering 9 million shares at a price range of $13 to $15. At the ...
Stem Cells And Its Role In The Treatment Of Macular Degeneration
Checkbiotech.org (press release)
The late macular degeneration can also be divided into dry and wet macular degeneration. Macular degeneration can be prevented by exercising well, eating well, and also avoiding smoking. This disease has no cure yet or treatment that could restore ...
Sustained delivery system intended to ease AMD treatment burden
A new port delivery system may secure sustained, long-term release of anti-VEGF in patients with wet age-related macular degeneration, easing the burden of repeated injections. The implantable device was recently tested in a phase 2 trial with positive ...
After Lucentis setback, Novartis trumpets data on follow-up drug
The study found that fluid in the retina was detected less often in patients treated with brolucizumab than with Eylea between weeks 36 and 48 of the phase 3 HAWK trial, which enrolled patients with the neovascular or 'wet' form of AMD. It's now well ...
Prolonged aflibercept dosing intervals yield consistent results for treating AMD
VIENNA — Ninety-six-week outcomes of the ALTAIR study demonstrated safety and efficacy of treat-and-extend aflibercept administration with both 2-week and 4-week adjustments in patients with wet AMD. The study involved 255 patients treated at 40 sites ...
Mediterranean Diet Can Be a Sight-Saver
European researchers have found that people who adhere to a Mediterranean diet can cut their risk of late-stage age-related macular degeneration (AMD) by 41 percent. It's been ... In the wet form, blood vessels grow under the retina and leak. While ...
Regeneron's Dupixent Meets Goals in Nasal Polyps Studies
The FDA had earlier approved a supplemental Biologics License Application (sBLA) for Eylea injection in patients with wet age-related macular degeneration (wet AMD). Regeneron has co-developed Eylea with the HealthCare unit of Bayer AG (BAYRY ...
New options for treatment of wet AMD
The options for treatment of wet age-related macular degeneration (AMD) have widened for clinicians and patients. This is due to the recent High Court ruling that the drug Avastin can be used to treat the condition despite it not being licensed for ...
Operational Strategies of Wet Macular Degeneration Market – Global Industry Analysis, Size, Share, Growth, Trends ...
Researchmoz added Most up-to-date research on “Wet Macular Degeneration Market – Global Industry Analysis, Size, Share, Growth, Trends and Forecast 2016 – 2024” to its huge collection of research reports. Wet Macular Degeneration Market: Overview.
Researchmoz Global Pvt. Ltd. | LinkedIn
The Pharmaceutical Journal
Legal ruling on off-label drug use could save NHS money
The Pharmaceutical Journal
A landmark ruling on treatment for wet age-related macular degeneration (wet AMD) that could save the NHS millions of pounds has been welcomed by healthcare leaders and clinicians. The High Court ruled that, in certain circumstances, it is potentially ...
Bayer to challenge Avastin legal ruling
A week ago the UK's High Court ruled that it was lawful for local NHS Clinical Commissioning Groups (CCGs) to offer patients Avastin (bevacizumab) injections for the treatment of wet age-related macular degeneration (wet AMD) in place of two licensed ...
Bayer to appeal High Court ruling over Avastin for age-related macular degeneration
Intravitreal Injection of Therapeutic Protein for Treatment of Retinal Degeneration
Age-related Macular Degeneration (both “wet” and “dry” forms) and Diabetic Retinopathy are the most common causes of vision loss in the U.S., accounting for approximately 18 million sufferers. Another approximately 200,000 individuals are born with ...
OSN's top news of the week
Adverum Biotechnologies receives fast track designation for wet AMD therapy. The FDA granted fast track designation for ADVM-022, a novel gene therapy candidate for the treatment of wet age-related macular degeneration. Read more. PACK-CXL yields ...
What about Resources?
Dr. Pautler's Blog
- Dr. Pautler's Blog on AMD
All about AMD
American Academy of Ophthalmology
- What Is ARMD?
The basics about AMD
- Macular Degeneration
Extensive list of links from excellent sources
National Institutes of Health
NIH's SeniorHealth website covers the topic of Age-Related Macular Degeneration
National Eye Institute
- ARMD Resource Guide
Answers questions about causes and symptoms, and discusses diagnosis and types of treatment.
- ARMD What You Should Know
Booklet covering the same topic as provided in the NEI website, in printable PDF format.
- AREDS Information
Age-Related Eye Disease Study
- AMD Video
Video illustration of changes in the eye associated with AMD.
American Foundation for the Blind - Senior Site
- Macular Degeneration
Basic information about AMD and low vision; includes a self-test using an Amsler Grid
Journal of the American Medical Association (JAMA)
- Macular Degeneration
Patient page providing the basics of AMD
- Macular Degeneration
Detailed article covering all aspects of AMD.
- Macular Degeneration
Provides a general overview of the basics of AMD, and a simulation showing a scene as it might be viewed by a person with AMD
Prevent Blindness America
- AMD Learning Center
AMD basics and links to relevant news stories