How Effective Is Bevacizumab for Macular Degeneration?

Macular degeneration (MD) is a degenerative eye disease that commonly affects those over 50 years of age. The condition leads to a gradual loss of central vision. There are two types of MD, wet and dry. No specific treatment exists for the most common dry form, but a number of treatment options are available for the wet type of the disease, including bevacizumab, a relatively new medication. The drug seems to have some promise in the treatment of wet MD but its use can have potentially serious side effects, such as eye infection, hemorrhage, or thrombotic events.

Macular degeneration is the leading cause of visual impairment in people over 50. The disorder causes a gradual worsening of central vision, necessary for activities that require detailed visual perception, like reading or driving, while leaving peripheral vision intact. The speed of visual decline can vary greatly between sufferers, depending on disease severity and type. There are two types of macular degeneration. In the atrophic or dry type, vision loss stems from the gradual atrophy of the outer layer of a structure in the eye called macula. Wet, or neovascular, MD usually has a more severe disease course with rapid degeneration of vision, sometimes within days or weeks. Wet MD involves a degree of atrophy in the macula, like its dry counterpart, but is mainly characterized by the formation of new, abnormal, and fragile blood vessels in the eye that cause significant damage to the macula, especially if they break or leak.

Current treatments cannot slow down the progression of, or reverse, damage done by atrophic macular degeneration, but several treatment options are available for the wet form of the disease. Bevacizumab for macular degeneration is an anti-vascular endothelial growth factor (anti-VEGF) drug. Vascular endothelial growth factor is a substance believed to be linked to the formation of abnormal blood vessels in the body. Anti-VEGF medications, like bevacizumab, block the action of this chemical, thereby reducing the potential for the creation of fragile blood vessels.

Other available treatments for neovascular MD have proven relatively successful at preserving visual acuity. Anti-VEGF drugs, like bevacizumab for macular degeneration, are the only class of medications that have shown any promise at improving vision in some patients. Long-term data on bevacizumab for macular degeneration is scarce, but medical studies indicate visual acuity improvement and preservation of vision with administration at three and six months to be equal to other anti-VEGF medications, and more effective than the absence of treatment.

An ophthalmologist typically injects bevacizumab directly into the eye every four weeks. Intravitreal injections commonly have minimal systemic side effects, but they do carry a small possibility of retinal detachment. Infection or inflammation at the injection site is another possibly side effect.