A drug has been developed to help those with the dry version of age-related macular degeneration (AMD) that up until now has remained untreatable.
Many people in Portugal and around the world suffer from this disease, which causes a loss of vision in the centre of the retina. It nearly always only affects people after the age of 50, but then it progressively worsens making it difficult, if not impossible, for them to carry out some ordinary activities such as reading, writing, driving and watching television.
There are two kinds of AMD: dry and wet. Both cause a blurring of vision that can eventually lead almost to blindness. The wet form has long been treatable, though it can be at considerable cost and the treatment is not always successful. For decades, most elderly people with the dry kind have given up hope of a remedy in their lifetime.
The president of the Portuguese Society of Ophthalmology, Dr Rufino Silva, explains on the society’s website that AMD initially shows practically no symptoms and affected people may not even know they have the disease. Only examination by an ophthalmologist allows the correct diagnosis to be made.
Prevention involves a diet rich in vegetables and fruit, taking vitamins and antioxidants that have been studied for this disease and which may be prescribed by an ophthalmologist. Importantly, it also involves taking physical exercise and not smoking.
Dr Silva says that anyone who notices a distortion of images should immediately consult an ophthalmologist, and that it is also important to start treatment within one or two weeks.
Persons who already know they have ADM at first see objects or people’s faces somewhat distorted, then a shadow appears in the central field of vision, preventing them from seeing clearly a face they may be looking at. They may not recognise friends passing by in the street or sitting at the next table in a restaurant.
The disease progresses with time and, in the intermediate stages, can cause changes in contrast, colour and low-light vision. In the later stages, there is a much more serious loss of sight that may almost reach blindness. It is the most common cause of near blindness in Portugal for persons over 65 years of age.
The treatment for wet AMD can prevent severe vision loss. It is done with intravitreal injections, and it may be necessary to maintain this treatment for several years. A new drug, Vabysmo, was introduced last year for both wet AMD and diabetic macular edema (DME). It was the first bispecific antibody approved for eye treatment.
The new drug for dry AMD is called Syfovre. Although it is not a cure and does not bring back normal vision, clinical trials have shown it can slow the progression of the disease. It will be administered with an injection to the eye every 25 to 60 days.
Syfovre has been approved by the US Food and Drug Administration and patients in the United States are expected to start having treatment this week. It is still too early to tell just how beneficial the drug will be and there are even question marks about possible risks, such as turning dry into wet AMD.
However, Geraldine Hoad, research manager at the Macular Society in the UK, has said: “This development is a huge milestone for patients living with dry AMD, who up to this point have not had any treatment available for their condition. We hope to have a clearer picture in the coming months.”
A submission is being made to the British Medicines and Health Products Regulatory Agency to have Syfovre approved in the United Kingdom.
Before it can be administered in Portugal or any EU member country, the drug will need the approval of the European Commission.
COMMENT By Len Port
Len Port is a journalist and author based in the Algarve. Follow Len’s reflections on current affairs in Portugal on his blog: algarvenewswatch.blogspot.pt