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Anti-VEGF therapy is a great option for patients suffering from wet age-related macular degeneration but it is also a procedure that comes with some serious risks. Make sure you know all the potential risks and benefits before agreeing to this procedure.

Wet macular degeneration is the more rapid and severe form of macular degeneration and patients must act quickly if they want to save their eyesight. One of the most effective options available is Anti-VEGF therapy to try to limit the number of blood vessels that are encroaching on the surface of the macula and causing the patient to lose their vision [1]. In this article, we will focus on this particular macular degeneration treatment and explain some of the benefits and side effects to be mindful of when you are using Anti-VEGF therapy for Wet Macular Degeneration. 

Benefits of Anti-VEGF Therapy 

Anti-VEGF is aptly named because it tells you exactly what to expect. The anti-vascular endothelial growth factor is a medication that doctors consider when they are wanting a way to stop blood vessels from growing. This is a useful option when you are considering diseases that grow or worsen when the blood supply increases to an area. Things like cancers and diseases of the eye are two of the most important diseases that fall under this category. 

Common drugs that are in this anti-VEGF category are: 

  • pegaptanib,
  • aflibercept,
  • ranibizumab 
  • and bevacizumab.

To put how effective this medication can be into more comprehensible terms, participants in one particular study were given anti-VEGF medication as a therapy for AMD and their visual acuity was measured during the trial to determine how well patients retained vision afterward. It was determined that participants receiving anti-VEGF therapy were 3 to 10 times more likely to gain at least 15 letters of visual acuity compared to patients not receiving any medication. This was also seen at the 2-year mark of the investigation which proved that these results are more long-term than alternative medications offered that use the same type of mechanism. [2]

In another study aimed at determining how effective anti-VEGF therapy for wet macular degeneration could actually be in a long-term study, participants were asked to continue therapy for 2 years and only come for therapy when new vessels were noted on eye examination. In this study, it was found that patients needed on average 8 visits during the first year but only 5 visits during the second year for anti-VEGF therapy. After 12 months and 24 months respectively, participants retain visual acuity of at least 15 letters in 97.5 and 95 percent of cases respectively. [3]

This proves that anti-VEGF is a great option to keep your eyesight from getting worse.

By preventing blood vessels from forming on the surface of the macula, you are able to slow down the process of neovascularization and help your eye retain vision.

The fact that you will reduce the number of visits in subsequent years also means that patients reduce the risk of having some of the possible side effects of anti-VEGF therapy. 

Side Effects of Anti-VEGF Therapy 

As evident in our investigations of the effectiveness of anti-VEGF therapy, there are many reasons to consider it to be a viable macular degeneration treatment option. Some of the adverse effects that have been noted in patients receiving this medication include inflammation of the eye and increased intraocular pressure, both of these seen in less than 1 percent of users who utilize anti-VEGF therapy. Patients will typically present with pain within 24 hours of injection but symptoms will generally resolve spontaneously. [4]

A potentially devastating complication of intra-ocular injections of anti-VEGF is the possibility of developing endophthalmitis. This is the inflammation of the internal eye and is generally caused by StreptococcusIn trails looking at long-term complications of anti-VEGF therapy, it was reported that patients developed this inflammation in up to 1.6 percent of cases. Reports did dictate that this number was artificially elevated because rates for infections were much higher during the early stages of the investigation but improved as physicians learned how to administer these injections properly. They also stated there was much variety based on the geographical territory this operation was performed in. Countries with higher levels of sanitation tended to have a lower incidence of endophthalmitis. [5]

Another possible consequence of anti-VEGF therapy for macular degeneration could be Rhegmatogenous Retinal Detachment (RRD). This was a complication is less than 1 percent of procedures and studies pitting anti-VEGF therapy against a control showed there was no statistical difference between procedures and outcomes of retinal detachment. This risk has been managed by improving the precise location of where this injection site can be and it virtually negates the risk of retinal detachments. [6]

The last noteworthy risk that patients need to consider when they are electing to have anti-VEGF therapy is the potential for intraocular hemorrhaging. Studies show that this risk was magnified in patients who were using Aspirin while they were receiving injections. Prevalence rates were as high as 10 percent in this studied population so obvious concern can be valid in this particular category. [7] Due to the complications associated with stopping Aspirin, especially in patients who are at risk for strokes, the risks do not outweigh the rewards and physicians currently do not recommend stopping Aspirin or other anti-coagulation therapy when administering anti-VEGF therapy. Blood-shot eyes for a day or two is a small price to pay for having to protect against strokes and these are common occurrences in the general population even without anti-VEGF therapy. 

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