Age-related macular degeneration (AMD) remains one of the leading causes of vision loss in older adults. But in recent years, treatment options have expanded dramatically—especially for the advanced forms of AMD. Below, we explore the most promising and newly approved therapies, plus emerging ones that could reshape how AMD is managed in the near future.
Understanding AMD: Why New Treatments Matter
AMD comes in two broad types:
- Dry (non-neovascular) AMD, which can progress to geographic atrophy (GA)—a thinning or loss of the retinal pigment epithelium (RPE) and photoreceptors.
- Wet (neovascular) AMD, where abnormal blood vessels grow under the retina, leak, and cause rapid vision loss.
Historically, there were limited treatments for dry AMD, and wet AMD therapy often required frequent injections. Now, thanks to recent scientific breakthroughs, patients have more options that target different disease mechanisms.
New & Recently Approved Treatments for AMD
1. Complement Inhibitors for Geographic Atrophy (Dry AMD)
Two major drugs have recently been approved to treat GA, targeting the immune “complement system” involved in AMD pathology.
- Syfovre (pegcetacoplan)
- Mechanism: A C3 inhibitor that modulates a central part of the complement cascade. Apellis Investors+2Apellis Investors+2
- Clinical data: In Phase 3 OAKS and DERBY studies, it reduced GA lesion growth by 17–22% compared to sham treatment. Apellis Investors+1
- Long-term data: The GALE extension study showed preserved visual function at 36 months. Apellis Investors
- Safety: Because it affects the complement system, there’s a risk of inflammation and possibly conversion to wet AMD, so patients are closely monitored. Apellis Investors
- Regulatory status: FDA-approved for GA secondary to AMD. Apellis Investors
- Izervay (avacincaptad pegol)
- Mechanism: A C5 complement inhibitor, working downstream from C3 in the complement cascade. Wikipedia+1
- Clinical relevance: Slows the progression of GA by acting on a different complement protein, providing an alternative pathway to control complement overactivation. nicholaslee.co.uk+1
- Approval: Also FDA-approved for geographic atrophy in advanced dry AMD. Foundation Fighting Blindness
These complement inhibitors are groundbreaking because they, for the first time, target the dry form of AMD in a way that actually slows its progression, rather than just managing symptoms. National Eye Institute
2. Long-Acting & Bispecific Therapies for Wet AMD
Wet AMD remains treated primarily with anti-VEGF injections, but newer drugs are improving durability and reducing treatment burden.
- Vabysmo (faricimab-svoa)
- Mechanism: A bispecific antibody that inhibits both VEGF-A and Angiopoietin-2 (Ang-2), stabilizing blood vessels more effectively. Roche+1
- Durability: Studies (like GENENTECH’s TENAYA and LUCERNE trials) found that Vabysmo can be dosed every four months in many patients—with similar efficacy to other anti-VEGF agents. Gene+1
- New formulation: As of July 2024, the FDA approved a prefilled syringe (PFS) version of Vabysmo, which simplifies administration. AJMC+1
- Safety: As with any intravitreal injection, risks include intraocular infection (endophthalmitis), intraocular pressure spikes, and inflammation. Business Wire
- Susvimo (ranibizumab port-delivery system)
- While not brand new, there’s growing long-term data supporting the implant-based delivery of ranibizumab. For example, Roche reports that with two refills per year, Susvimo maintains efficacy over five years in some patients. Roche
- This system can greatly reduce the number of invasive injections required, improving patient quality of life.
Emerging & Experimental AMD Treatments
Beyond these approved therapies, several promising treatments are in development:
- Cell Therapy (Regenerative Approaches)
- OpRegen (RG6501): Developed by Lineage Cell Therapeutics, this is an allogeneic RPE (retinal pigment epithelium) cell therapy delivered via subretinal injection. Wikipedia
- This therapy aims to replace lost RPE cells, potentially slowing or reversing geographic atrophy.
- Gene Therapy & Other Novel Approaches
- Several companies are exploring modifier gene therapies, which target inflammation, lipid metabolism, or oxidative stress in GA (dry AMD). Foundation Fighting Blindness
- Photobiomodulation / Thermal Therapy: Though still early-stage, there is research into using light or heat-based, non-invasive therapies to protect or rejuvenate retinal cells. zoomax.com
- Robotic Injection Systems: Precision robotics may one day improve the safety of delivering these novel therapies via subretinal injections. arXiv
Why These Advances Matter
- First Real Treatments for Geographic Atrophy
Until recently, patients with GA had no FDA-approved drug to slow their disease. With Syfovre and Izervay, that’s changing. National Eye Institute - Reduced Treatment Burden for Wet AMD
Vabysmo and long-acting delivery systems like Susvimo help reduce how often patients need painful eye injections. - Potential for Regeneration
Cell therapies like OpRegen represent a paradigm shift: not just slowing vision loss, but possibly regrowing or repairing damaged retinal tissue. - Personalized & Next-Generation Care
These treatments underscore a broader shift in AMD therapy—from “one-size-fits-all” to tailored, mechanism-based interventions.
Considerations & Challenges
- Risk vs. Benefit: New therapies often involve immune modulation (e.g., complement inhibitors), which can increase risk of inflammation or other side effects. Patients must be carefully monitored.
- Cost & Access: Cutting-edge treatments may be expensive and not fully covered by insurance yet.
- Long-Term Data: While results are promising, long-term safety and effectiveness (5-10 years) are still being studied.
- Patient Selection: Not every treatment is appropriate for every patient. The decision depends on disease type (GA vs. neovascular), progression rate, eye health, and other factors.
Final Thoughts
The landscape for AMD treatment is undergoing a real transformation. For the first time, dry AMD patients with geographic atrophy have approved drug options, and those with wet AMD can benefit from therapies that require fewer injections. At the same time, regenerative medicine and gene therapy are pushing into exciting new territory.
