With the aging of the population, the incidence rate of age-related macular degeneration is also rising. It may lead to a decrease in central vision, affecting daily activities such as reading, face recognition, driving, and in severe cases, even blindness.

 

In this article, we will focus on discussing the medication for macular degeneration and the differences between several common products to better prevent and slow down the progression of macular degeneration, safeguarding our right to 'see'.

 

What is macula?

The macula is an area located in the center of the retina, which gathers important cells that determine vision. Therefore, most of the light information related to recognizing objects, such as shape, size, color, depth, distance, etc., is related to this area. When structural changes occur in the tissue of the macula, the cells responsible for vision are affected, leading to visual abnormalities.

 

What is age-related macular degeneration (AMD)?

Age related macular degeneration (AMD) is a diagnosis caused by age-related changes in the structure of the macula, resulting in blurred vision or central visual field impairment. Currently, it is the main cause of low vision and even blindness in the elderly population.

 

Currently, the population aged 70 and above in China AMD The incidence rate is 20.2%. With the intensification of population aging, AMD The number of patients is also continuously increasing. Expected by 2040, globally AMD The estimated number of patients will reach 288 million.
The possible diagnostic symptoms are as follows:

• Observe the deformation of objects

• Unable to see the center of the field of view clearly

• Blurred visibility

• Decreased color perception

Macular lesions generally include four types: macular membrane, macular edema, macular hole, and macular degeneration. The medication treatment plan mainly introduced here is discussed for macular degeneration.

 

What is macular degeneration?

Macular degeneration is known as the leading cause of blindness among people over 60 years old. It is mainly divided into two categories: dry and wet:

Dry macular degeneration is caused by the aging and decomposition of cells in the macular area of the retina, resulting in a gradual loss of central vision due to the thinning of the entire macular area. Currently, there is no medical treatment available for dry macular degeneration.

Wet macular degeneration is the result of abnormal development of blood vessels below the macular area, which are fragile and prone to bleeding, causing damage to the retina and rapid decline in vision. Abnormal development of blood vessels and VEGF（ Related to vascular endothelial growth factor, VEGF Like a commander commanding the growth of blood vessels in a specific area.
 

 

According to the latest clinical diagnosis and treatment guidelines for age-related macular degeneration in China released in 2023 VEGF（ Vascular endothelial growth factor (VEGF) therapy is the first-line treatment for wet macular degeneration. This method is commonly referred to as "eye injection", which involves injecting specific drugs into the eye to inhibit abnormal blood vessel growth.

 

Therefore, the effective way to treat wet macular degeneration is to prevent it VEGF Its function makes it unable to 'command' blood vessel growth. Medical treatment for macular degeneration can only alleviate or prevent the worsening of the condition, but cannot reverse the decline in vision. Currently, it has become the third leading cause of blindness worldwide after glaucoma and cataracts. Therefore, timely treatment is very important.

 

resist VEGF What are the drugs?

suppression VEGF There are three different monoclonal antibodies available to improve the treatment of wet macular degeneration (all of which can be provided by our hospital to provide personalized and efficient treatment options for wet macular degeneration patients).

1. Leizhu monoclonal antibody
The first generation product for treating macular degeneration directly inhibits VEGF To prevent the development of neovascularization in the macular area, it is necessary to inject once a month.
 

2. Abacip
The second generation product has a mechanism of action similar to that of ranibizumab, requiring continuous monthly injections for the first 5 months, followed by injections every two months.
 

3. Fariximab
The third generation product, in suppressing VEGF On top of that, there is also resistance AND-2（ To achieve faster elimination of fluid accumulation and improvement of vision, it is necessary to inject once every two months in the first year and once every four months in the following year to prevent and promote the growth of pericytes.
 

Here is a more detailed comparison:

Drugs Name	Leizhu monoclonal antibody	Aflibercept	Fariximab
trade name	Lucentis	Alya	Luo Shijia
English name	Ranibizumab (Lucentis)	Aflibercept (Eylea)	faricimab (Vabysmo)
mechanism	resist VEGF monoclonal antibody	resist VEGF fusion protein	targeting Ang-2 and VEGF-A Dual resistance
Adjust diagnosis	Age related macular degeneration (AMD), diabetes macular edema (DME), retinal vein occlusion (RVO), choroidal neovascularization CNV	Age related macular degeneration (AMD), diabetes macular edema (DME), retinal vein occlusion (RVO), choroidal neovascularization CNV	Age related macular degeneration (AMD), diabetes macular edema (DME), macular edema secondary to branch retinal vein (BRVO)
manufacturer	novartis	BAYER	Roche
Domestic listing time	2012	2018	2023
cost price	3950	4100	9000
specifications	10mg	40mg	6mg
usage	0.5mg Inject once a month	Inject once a month continuously for the first 5 months mg( 5 injections), followed by examinations and injections every two months (8 weeks)	As low as 6 injections in the first year and as low as 3 injections in the following year; Load period: 4 injections, maintenance period: up to 4 months, once