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Say goodbye to injections for Wet AMD

As someone who has carried out injections into the eyeball of patients with Wet Age-related Macular Degeneration (AMD), I was excited and pleased to learn about the research being undertaken at the University of Birmingham to develop eye drops which do the same job. These eye drops have only been tested in the laboratory up until now, but show promising results that they are just as effective as the injections at reducing the overgrowth of blood vessels in the back of the eye which cause the central vision problems associated with Wet AMD.

Injections can cause pain to the patient, even though anaesthetic eye drops are used in advance to reduce this, and also require skill and experience on the part of the ophthalmologist. There is a relatively narrow field where it is safe to push the needle through the sclera (the white of the eye.) If you push the needle in too far forward, this can damage the lens, causing a severe cataract due to the intrusion of vitreous humor. If you push your needle in too far back, you risk dislodging the retina leading to retinal detachment and potential blindness.

The injections also have to be done in a sterile room, to minimise the risk of infection at the injection site. This means that patients always need to travel to a hospital or specialist clinic, which may be time consuming. It is also expensive for the NHS and there is a nationwide shortage of eye specialists who are able to carry these injections out. Nurses are now being trained to undertake this task, but there is a still an issue with trying to find enough experts who can give these injections safely.

Daily eye drops, which use specialised cell-penetrating peptides to carry the active drug through the sclera into the eyeball jelly, can be used by the patients in their own homes with minimum fuss and no pain. It could really revolutionise the treatment for Wet AMD, which in my opinion, can often be very traumatic for the patient.

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Daniel Ezra: Consultant ophthalmic and oculoplastic surgeon at Moorfield’s Eye Hospital in London
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