Age-related macular degeneration (AMD) is a major cause of blindness in individuals older than fifty-five. It is a progressive disease in which there is damage to the macula, the central area of the retina. A functioning macula is needed for sharp central vision required for reading and driving. Most cases of vision loss occur in individuals with advanced AMD, and almost all of these are associated with the wet form of AMD. In wet AMD, abnormal blood vessels grow under the macula, leaking fluid and blood, causing swelling and damage to the retina.
Introduced in 2006, Lucentis (ranibizumad) cannot cure AMD but can very effectively stop its progression by preventing the growth of new blood vessels by inhibiting vascular endothelial growth factor (VEGF). When injected directly into the eye at four-week intervals, this biologic drug stabilizes vision in 95 percent of patients and may, in some cases, be able to partially restore lost vision.
Genentech developed Lucentis specifically for the treatment of AMD. It is a fragment of the larger drug Avastin (bevacizumad), which is also a VEGF inhibitor and Genentech product. The smaller Lucentis molecule is thought to better penetrate the retina and stop the abnormal growth of blood vessels. Avastin is an anticancer drug that has been widely used around the world for AMD before and since the approval of Lucentis, with excellent results.
Why use Avastin instead of Lucentis? Lucentis costs forty times more than Avastin—$1,593 per dose vs. $42 per dose! Genentech’s attempt to restrict the sale of Avastin for use in the eye has been largely unsuccessful and has generated considerable ill will among eye doctors.
In 2011, a large-scale, two-year National Eye Institute–funded study directly comparing the two drugs found that both drugs are just as effective in preventing AMD and improving vision, although Lucentis may cause slightly fewer side effects.
SEE ALSO Avastin (2004).
Hospital Corpsman Brian Long attempts to read a standard eye chart from twenty feet with the help of an optical refractor aboard the USS John F. Kennedy. Whereas infections are common causes of blindness in developing countries, blindness is often attributed to age-related macular degeneration (AMD), which, in developed nations, can be treated with drugs like Lucentis if diagnosed early enough.