New drug approved in U.S. for treatment of macular degeneration

Blog vol 4.19. New drug approved in U.S. for treatment of macular degeneration.


One of my patients has been arranging to get a new treatment, an FDA-approved drug which will hopefully slow down his worrisome macular degeneration. Macular degeneration is a disease of the central retina that affects the most crucial part of vision. It can be devastating, with large central vision losses and consequently, life restrictions, the most disturbing being in driving and reading.


There have been many advances in treatments in the last few decades, the most notable being AntiVgef injections for wet macular degeneration. So far there has been very little help for the dry type of the disease, until now. (Simply, there are two types of macular degeneration: “wet” and “dry”.)


We routinely recommend that patients take daily doses of lutein, zeaxanthin, and other carotenoids to slow both types of macular degeneration down. Frustratingly, some patients progress to full-blown macular atrophy in spite of our best efforts. These unfortunate few have “geographic” atrophy: a lot of retinal cells and underlying blood vessels in and around the macula are damaged. 


There are approximately 1 to 1.5 million people in the USA who have this condition and as many as 5 million worldwide. In the past year, two new drugs have been approved by the FDA. They are Syfovre and Izervay.  These drugs work on the complement system that breaks the retina down.


Syfovre’s drug name is pegcetacoplan and it binds to C3 and slows down compliment activation to C3b. Izervay, or avacincaptad pegol, binds to C5 and blocks the activation to C5a and C5b. Both these drugs must be injected in the eye monthly, nobody’s idea of a good time, but clinical trials for these drugs show a slowing of atrophy progression by as much as 35% in the first year. Very significant.


Patients eligible for the drug must have geographic atrophy and cannot have any subfoveal (an area under the macula) involvement. Do note that these new drugs do NOT reverse existing atrophy, they only slow it down. Health Canada will hopefully approve these new drugs soon.


My patient is very proactive and seeking treatment at an American Retinal clinic as we speak. Cannot blame him.  Wonderful news for a nasty condition.         


Til next week,  



 

the good doctor


The good doctor take a deeper look at how gut health is connected to eye tissues.
By Dr. Mark Germain April 29, 2026
Blog vol 6.40. The Gut and the Eyes. One of my biggest jobs is to keep abreast of new research and advances in eye health. Most recently, we have seen new stem cell research, gene therapies, as well as new drugs for dry and wet macular degeneration. In January of this year, there was an article in the journal, Cell Death and Disease, that looked at cell apoptosis, specifically with the photoreceptors of the eye. (Read the article here ). Apoptosis is the genetic programming of deliberate and constructive cell death, allowing for the maintenance of healthy structures and systems in the body. Some estimates have the body replacing 50 to 70 billion cells daily by this process. Necrosis, on the other hand, is unplanned cell death caused by injury, toxins, or other negative outside factors; this causes inflammation and disrupts the body’s balance of things. There are stressors that speed up cell turnover. The study looked at photoreceptors in the retina and were able to demonstrate cellular recovery, even in late stages of apoptosis, recovery not breakdown. When certain stressors were reduced, by working with the mitochondria, there was recovery of the photoreceptor cells. How? Mitophagy, the mitochondria’s own process of programmed breaking down and then repurposing the recycled components for new ones. This mitochondrial repair helps to reverse the sequence of apoptosis for the photoreceptors. Mitochondria, how cool. How is this helpful for our eyes? Conditions like retinitis pigmentosa or macular degeneration directly involve the photoreceptors and may be slowed or reversed by helping the mitochondria. So, let’s take care of those mitochondria. There is some evidence for nutritional support for the mitochondrial system. The nutrient, Urolithin A (UA), which is a compound made in our gut from fiber found in pomegranates, berries, and nuts is the only clinically proven substance known to trigger mitophagy, made in the gut no less. Vitamin B3 is critical for mitochondria function, however vitamin B3 based supplements are still to be clinically tested for their support of cell recovery. Nutrients Coenzyme Q10 and L-carnitine are known to help the mitochondria generate energy, and interestingly, infrared light therapy has also been shown to benefit mitochondrial function. Again, food for thought. The gut and its function needs a lot of research. How do probiotics and nutrient precursors affect eye tissues? It is so interesting that the gut can be a factor in eye health. Maybe adding Urolithin A as a supplement is wise, along with the antioxidants in Lutein and Zeaxanthin we use to combat photoreceptor degeneration. Will keep you posted on any new developments.  The good doctor
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