Anti-vascular endothelial growth factor (VEGF) therapy is highly successful, but as Raj Maturi, MD, pointed out, also has some limitations.
With anti-VEGF therapy, visual acuity deteriorated by more than 2 lines at 5 years after the start of treatment compared with the peak at 2 years. Another challenge is that intraretinal fluid was present in 60% of patients after 5 years, despite treatment, which resulted in worse visual acuity outcomes, he noted.
In addition, some evidence indicates that monthly injections of anti-VEGF drugs increase the development of geographic atrophy, according to Dr. Maturi, who is in private practice, Midwest Eye Institute, Indianapolis.
Dr. Maturi suggested there might be a benefit in discovering alternative treatments.
Sirolimus (also known as rapamycin; DE-109, Santen Pharmaceutical Co.) might be an acceptable alternative, according to Dr. Maturi.