New Breakthroughs in Treating Advanced Dry Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is among the most common eye conditions in older adults, affecting roughly 30 percent of people aged 60 and above to some degree. About 10 percent of these individuals progress during their lifetimes to the advanced dry form known as geographic atrophy (GA).

"In the early stages of dry macular degeneration, deposits called drusen form in the outer layer of the retina," explains Prof. Omer Trivizki, deputy head of the ophthalmology department and director of the research and innovation unit at the Tel Aviv Sourasky Medical Center (Ichilov). "In most cases, there are no symptoms, so many people remain unaware until they undergo an examination by an ophthalmologist."

While some patients progress to the wet form treated with intraocular injections, others develop GA. This advanced stage involves the death of outer retinal layers, including photoreceptors—critical cells essential for normal vision. The condition creates a "dead island" of the retina, impairing vision, daily functioning, and patient independence.

Breakthroughs in Treatment and Clinical Research

For years, physicians had virtually nothing to offer patients at the advanced dry stage. However, following decades of research costing tens of millions of dollars, the landscape is shifting. In 2023, two medications targeting the complement system—part of the immune system involved in inflammation and tissue damage—were approved in the United States. Clinical trials indicate that these treatments slow the progression of the disease by approximately 20 percent annually through monthly or bi-monthly intraocular injections.

One of the therapies has also received approval in Japan and Australia, alongside preliminary approvals in Switzerland and for registration in Israel. Prof. Trivizki emphasizes the importance of setting realistic expectations, noting that the treatment slows progression rather than halting it entirely, and requires consistent administration to maintain its effects.

Prevention and Early Detection

Prof. Trivizki highlights that the disease is multifactorial with a genetic component. He urges individuals aged 50 and older, particularly those with a family history of retinal degeneration, to undergo dilated eye examinations with a retinal specialist. Preventive measures include avoiding smoking, adopting a diet rich in green vegetables, and taking specialized vitamins in advanced stages upon a physician's recommendation.

To drive future innovations, the I-DARE Israeli Dry AMD Research And Excellence Center was recently established within Ichilov's ophthalmology research unit. The center participates in global clinical trials and long-term studies, aiming to identify high-risk subgroups and develop advanced therapies, including gene and cell treatments.