New Perspective of Biological Therapy in Treatmentof Age-related Macular Degeneration

Anti vascular endothelial growth factor (anti VEGF) therapy as a biological therapy has been introduced in the treatment of retinal vascular and exudative diseases, age-related macular degeneration, diabetic retinopathy, retinal vein occlusion and myopic choroidal neovascularization. It involves repeated intravitreal injections of anti-VEGF agents which are administered as solutions to achieve and maintain effective concentrations in the retina and choroid. The aim of the study is to determine the efficacy of Brolucizumab as an anti-VEGF agent and therapy in patients with wet macular degeneration, the duration of the drug's action, the frequency of injection and the length of the therapy in addition to stopping the progression of the disease. The study has a retrospective-prospective character and includes about 150 patients with wet macular degeneration who were treated and treated at the Italian Eye Hospital in Pristina, Republic of Kosovo. Results: Before application of Brolucizumab, the visual acuity of this group of patients ranged from 0.1 to 0.4. The majority of patients had a visual acuity of 0.1 - 130 (86.67%). Only 2 (1.33%) patients had a visual acuity of 0.4 before the treatment. After prescribing the first injection, the visual acuity ranged from 0.1 to 0.6; 97(64.67%) patients had a visual acuity of 0.1, the maximum visual acuity of 0.6 was registered in 3(2%) patients; 25(16.67%) patients had visual acuity 0.3, 21(14%) patients had visual acuity 0.2. After prescribing the second injection, visual acuity ranged from 0.1 to 0.7; 67(44.67%) patients had visual acuity 0.1, followed by individually equal number and percentage of patients with visual acuity 0.2 and 0.4 – 28(18.67%). The maximum visual acuity of 0.7 was registered in 1(0.67%) patients. After the third injection of anti-VEGF, the most frequently recorded visual acuity was 0.1, 0.2 and 0.4, obtained in 40(26.67%), 35(23.33%) and 33(22%) patients, respectively; visual acuity of 0.5 and 0.6 had a similar number, i.e. percentage of patients – 11 (7.33%) and 10 (6.67%) patients. After the third injection, a maximum visual acuity of 0.8 was achieved in 2 (1.33%) patients. After prescribing the last fourth injection, the visual acuity ranged from 0.1 to 0.8; patients after the completed treatment mostly had visual acuity 0.4, - 35(23.33%), followed by visual acuity of 0.2 – 34(22.67%) patients; visual acuity of 0.3 and 0.5 had an individually identical proportion of patients – 22(14.67%); 17(11.33%) patients had a visual acuity of 0.1, while the maximum visual acuity of 0.8 was registered in 2(1.33%) patients. Conclusion: Anti-VEGF therapy in the form of injections placed directly into the eye stops the growth of abnormal blood vessels and reduces the leakage of fluid into the surrounding tissues. In this way, swelling of the retina is reduced and vision is improved.