The Future of AMD Treatment: Could a Single Injection Replace Monthly Eye Injections?
For millions suffering from neovascular age-related macular degeneration (AMD), the reality is a lifetime of frequent, and often uncomfortable, injections directly into the eye. But a recent breakthrough presented at the Academy 2025 conference suggests a radical shift is on the horizon: a one-time subretinal injection that could dramatically reduce, and in many cases eliminate, the need for ongoing anti-VEGF therapy. Data reveals that Sura-vec, an investigational gene therapy, reduced the annualized anti-VEGF injection rate by up to 77% in a Phase 2 trial, offering a potential paradigm shift in how we treat this leading cause of vision loss.
How Sura-vec Works: Turning the Eye Into Its Own Pharmacy
Currently, patients with wet AMD require regular anti-VEGF injections to block vascular endothelial growth factor (VEGF), a protein that causes abnormal blood vessel growth in the retina. These vessels leak fluid and blood, leading to vision impairment. Sura-vec takes a different approach. “It turns on the gene for anti-VEGF in the eye, so the eye can make its own anti-VEGF,” explains Mary Beth Yackey, OD, of the Cincinnati Eye Institute and lead author of the study. This means the eye essentially becomes its own drug factory, continuously producing the necessary medication, rather than relying on repeated external injections.
Phase 2 Results: Significant Reduction in Injection Burden
The Phase 2 trial involved 60 adults with previously treated neovascular AMD. Participants received either a high or low dose of Sura-vec via a subretinal injection following vitrectomy surgery. The results were compelling: after one year, 53% of patients in the high-dose group and 60% in the low-dose group were free from the need for any further anti-VEGF injections. On average, the annualized injection rate was reduced by 76% with the high dose and 77% with the low dose. This translates to a significant improvement in quality of life for patients, reducing treatment burden and the associated risks of frequent injections.
Navigating the Surgical Procedure and Potential Side Effects
While promising, Sura-vec isn’t without considerations. The delivery method – a subretinal injection following vitrectomy – is a surgical procedure. The study reported seven serious adverse events, none of which were deemed drug-related. A common side effect observed in nearly all patients (97% high-dose, 90% low-dose) was peripheral retinal pigmentary changes at the injection site. Dr. Yackey explains this is expected, as the procedure involves a temporary detachment of the retina to allow for accurate medication delivery. Interestingly, the study also pinpointed the inferior injection site as optimal, minimizing the risk of vision impairment due to drug settling on the macula.
Beyond AMD: The Potential of Gene Therapy in Ophthalmology
The success of Sura-vec highlights the growing potential of gene therapy in treating a range of ophthalmic conditions. While this particular therapy focuses on AMD, the principle of delivering genes to the eye to produce therapeutic proteins could be applied to other diseases, such as diabetic retinopathy and inherited retinal dystrophies. This approach offers the possibility of long-lasting treatment effects with a single intervention, potentially revolutionizing the field of ophthalmology. The National Eye Institute provides further information on AMD and ongoing research.
What This Means for Optometrists and Patients
Dr. Yackey emphasizes that optometrists should be aware of this emerging treatment option. While ophthalmologists will administer Sura-vec, optometrists play a crucial role in monitoring patients and identifying those who might benefit from this therapy. The potential for reduced injection frequency will undoubtedly impact patient management and improve adherence to treatment plans. The future of AMD treatment is looking brighter, offering hope for a less invasive and more sustainable approach to preserving vision.
What are your thoughts on the potential of gene therapy to transform eye care? Share your perspective in the comments below!
