Two New Drugs Offer First Real Hope for Dry AMD—Here's What You Need to Know

For the first time in history, people with late-stage dry age-related macular degeneration (AMD) have treatment options that can slow their vision loss. The Food and Drug Administration (FDA) approved two groundbreaking drugs in 2023—Syfovre and Izervay—that target the immune system to preserve sight in patients with geographic atrophy, the advanced form of dry AMD.

What Makes These Drugs Different from Previous Treatments?

Unlike wet AMD, which has had effective treatments since 2005, dry AMD has remained largely untreatable until now. These new medications work by targeting the complement pathway, a part of the immune system that normally protects against infections but can go haywire and attack healthy retinal tissue in AMD patients.

The breakthrough came from years of research funded by the National Eye Institute, starting with a 2005 discovery that linked complement factor H (CFH) genes to AMD risk. "This is truly an exciting time for the field and underscores the importance of basic and translational scientific research," said National Eye Institute Director Michael F. Chiang, M.D..

How Effective Are These New Treatments?

In clinical trials, both drugs demonstrated meaningful but modest benefits for slowing disease progression:

• Syfovre (pegcetacoplan): Monthly injections decreased the rate of retinal lesion growth by 18-22% over two years when administered directly into the eye
• Izervay (avacincaptad pegol): Monthly treatments reduced lesion growth by 14% over one year, targeting a different part of the complement system than Syfovre
• Treatment limitations: Neither drug improves existing vision or prevents all vision loss—they simply slow the progression of geographic atrophy

Geographic atrophy affects approximately 1.5 million Americans with vision-threatening AMD out of the estimated 20 million total Americans living with some form of the disease.

What Are the Risks and Side Effects?

Both treatments come with important safety considerations that patients must discuss with their retinal specialists. The most concerning risk is that patients receiving either drug face an increased chance of developing wet AMD, which progresses faster than dry AMD but has more established treatments available.

Additionally, Syfovre has been associated with a very rare but potentially severe inflammatory reaction called occlusive retinal vasculitis since its FDA approval. "Small effects of these drugs on geographic atrophy are not surprising, as these molecules are targeted to one complement component," noted researcher Anand Swaroop, Ph.D., explaining that AMD is a complex condition involving multiple genetic factors.

The treatments require regular eye injections, similar to current wet AMD therapies, which can be challenging for elderly patients who may have difficulty maintaining frequent medical appointments.

Looking ahead, researchers emphasize the need for long-term studies to fully understand these treatments' benefits and risks. "We're at the very early stages," said Rajendra Apte, M.D., Ph.D., from Washington University in St. Louis, comparing the current moment to early laser therapy developments for wet AMD.