What are Syfovre and Izervay?
Syfovre and Izervay are medications used to treat geographic atrophy (GA) caused by dry-type age related macular degeneration (AMD). It is given by injection into the eye.
What is geographic atrophy (GA)?
Geographic atrophy is a common cause of loss of central vision in AMD. It occurs when retinal receptor cells die. GA leaves blinds spots and missing areas in the vision. It is different from wet AMD. Until now, there was no treatment for geographic atrophy from AMD.
How do Syfovre and Izervay work?
Syfovre and Izervay block the complement proteins in the body. Complement is involved in the normal inflammatory response of the body. The inflammatory response is important to fight infection. However, in AMD the complement proteins appear to be involved in the development on geographic atrophy and loss of vision.
How well do Syfovre and Izervay work?
Syfovre and Izervay are not cures for dry AMD. They do not reverse the past damage by geographic atrophy. Syfovre and Izervay, when given by monthly injection, was shown to reduce the rate of worsening of geographic atrophy by a small amount in a two-year study.
What are the adverse effects of Syfovre and Izervay?
As with all intraocular injections there are risks. The risks involved with the introduction of a needle into the eye include bleeding, inflammation, infection, and retinal detachment. These problems may require surgery and risk loss of vision. The known risks of Syfovre and Izervay include the new start of wet AMD threatening loss of vision. This appears to occur in 10-20% of eyes. This risk of new wet AMD may be reduced by avoiding treatment in high-risk eyes. It is important to avert the development of new wet AMD because the treatment of wet AMD involves routine, long-term injection of another medication to prevent severe loss of vision.
There is a risk of infection (endophthalmitis) after any eye injection. There is some concern that Syfovre and Izervay may increase the risk of developing infection or worsen the final vision after infection. The suppression of the natural defense against infection by both of these drugs, explains the concern over increased risk of infection. Not surprisingly, similar drugs given systemically have been shown to increase the risk of infection outside the eye.
Which is better: Syfovre or Izervay?
There have been no studies to date directly comparing Syfovre and Izervay. However, Syfovre has rarely been associated with loss of vision from ischemic optic neuropathy (1-2%) and ischemic retinal vasculitis (~1 in 10,000). To date it is not known if Izervay also shares this adverse effect. Regardless, some doctors prefer Izervay because the injection may be given with a finer needle (i.e. it is less viscous), making the injection more comfortable compared with Syfovre.
The decision to use Syfovre or Izervay with the intent to slow the progression of dry AMD (geographic atrophy) must be weighed against the potential adverse effects in any given patient. Your doctor will help you decide.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida.
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