Macular Degeneration

Macular Degeneration Diagnosis and Treatment

Age-related macular degeneration (AMD) is a chronic condition that causes central vision loss. It affects millions of Americans. In fact, it is a leading cause of blindness in people 60 and older. The older you are, the greater your chance of being affected. That’s why it’s important to learn the symptoms of AMD now, so if you ever notice anything wrong, you can see an ophthalmologist right away.Early detection is key to avoiding vision loss.

LEARN THE SYMPTOMS SO YOU KNOW WHAT TO LOOK FOR

AMD symptoms include blurriness, wavy lines, or a blind spot.

You may also notice visual distortions such as:

bulletStraight lines or faces appearing wavy
bulletDoorways seeming crooked
bulletObjects appearing smaller or farther away

If you notice any of these symptoms, you should see an ophthalmologist as soon as possible. If you are diagnosed with wet AMD, it is important to see a Retina Specialist for the most appropriate care.

AMD occurs when the macula—the central portion of the retina that is important for reading and color vision—becomes damaged. AMD is a single disease, but it can take 2 different forms: dry and wet.

Wet AMD is the more serious form, with more than 200,000 people in the United States diagnosed every year. Without treatment, patients can lose their central vision over time, leaving only peripheral, or side, vision. The symptoms can occur suddenly or gradually over time.

Early detection and treatment can help you avoid severe vision loss.

 

         wet macular degeneration, macular degeneration, ARMD

How is Wet AMD treated?

Wet AMD can be treated with laser surgery and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment.

bullet Laser surgery.This procedure uses a laser to destroy the fragile, leaky blood vessels. A high energy beam of light is aimed directly onto the new blood vessels and destroys them, preventing further loss of vision. However, laser treatment may also destroy some surrounding healthy tissue and some vision. Only a small percentage of people with wet AMD can be treated with laser surgery. Laser surgery is more effective if the leaky blood vessels have developed away from the fovea, the central part of the macula. (See illustration at the beginning of this document.) Laser surgery is performed in a doctor’s office or eye clinic.

The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary. In some cases, vision loss may progress despite repeated treatments.

 
bullet Injections. Wet AMD can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor.

You will need multiple injections that may be given as often asmonthly. The eye is numbed before each injection. After the injection, you will remain in the doctor’s office for a while and your eye will be monitored. This drug treatment can help slow down vision loss from AMD and in some cases improve sight. The two most common injections treatments used by the Idaho Eye Center are Avastin and Lucentis.

About Avastin

Treating the wet form of macular degeneration with Avastin provides hope for the more than 10million Americans suffering from the incurable eye disease, according to the American Macular Degeneration Foundation. Known for its cancer-fighting abilities, Avastin retards the growth of abnormal blood vessels in the rear portion of the eye.

How Avastin Treats Macular Degeneration

Inhibiting the growth of blood vessels in the retina is the main purpose of Avastin, according to the American Macular Degeneration Foundation. Leaking blood vessels in the retina cause vision loss, or blurred spots, for wet macular degeneration patients. Administering Avastin through an IV drip works to reduce the growth of these cells. Given as an off-label drug, Avastin had not been FDA-approved for the treatment of macular degeneration. Used primarily for the treatment of cancer, Avastin has not been tested for ophthalmic uses.

When to Use Avastin for Macular Degeneration

Used within the first six to 12 months of onset, patients with macular degeneration may see a slowing in the process of the eye disease. Avastin is not a cure, simply a treatment, to slow the growth of blood cells. Avastin is a name brand formula of bevacizumab manufactured by Cerner Multum, Inc.

Improvement of vision within a week is the top selling point for patients investigating Avastin for ocular treatment. Dr. Rosenfeld also noted restoration of the ocular cells after treatments of Avastin, making the treatment desirable.

Warnings Regarding Avastin

Starting Avastin as a treatment of macular degeneration should be carefully considered. Wait at least four weeks, or until the incision is completely healed, from any type of surgery before beginning this regime. Known to cause increased bleeding and infection, Avastin may delay post-operative healing.

Labeled as pregnancy category C by the FDA, Avastin has not been determined safe for pregnant or lactating mothers. It is unclear if the drug can be passed to newborns through breast milk.

On rare occasions, Avastin has been known to cause neurological disorders that affect the brain. Common side effects include feeling light-headed, faint or dizzy. Used primarily with cancer patients, Avastin has been documented to cause an increased risk of heart attacks and strokes
.

About LUCENTIS®(ranibizumab injection)

LUCENTIS is an FDA-approved treatment for wet age-related macular degeneration (AMD). LUCENTIS is an injection given into the eye. Before you get your LUCENTIS injection, your eye will be prepped—or cleaned thoroughly—to help you avoid eye infections. Then your retina specialist will numb your eye to limitany discomfort you might feel. Many people who get injections for wet AMD feel some pressure on their eye. Most of the time this pressure is all you will feel. After your retina specialist gives you the injection, the pressure should go away.

Who is LUCENTIS for?

LUCENTIS®(ranibizumab injection)is a prescription medicine for the treatment of patients with wet age-related macular degeneration (AMD).

What important safety information should I know about LUCENTIS?

Like any prescription medication, LUCENTIS is not for everyone. You should not use LUCENTIS if you have an infection in or around the eye.

Like other injections given into the eye, serious eye infection (endophthalmitis) and detached retina have occurred with LUCENTIS. Increases in eye pressure have been seen within 1 hour of an injection. Your eye doctor should monitor your eye pressure and eye health during the week after the injection.

If your eye becomes red, sensitive to light, painful, or has a change in vision, you should seek immediate care from your eye doctor.

Although uncommon, conditions associated with eye- and non-eye-related blood clots (arterial thromboembolic events) may occur.

Serious side effects related to the injection procedure were rare. These included serious eye infection, detached retina, and cataract. Other uncommon serious side effects included inflammation inside the eye and increased eye pressure.

The most common eye-related side effects were red eye, eye pain, small specks in vision, the feeling that something is in your eye, and increased tears. The most common non-eye-related side effects were nose and throat infection, headache, and respiratory and urinary tract infections.

LUCENTIS is for prescription use only. Individual results with LUCENTIS may vary.

How is Dry AMD treated?

Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage, in which vision loss occurs.

The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking a specific high-dose formulation of antioxidants and zinc significantly reduces the risk of advanced AMD and its associated vision loss. Slowing AMD’s progression from the intermediate stage to the advanced stage will save the vision of many people.