Lucentis Vs. Avastin: The Competition For Treatment Of Macular Degeneration 0
Treatment Of Macular Degeneration
When Lucentis was presented to the Food and Drug Administration(FDA), they approved it after a lengthy testing period. There were celebrations going on all over the eye care world. Not only had they found an effective treatment for AMD, but it would be hefty in the pocket book department. The day they received the good news was in 2006. Lucentis was a step into the technology age.
Another drug we will discuss is Avastin. If you have received a diagnosis of macular degeneration (AMD), you are well aware of these two drugs. The debate between doctors is which drug is more effective and which is proper to use. If you are using one of these two treatments, then we recommend you read this article to become more aware. Not only will you be aware, you will also be able to inform your friends and loved ones as well.
Does Avastin work as well as Lucentis in treating Macular Degeneration?
The cost of both drugs is very different. Lucentis is way more expensive than Avastin because it is FDA approved for the treatment of macular degeneration. Your cost is high for treatment with Lucentis versus a much lower cost per treatment for Avastin. Doctors argue that Avastin is just as effective as Lucentis but at a more affordable price. Besides the cost difference in the two drugs, there is another concern that arises. Avastin came into being for treatment of colon cancer and other cancers. It has not been FDA approved for the treatment of AMD and is considered “off-label” for this purpose.
Knowing this, there is not enough evidence either way to answer the question of which drug works best. Back in October of 2007, Genentech, the company which markets both drugs, had a plan. They were going to limit availability of Avastin for ocular uses. Some doctors say that the drug is as effective as, if not more so than, Lucentis, but others claim that it is not as effective.
Where the Lucentis and Avastin debate stands today
Some doctors expressed safety concerns when asked about Avastin as a macular degeneration treatment. As a matter-of-fact, they refused to prescribe it. Still, others will not prescribe anything else. The debate continues to this day about which drug works best, and it’s been found that either drug can work well. Most of the time, a patient will respond better to one drug or the other, but both Lucentis and Avastin have shown efficacy.
If you are having either one injected, you are in good shape according to most in the medical field. One is more expensive than the other, but the effects are the same. No matter which one your doctor prescribes, that treatment is right for you, but if you are having complications, let your doctor know, because there may be other issues. Have you gotten injections for macular degeneration? We’d love to hear about your experience!
Dr. Jenna Zigler
Surgical Options for Wet Macular Degeneration 0
The wet type of macular degeneration is considered advanced. Usually the eye disease begins as the dry type of macular degeneration. When the macula in the retina begins to leak blood and fluid, it becomes the wet form. The risk of partial or complete blindness increases when the disease becomes the wet form, so many options are available, from nutritional and supplement therapy to prescription drugs and surgical options.
Here are the surgical options currently available for people with wet macular degeneration:
Photodynamic therapy (PDT) was developed by researchers at the Massachusetts Eye and Ear Infirmary and approved for AMD treatment in April 2000. PDT involves a 10-minute intravenous administration of Visudyne (a light-sensitive drug) followed by a low-dose, non-thermal (light only) laser to the affected area of the retina. The drug circulates through the body's blood vessels and is particularly attracted to new blood vessels formed by the diseased macula.
The laser activates the drug, which can selectively seal off the leaking blood vessels without damaging the healthy retinal tissue surrounding them.
Thermal Laser Photocoagulation
Thermal laser photocoagulation is a process used by eye surgeons to treat a number of eye conditions, including the wet form of AMD. A thermal laser is used on the eye, focused on abnormal blood vessels growing beneath the retina. The heat from the laser closes off the unwanted blood vessels, preventing additional leakage and vision loss.
This process of thermal laser photocoagulation does not restore lost vision. In the past, it was critical that this treatment was initiated as early as possible in the course of the eye disease. Unlike PDT, thermal laser can also destroy healthy retinal tissue as it seals the leakage from abnormal blood vessel growth. Presently, thermal laser is rarely used in clinical practice to treat wet macular degeneration.
Macular Translocation Surgery
Macular translocation is a surgical procedure involves detaching the retina from the base, rotating it slightly, and replacing it in a different position so that the macula rests on a different, healthier base. While this kind of macular translocation surgery is unlikely to become standard treatment for everyone with wet AMD, it has been effective for some people when done promptly. It does not seem to work for the dry type of AMD because, for reasons not fully understood, degeneration continues in the new position. This procedure is rarely used anymore!
Undoubtedly there will be other surgical procedures developed in the future as the population continues to age. Have you had any of the above procedures?
Dr. Travis Zigler
Macular Degeneration vs. Macular Pucker or Epiretinal Membrane 1
Do you Know the Difference between Macular Degeneration and Macular Pucker/Epiretinal Membrane?
In the ever-changing world of research, many new advancements in technology have come about. These advancements have changed the way eye doctors look at macular degeneration (AMD). Also, they have changed the way they see macular pucker (MP) as well. Research started in the late 1800's and has given doctors more of an understanding of the two conditions.
In this article, we will discuss the differences between the two conditions. The point of this article is to keep you informed of the latest advancements, as well as the answers you seek. If you or your loved ones suffer from AMD or MP, then we recommend you read this article.
What Is Macular Degeneration?
AMD is an eye condition that results from damage to the macula, or the center of vision. Many people suffer from this condition and AMD is also the cause of severe vision loss in many of the elderly. The damage that AMD causes is not curable, but the condition is treatable in most cases.
Doctors today use a variety of treatment methods to slow down and stop the damage that AMD causes. Treatments often begin with AREDS2 vitamin supplementation and diet/lifestyle changes (like removing smoking from your life!) and may progress to injectable medications like Lucentis, Eylea, Macugen, and Visudyne. These are all administered in office by an ophthalmologist.
What Is Macular Pucker?
A macular pucker is scar tissue that has formed on the eye’s macula. The macula is in the center of the retina. It is one of the components in the eye that makes the eye light-sensitive. When enough scar tissue builds up, it makes the macula less sensitive to the light and may inhibit light filtration. MP (or Epiretinal Membrane) gives the appearance of wrinkled cellophane over the macula, so this condition is sometimes also known as Cellophane Maculopathy.
So now you are likely asking yourself if AMD and MP are related in any way. The answer is no. The two conditions are as different as night and day. So different in fact that they both take two different treatments. Where AMD takes supplements, laser, and injections to treat, macular pucker requires no treatment in the early stages. The blurry effects that the scar tissue has on the macula is minimal in most cases.
The condition becomes more likely as you age. The vitreous fluid in the eye shrinks and pulls away from the retina. That is what causes blurry vision in some elderly people. If the vision loss from MP is significant, extensive procedures (like a vitrectomy) can be done to treat it...but only in the most severe cases!
Macular degeneration and macular pucker are two different issues, but they can both be present at the same time. If you are having blurry vision, we recommend you visit your eye care specialist as soon as possible. Seeing your eye doctor now can reduce the risk of vision loss and ensure great vision for as long as possible. Do you have either of these conditions? Let’s hear about your experience below!
Dr. Travis Zigler
- Dr. Travis Zigler
- Tags: age-related macular degeneration AMD blurry vision damage to the macula Dr. Travis Zigler eye health inhibit light filtration Macular Degeneration Macular degeneration support community Macular Pucker Macular Pucker Epiretinal Membrane MP symptoms treaments for AMD treatments vision
Macular Degeneration or Macular Hole? What’s the Difference? 0
Macular Degeneration or Macular Hole? What’s the Difference?
Many people each year go blind or have severely impaired vision as a result of macular degeneration. Macular degeneration is a progressive eye disease, mostly associated with age, that affects millions of Americans each year. In fact, it’s the leading cause of vision loss for senior citizens in America.
What is Macular Degeneration?
Macular degeneration occurs in the macula, the region at the center of the eye’s retina. It’s the part of the eye that responds most readily to light and allows the eye to focus precisely on small regions, such as the print on a book or the pixels on a phone screen. The pigmentary cells in the macula deteriorate and break apart, leading to the buildup of a substance called drusen in the eye which impedes clear vision. Because the macula is closely associated with precise focus, you may still be able to see quite well on the periphery even as the macula breaks down.
Macular degeneration is simply the progressive breakdown of the macula over time, stemming from this “clogging” effect as drusen builds up within the eye. In contrast, macular hole is a more distinct problem. As the name implies, it is literally a hole that develops in the macula. It can begin as the result of trauma or disease, but like macular degeneration — it generally begins simply as the result of aging.
An explanation of Macular Holes
Unlike macular degeneration, which starts in the macula, a macular hole actually begins in the vitreous body, which is the “jelly” that fills your eye. As you age, the vitreous body naturally contracts over time, stressing the fibers that connect it to the retina. In addition, these miniscule fibers can break down, allowing the vitreous to move more than it should. The combination of vitreous shrinkage and degradation of the connective fibers can actually pull the vitreous body far enough away from the macula to create a small tear in the macula itself. This tear typically develops first into a macular cyst and then, if left untreated, progresses to a macular hole.
A small fraction of macular holes will actually heal themselves; for the rest, treatment typically involves a surgery called vitrectomy. In this procedure, the vitreous body is actually severed from the eye and replaced with an artificial vitreous “bubble.” This bubble presses against the macula, sealing the macular hole and enabling it to heal. As the macula heals, the eye’s cavity will refill itself with fluid and the bubble will naturally be absorbed by the eye. This process will require the patient to lie face-down for anywhere from two days to three weeks. Yikes! As you can tell, this is an extensive procedure and will only be performed if vision loss is severe. Because this is a progressive problem that can lead to serious vision impairment or loss, it’s important to discuss any vision issues quickly with your doctor if you suspect you may be developing a macular hole.
Have you ever experienced a macular hole? What did you notice?
Dr. Jenna Zigler