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
Age-Related Macular Degeneration 0
Age-Related Macular Degeneration
Age Related Macular Degeneration (AMD) is damage that occurs to the macula which is located in the back of the eye, directly at the line of sight. The macula is the part of the eye that is responsible for sharp central vision, which enables a person to pinpoint objects and recognize faces. This deterioration occurs from older age in many individuals, as the name suggests.
There are two types of AMD. The first type is dry AMD, which is characterized by a breakdown of the macular tissues which causes a buildup to form underneath the retinal layers, called drusen. If the yellow deposits of drusen increase in size, then the tissue at the back of the eye may be cut off from its blood supply. If this occurs, new blood vessels form and tend to leak. This leads to the second type of macular degeneration, which is wet or exudative AMD. Both of these types of macular degeneration can lead to devastating loss of vision.
AMD is preventative by eating approximately 2.5-5 cups of leafy, green vegetables a day which boost antioxidants and help fight free radicals that take part in the age-related breakdown of the macula. Wearing proper UV protection, a healthy exercise regimen, and not smoking may also decrease the risk of AMD. In fact, smoking increased your AMD risk by over four times!
There are vitamin supplements that are available which have antioxidants in them, such as lutein and zeaxanthin, that have been shown to help filter oxidative chemicals and harmful blue light causing damage to the macula. However, it is important to consult with an eye doctor before beginning any new eye vitamins. Our Ocular Health Formula from Eye Love is used daily with our patients and is definitely approved by us!
Patients who have dry AMD are commonly monitored with an Amsler Grid. Patients are given this grid to monitor how their vision is functioning. If they see any parts of the grid missing, or wavy lines, it may indicate that their condition is changing. If wet AMD begins, they will likely become a candidate for anti-VEGF injections. Anti-VEGF (vascular endothelial growth factor) is a drug that is used to stop new blood vessel formation in its tracks. Eylea, Avastin, and Lucentis are the names of the drugs that are successfully being used at this time. These drugs aim to preserve vision and in some cases improve sight. If you’re suffering from macular degeneration, don’t wait to begin supplements and definitely don’t delay that eye exam!
We love hearing from those with AMD and especially hearing success stories. If you’ve got one, post it in the comments below!
Rufino, Silva. Age Related Macular Degeneration . Portugal : GER Group , 2010. Print.
- Dr. Jenna Zigler
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Low Vision Aids to Help with Late Stage Macular Degeneration 0
Macular degeneration currently has no medical treatment that reverses its effects, but there are ways you can slow it down during the early stages. For those for whom the disease has progressed into a later stage and who are dealing with low vision, there are some devices that can amplify remaining vision.
All of the devices used now are based on some form of magnification. Since the central field of vision is lost with macular degeneration, magnification extends images outward from that lost central vision, making it possible to see more of what is in front than would be possible without these aids. The problem comes from each device being made for specific tasks. Reading, driving, and watching television all require a different type of magnification.
How a specialist helps
One of the first things a specialist will do is find out the most important needs of the patient. A researcher who seldom ventures away from home or who doesn’t drive would be more focused on aids to make reading and computer work easier. An adventurer, who only reads to figure out how to get from point A to point B would look for another type of device.
Next, the eye doctor will determine how much vision has been lost already. And finally, they will design a device for the person with low vision creating the right amount of magnification for the most necessary tasks to aid the person with low vision.
Types of devices
Telescopic low vision devices help with distances – near and far aids are made specifically for the wearer. These could be made to help one or both eyes depending on the needs of the patient and can help with identifying faces and facial expressions, reading, walking, playing cards, and watching television.
E-Scoop low vision glasses are considered a simplified version of telescopic low vision devices, though the E-Scoop glasses are actually very sophisticated and enhance vision significantly. They transfer images as they hit the eye to the healthy area(s) of the macula. Using these glasses, some have been able to pass their DMV driving test without problems. Others with more severe vision loss may require a telescope to pass their test and drive safely.
Microscopic low vision magnifiers make everything bigger, especially print for reading. The amount of magnification depends on the needs of the patient, and the magnifying portion of a lens is combined with the patient’s prescription lenses. They can be used for either one or both eyes. These are the best resort for patients who have run out of other options.
For those who have approximately the same amount of remaining vision in both eyes, prismatic low-vision readers afford a higher amount of magnification than can usually be found in reading glasses. A specialty eyewear lab is required to make these because most do not have the equipment to make them.
In 2010 the FDA approved another device known as the implantable miniature telescope (IMT) for those with end-stage age-related macular degeneration. This implant helps visual acuity by reducing the central “blind spot” of the patient. The implant is a telescope that is about the size of a pea. The procedure is surgical, and the natural lens is removed and replaced with the IMT in the eye capsule. After surgery, as light enters the eye, images are enlarged at three times magnification. This does not repair the damage already done; it’s purpose is to enlarge the remaining field of vision.
Have you tried any magnifiers to improve your vision? Let us know what worked best for you!
Dr. Travis Zigler
- Dr. Travis Zigler
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Are Injections For Macular Degeneration Painful? 2
There are currently no treatments for macular degeneration that completely cure the disease or even stop its progression. Research in recent years has discovered various ways to slow inevitable vision loss and, although rarely, improve vision in particular areas. Several types of treatment include laser treatment, combinations of medicines, and injection. Concerns about injections for macular degeneration being painful should be eased since they are regarded as straightforward and painless. Several injection-based treatments are detailed below.
Visudyne drug treatment is a photodynamic therapy that was the first drug therapy ever approved for the treatment of the wet form of macular degeneration. It is designated exclusively for people who have what is called a “predominantly classic” growth pattern of new blood vessels directly under the retina. An area of the arm is numbed with a painkiller after which the drug is delivered via a painless injection. Once the drug reaches the newly growing blood vessels under the retina, a low-energy laser beam is shone into the eye to activate the medication. Upon activation, Visudyne creates a chemical reaction that extinguishes unwanted blood vessels in the eye. Both the injection and the laser are considered virtually painless.
Visudyne diminishes the symptoms of wet macular degeneration and slows down the development of legal blindness in many patients. This laser-activated drug can also be administered along with other treatments, including Lucentis or Avastin.
Lucentis is actually an altered form of the colorectal cancer treatment drug Avastin. Lucentis has more recently been FDA approved as a way to treat advanced stages of the wet form of macular degeneration. In advanced stages of macular degeneration, there is an overgrowth of abnormal blood vessels triggered by a compound called vascular endothelial growth factor, or VEGF for short. The way Lucentis functions is by blocking VEGF proteins and thus preventing them from growing unnecessary blood vessels in the retina.
Most of the research surrounding Lucentis shows that it has a mostly positive effect. It was beneficial in improving, or at least stabilizing, the vision of nearly all of the people who took it. By limiting VEGF, many Lucentis users experienced improvements in vision, whereas the majority of other treatments simply stop macular degeneration from getting worse.
The way Lucentis is given is through an injection directly into the eye at monthly intervals (or as directed by your retinal specialist). Although the actual injection is considered to be painless, there have been scenarios were adverse reactions took place, such as eye inflammation, elevated eye pressure, and cataracts due to trauma. Continuing studies are required in order to fully explain the implications and side effects of taking Lucentis as an eye injection, but it is considered very safe and effective.
Macugen and Eylea
Macugen and Eylea, like Lucentis, are other forms of eye injection treatment. They both act similarly in that they attempt to stop VEGF from creating more hazardous blood vessels in the retina. Whereas Macugen is given every six weeks, Eylea is only needed once every other month (at the discretion of your doctor). Have you experienced any of the above procedures? Did they work for you?
Dr. Travis Zigler
- Dr. Travis Zigler
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