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
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
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Macular Degeneration: Prevention Principles You Need To Know 0
Macular Degeneration: Prevention Principles You Need To Know
Macular Degeneration is the leading cause of vision loss in people over the age of 60. It occurs when the small central portion of the retina, known as the macula, deteriorates. The retina is the light-sensing nerve tissue at the back of the eye.
There are two types of macular degeneration: dry and wet. Most of the time, Macular Degeneration begins as the dry type, but in 10-20% of cases it progresses to the wet type. Age-related macular degeneration (AMD) is almost always bilateral (occurs in both eyes), but does not necessarily progress at the same rate in both eyes. Therefore, it is possible to experience the wet type in one eye and the dry type in the other eye.
Dry Macular Degeneration
Dry AMD is known as the atrophic type, affecting approximately 80-90% of individuals with the disease. Its exact cause is unknown and it tends to progress more slowly than the wet type, but there is not an approved treatment or cure. In dry age-related macular degeneration, small white or yellowish deposits, called drusen, form on the retina beneath the macula, causing it to deteriorate over time.
Wet Macular Degeneration
The wet type of AMD, known as neovascular, affects approximately 10-15% of people with age-related macular degeneration, but it accounts for approximately 90% of all cases of severe vision loss from the disease. Therefore, the wet type of macular degeneration is considered the worse diagnosis of the two. But it’s important to remember that the dry type of AMD often progresses to the wet type.
In wet age-related macular degeneration, abnormal blood vessels form under the retina and begin to grow toward the macula. These new blood vessels are abnormal, so they tend to break and bleed, and the leaks of blood damage the macula by causing the macula to pull away from its base. This tends to cause a rapid and severe loss of central vision ability.
The FDA recently approved the Implantable Miniature Telescope (IMT) for End-Stage Age-Related Macular Degeneration. Read more about it here. This telescope does not treat the disease, but rather gives the patient some form of sight after the disease has progressed to vision loss. At this time, vitamin supplementation for dry AMD and anti-angiogenic injections for wet AMD are the best known treatments. Many clinical trials are underway to discover a more effective drug or surgical treatment for macular degeneration but at this time, it seems that prevention is the best defense against the disease.
Here’s a list of 7 suggestions that may help prevent the development of Macular Degeneration. This list is not intended to be exhaustive. There are many studies currently exploring natural ways of preventing and treating AMD.
- Quit smoking!
- Eat plenty of dark, leafy green vegetables, such as raw spinach.
- Eat fish or take a fish oil supplement.
- Exercise regularly, maintaining a healthy weight.
- Eat fruit and nuts daily.
- Reduce intake of refined carbohydrates.
- Control blood pressure and cholesterol.
If you are currently suffering from Macular Degeneration, or know someone who is, take solace in the fact that the medical community is committed to finding an effective cure for this disease. If you are concerned about developing AMD, there are many actions for prevention that can be utilized as well. Comment below if you or someone you love suffer from this awful disease. What have you found to treat it or cope with the vision loss?
Dr. Jenna Zigler
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Avastin: Reliable Vision Improvement For AMD Patients 0
Avastin: Reliable Vision Improvement For AMD Patients
The wet type of age-related macular degeneration (AMD), which occurs when the disease has progressed from the dry type, is one of the leading causes of blindness in the United States, according to the Center for Disease Control (CDC).
The drug Avastin is used to treat the wet type of macular degeneration. According to amd.org, “Avastin was developed by Genentech to treat colon cancer. It uses the same antiangiogenic approach to stop the growth of blood vessels to the cancer tumor.”
What is Avastin?
Avastin is the brand name for “bevacizumab,” a drug injected into the eye in order to slow vision loss in people who have wet AMD. Avastin is part of a class of drugs that block the growth of abnormal blood vessels, which are the cause of wet AMD. Avastin is also used to treat macular edema, swelling of the macula, which is often associated with diabetic retinopathy. Since Avastin was approved as a cancer treatment, this use of the drug is considered “off-label” use but this is permissible if a drug is demonstrated to be effective for treating other diseases.
According to the American Academy of Ophthalmology, when asked about the risks of injecting Avastin into the eyes to treat AMD, Dr. Richard Bensinger responded, “Avastin has been a terrific improvement in the treatment of wet macular edema and bleeding as well as new disease states of the eye, which seem to be introduced each day.” The list of potential side effects is long and concerning, as with any cancer treatment, but the amount used to treat the eye is very small, also reducing the risks of side effects.
What are the side effects of Avastin?
Avastin can cause infection in the eye as well as bleeding and inflammation, but these are uncommon. It can also cause the pressure in the eye to rise as well as increase the risk of cataracts but again, these occurrences are rare.
In addition to Avastin, there is another drug frequently prescribed called Lucentis (ranibizumab). It received FDA approval in late June 2006 and the new macular degeneration drug was celebrated as a major breakthrough. Many Americans with the more severe or wet forms of AMD endure gradual loss of central vision. In clinical trials Lucentis has been shown to stop and, in many cases, reverse at least some vision loss. These findings clearly indicate Lucentis is the most effective FDA-approved treatment currently available for AMD.
But some eye doctors suggest that Avastin remains just as effective and is a more realistic option for lower-income people with advanced AMD. The issue remains that Avastin is approved by the FDA only for treatment of colon and other cancers, but not for AMD. Many eye doctors have been using Avastin off-label to treat advanced AMD. Like any treatment plan, one should investigate not only the available options but the risks and side effects of each option in order to make the most informed decisions. Do you suffer from AMD? Have you undergone injections to treat it?
Dr. Jenna Zigler
We would love for you to join our Macular Degeneration Support Community on Facebook.