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New medication for those who have Macular Degeneration In the last couple of years there has been several new medications that have become available for those who have the wet form of macular degeneration. Drugs such as Macugen, Lucentis, Avastin and now Eylea all belong to a class of drugs called anti-VEGF drugs or anti-angiogenesis drugs. The use of anti-VEGF therapy has become standard therapy for the treatment of wet macular degeneration (AMD). Angiogenesis is the formation of new blood vessels. Vascular Endothelial Growth Factor (VEGF) is a hormone that is produced by cells that are deprived of oxygen. Anti-VEGF medications work by blocking or preventing the growth of new, leaky, capillaries that cause the macula to raise which results in distorted vision. However, for anti-VEGF medications to work they need to get to the area where the fragile blood vessels are located - the back of the eye. Which is why retina doctors have to give the drug through an intra-ocular injection, an injection right into the eye. Not only does the injection have to be given into the eye, it needs to be done repeatedly. There are different schedules for different patients but the injections can be given as frequently as once a month. Patients’ reaction to the eye injections vary. While some patients find it to be a little more than an annoyance, other patients experience severe pain that may last for most of the day. A New Mirconeedle For Wet Macular Degeneration A new technology is being developed right in my hometown of Atlanta. A collaboration between Georgia Institute of Technology and Emory Eye Center is leading two researchers into developing a way to deliver drugs to the back of the eye more efficiently and more effectively. Dr. Mark Prausnitz, Professor of Chemical and Biomolecular Engineering at Georgia Institute of Technology and Dr. Henry Edelhauser, a drug delivery expert at Emory Eye Center are working on a new needle called a mirconeedle. Currently anti-VEGF drugs are given using a hypodermic needle. “For comparison, the microneedle is about as long as a regular hypodermic needle is wide. It enables us to reach not just the eye in general, but specific places in the eye - exactly where the medication needs to be, “ states Dr. Prausnitz. The microneedle is shorter and much less invasive, yet it can reach the suprachoroidal space which lies between the sclera and the choroid. Dr. Edelhauser explains, “We found that the fluorescent particles had spread throughout the suprachoroidal space. Since that space expands when filled with liquid, it makes an ideal pipeline where fluid can move to the back of the eye, toward the macula. “ Find out about other new developments in the treatment of wet macular degeneration by going to: Wet Macular Degeneration Clinical Trials Leslie Degner, RN, BSN Better Health for Better Vision
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Medical treatment or cure to reverse advanced macular degeneration?
While there is no medical treatment or cure to reverse advanced macular
degeneration, there are several different companies that are developing
retinal implants that help to restore some of the vision that is lost due to the
degeneration or death of photoreceptor cells. The technology for these
implants vary and each implant is designed to work differently. The macular
degeneration telescope, developed by CentraSight has been in research
for several years at 28 eye centers across the United States. The small
device is implanted in one eye and functions as a telescope, magnifying
one’s vision 2.2 to 2.7 times.
Much like cataract surgery, the actual procedure is done as an outpatient
surgery and takes about one hour. The surgery is done by an
ophthalmologist who is a corneal/cataract surgeon who has been specially
trained in implanting the telescopic device. Only one eye is implanted with
the telescope. However this is where the similarity to cataract surgery ends.
Those who are candidates for the implant or telescope must go through
four different steps to ensure a successful outcome. They are diagnosis,
screening, implanting, and training.
Once a confirmed diagnosis is made of advanced macular degeneration in
both eyes, a low vision specialist performs a simulation with external
telescopes. At this time the patient and the low vision specialist get an idea
of how the patient’s vision will improve with the telescope and the patient
better understands how the implant requires an adjustment to a new way of
seeing. The screening process allows the patient to better grasp how their
vision will improve with the implanted telescope and to manage their
expectations. If the patient meets the candidate requirements and if he/she
and the low vision specialist agree that the telescope offers an
improvement in vision, there is still another important consideration. The
patient needs to understand and agree to low vision rehab after the implant
procedure to help the patient use their new vision effectively. The low vision
specialist will also help the patient maximize their new usable vision by
combining it with other low vision aids, magnifiers and glasses.
Unlike those who have cataract surgery and find that their cloudy, blurry
vision is suddenly clear after surgery, those who have the macular
degeneration implant need to be trained in how to “see” with this new
device. The eye with the implant is used for straight ahead vision, while the
the other eye is used for peripheral or side vision. Training by a low vision
specialist is needed to adjust to using the telescopic device.
Find out what kind of vision improvement was found in the research studies
and how this macular degeneration implant impacted patient’s quality of
life:
Macular Degeneration Implant
Better Health for Better Vision
Leslie Degner, RN, BSN
