Age-related macular degeneration (AMD) is the leading cause of vision loss among people age 60 and older. Both wet (bleeding) and dry (non-bleeding) forms of AMD cause the central retina, or “macula” to deteriorate, leading to severe loss of central vision.
What Causes Macular Degeneration?
The leading cause of AMD is genetic; however, poor diet, smoking, and sunlight exposure also play a part. At Bloomberg Eye Center in Columbus and Newark, Ohio, we advise our patients to take multivitamins and to wear protective sunglasses to reduce their risk of developing AMD.
For patients who have developed advanced AMD, new drugs have been successful in preventing further vision loss, and in some cases can even improve vision.
Photodynamic Therapy with Visudyne® (“Cold Laser”)
Photodynamic therapy combines the use of Visudyne®, a photo-sensitive drug, and a “cold laser” to treat AMD. At Bloomberg Eye Center, we have been using photodynamic therapy since 2001 for the treatment of AMD, and Dr. Shahinfar took part in the national clinical investigations of Visudyne®, prior to its FDA approval.
Treating AMD with Medications
Ever since the development of new anti neo-vascular agents, injectable drugs have become the mainstay of treatment for macular degeneration.
Approved for treatment of colorectal cancer, Avastin® has found an off-label use in the treatment of AMD at a much lower cost than other types of treatment. This drug has to be administered as an eye injection multiple times for best results. Intra-ocular injections are routinely done in our office with topical anesthesia to reduce discomfort. Most people receive a few monthly injections until retinal leakage has stopped, and are then observed for recurrence. Avastin® has also been found useful in the treatment of vascular occlusions and diabetic eye disease.
LUCENTIS® is related to Avastin® and has been developed and marketed for the treatment of wet AMD. The cost of LUCENTIS® is much higher than Avastin® . Studies show that patients receiving monthly intraocular injections of both LUCENTIS® and Avastin® may actually gain vision and maintain that over time.
Recently approved by the FDA, EYLEA® is part of a new class of drugs intended to suppress abnormal vascular growth that occurs in AMD. The drug has to be injected multiple times for continued efficacy, but at longer intervals than either Avastin® or LUCENTIS®.
This is an injectable slow-release steroid used to reduce macular edema associated with vascular occlusions, diabetic retinopathy, and sometimes macular degeneration. The effect can last several months, but may need to be repeated. Side-effects may include cataract formation and glaucoma.