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Age-Related Macular Degeneration: Evolution in Treatments

Created May 16, 2016 by in Retina Specialist
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Age-Related Macular Degeneration (ARMD) is one of the most common causes of central vision loss in adults over the age of 65. This disease affects the macula, which is the central portion of the retina, and allows us to see fine detail to the level that we can. The disease is divided into the wet and dry form. The wet form causes the greatest amount of vision loss and is associated with abnormal blood vessels and bleeding. When a patient has macular degeneration, the central vision becomes distorted, sometimes to the degree that the large letter “E” on the eye chart can no longer be seen.

The reason we can now say “sometimes” is because there has been a revolution in just the past 10 years in the way we are able to treat the wet form of this disease. Medications like Avastin, which is part of a drug class that prevents the abnormal growth of blood vessels, was originally created to treat cancer, and is now the most common drug used in those with wet ARMD.

Prior to the advent of this treatment, the only other option was applying a laser to the abnormal blood vessels, in hopes that the damage from the laser would be less than the natural course of the disease. Most patients would end up with 20/400 vision, which is not good enough to drive or perform many day-to-day functions. With these new medications however, one-half of all patients maintain 20/40 or better vision. This means that these patients are now able to legally drive, greatly improving their quality of life.

For those of you who have friends or relatives with this disease, you may have heard that this medication is delivered by an injection into the eye. This may be true, but not nearly as barbaric as it may seem. We use a very small needle and apply generous numbing medication prior to performing the procedure. The most common response from patients after their first injection is: “That’s it?”

There are some downsides to this treatment, with the frequency of needing an injection being the most common complaint. Future treatment options look to decrease the number of injections a patient may need while still maintaining the same level of efficacy.

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