If your doctor approached you with a needle and said, “I’m just going to stick this in your eye,” you’d probably think he was joking. But if you have a particular kind of macular degeneration, injections in the eye may be just what the doctor ordered.
Defining Macular Degeneration
Age-related macular degeneration or AMD is a condition that causes gradual loss of the sharp, center part of your vision that is necessary for activities such as reading and driving. When light enters the eye, it passes through the cornea and lens and is focused on the retina which is the inner lining on the back of the eye. The retina contains special cells that act as light receptors. The macula is the center portion of the retina which allows you to see fine details. In macular degeneration, the macula becomes damaged and blank spots appear in the vision. It may appear as though there is a hole or black spot in the center of your vision.
Types of Macular Degeneration
There are two types of AMD:
• Dry AMD- Most patients have what is known as dry macular degeneration, which can be a normal byproduct of aging as tissues in the eye become thinner.
• Wet AMD - Approximately 10 percent of macular degeneration cases are the wet form of the disease. This type of AMD is caused by new blood vessels that are formed in the retina of the eye and which leak blood and fluid into the eye. This causes damage to the light sensor cells in the retina, which creates blind spots in the central vision.
Macular Degeneration Treatment Injections
Wet AMD develops as a result of abnormally high levels of a specific growth factor in the eye that trigger the development of new blood vessels. Treatments are now available to stop new blood vessels from forming by injecting medication into the eye that blocks the effects of the growth factor. During treatment, your eye will first be numbed, then your eye doctor will inject the medication through the white portion on the side of the eye. Injections can be given in the eye doctor’s office and may be needed as often as every month.
About 95 percent of patients who receive injections to treat macular degeneration are able to maintain the vision they had when the treatments begin, which means the progression of the disease is stopped. About a third of patients actually see improvement in their vision in the first months of treatment.
The FDA has approved Lucentis which is produced by Genentech for injection to treat macular degeneration. The high cost of this medication may mean some people with lower incomes are not able to afford Lucentis treatments. Another medication called Avastin which is also produced by Genentech was originally developed to treat other conditions but has now been found to be effective in treating AMD. The FDA has not yet approved Avastin for treating macular degeneration, but some eye doctors chose to use it “off-label”. One injection of Lucentis costs more than $2,000 while an injection of Avastin costs less than $150. Studies are underway to determine whether Lucentis or Avastin is more effective as treatment for macular degeneration.
Injection Treatment Risks
Injections to treat macular degeneration may increase your risk for the following health concerns:
• High pressure in the eye following injections
• Increased risk of stroke
• Eye inflammation
• Eye pain
Lucentis and Avastin are considered by some to be “miracle drugs” because they have the potential to reverse vision loss from macular degeneration. Be sure to schedule regular eye exams for early screening of macular degeneration and other eye health concerns and talk to your eye doctor to find out whether this treatment could benefit your vision.
Sources:
National Eye Institute
All About Vision
The Eye Digest