Galveston and Houston Ophthalmologists from The Eye Clinic of Texas remarked about Macular Degeneration (AMD) treatment. “The treatment of Wet Age Related Macular Degeneration (AMD) is one of the most active topics discussed in Ophthalmology today because of the aging of society and increasing overall life expectancy. If left untreated, Wet AMD causes progressive and irreversible vision loss, often leading to legal blindness”, commented Bernard Milstein, M.D. “With the advent of intravitreal anti-VEGF drugs such as Lucentis® many advances have been made in the treatment of this disease in the past decade. Now we are even more fortunate to have data from several large randomized clinical trials that provide us with evidence-based recommendations for treatment indication and assessment, re-treatment, and monitoring.”
Evidence suggests that a loading phase consisting of three monthly injections of Lucentis® results in a rapid visual acuity gain, mostly occurring after the first injection. The key is that the treatment should start as soon as possible after its indication and if at all possible within 2 weeks from diagnosis is ideal. To wait more than 1 month seems to lead to further visual loss. A number of clinical trials showed that a maintenance phase with continued monthly injections has provided the best visual acuity outcomes. Longer re-injection intervals, such as the quarterly re-injection, resulted in less favorable outcomes after the initial treatment and loading phase. If continued monthly injections are not possible, a flexible strategy appears viable, with monthly monitoring of lesion activity recommended. Continuous careful monitoring with flexible re-treatment might help avoid vision loss to recur. In fact, some data suggest that quarterly visits are insufficient, whereas monthly monitoring with re-injections on an as-needed basis warrants better outcomes.
Data from the long term clinical trials has further shown that there is variation in patient responses to Lucentis® injections and has given us a number of diagnostic and treatment parameters that are helpful to optimize treatment and monitoring regimens. Here are some interesting things to know:
- The initial visual acuity is not a good indicator for patients treated with monthly injections of Lucentis®. But, a poorer initial visual acuity seems to predict greater overall improvement.
- Smaller areas of blood vessel growth seem to respond better to treatment.
- If treatment begins BEFORE any hemorrhage has occurred there is usually a more favorable result.
- The visual acuity found between the 3 and 5 month visit seems to predict about where the 12 month visit acuity will end up.
- If there is a recurrence of subretinal fluid there is usually a negative effect on the long term visual recovery and functioning.
So, using this information we are able to help you maintain your eye health and vision and hopefully avoid the potentially devastating effects of Wet Age Related Macular Degeneration (AMD). YOUR role is to be consistent in scheduling routine eye exams if you are over 50 years old or even earlier if you have a family history of AMD. Should you notice symptoms including distortion of your vision, waviness or curving of lines or straight surfaces or a sudden change or spots of any kind, please call The Eye Clinic of Texas at 800-423-3937 for an immediate appointment.
The Eye Clinic of Texas is a leading eye care practice serving the greater Houston, Galveston, League City and Texas City area that provides all aspects of general, medical, surgical, laser and optical eye care services. Our Board Certified Ophthalmologists perform Laser Eye Surgery such as LASIK, Cataract Surgery & Lens Implants using advanced technology IOLs to correct complex problems such as astigmatism and near vision focusing problems including presbyopia, diagnosis and management of glaucoma, diagnosis and management of diabetic retinopathy, diagnosis and management of Age Related Macular Degeneration (AMD) and Pediatric Ophthalmology. Texas EyeWear at The Eye Clinic of Texas provides personalized consultation and fitting of eyeglasses and eyeglass lenses for greater Houston, Galveston, League City and Texas City area patients.