New drug treats age-related vision lossWritten by Scott McKimmy | | email@example.com
Three years ago on the golf course, Dean Applin aimed for the pin and noticed a change in his vision. The 71-year-old retiree said the flagstick seemed wavy, like the effect of heat waves rising from a hot sidewalk in the summer.
He told his wife about the experience, and she made an appointment with an ophthalmologist she worked for. The doctor referred him to Retina Vitreous Associates, where Dr. Nicholas J. Leonardy diagnosed him with age-related macular degeneration (AMD), a progressive eye disease that affects the lining of the retina.
Today, after ongoing treatments with a new drug called Lucentis, Applin’s condition has stabilized, likely saving his vision.
“I was really happy that it worked out the way it did because I could see the deterioration of my vision right away; things were kind of squiggly and crooked,” he said. “My mother went blind from it.”
Applin participated in a one-year clinical trial beginning December 2005, and continues to undergo an office-based procedure every six to eight weeks. Leonardy said he injects a tiny volume of the drug — .05 milliliters — into the eye after numbing it with a topical anesthetic. The goal is to eliminate “by far the most sight-threatening issue in the United States in everybody of retirement age.”
“The procedure itself is delicate, but brief and very well-tolerated by patients,” Leonardy said. “It varies by individual, but the effect tends to last four to eight weeks.”
“After [Leonardy] gives me the treatment,” Applin said, “there’s maybe a little blurriness for a few hours and not lot of discomfort — a little bit. Then after that the vision seems to settle back down and come back to where it had been.”
Supplementing the procedures may include dietary modifications or vitamin supplements to provide additional vitamins A (not suggested for smokers), C and E and zinc. Lifestyle changes, such as not smoking and controlling hypertension, if necessary, are also recommended. Although not directly transferred genetically, he explained, a family history of AMD remains a prominent risk factor.
Because of the clinical studies and development of Lucentis and a less expensive drug named Avastin, the evolution of available care for AMD has changed dramatically in the last 15 years, Leonardy said.
“Historically at the time — for example Mr. Applin mentioned that his mother had gone blind from this disease — there was essentially no treatment,” he said. “In the early ‘90s, the available treatment was thermal laser, which was used to coagulate or seal the bad blood vessels. That tended to be effective, but caused a central blind spot.”
Patients are commonly afflicted with dry AMD first, caused by wear and tear on the central vision cells of the retina. Without treatment, the dry form transitions to wet AMD as “bad” blood vessels leak fluid into the macula. About 10 percent of patients have wet AMD, but of those, 90 percent suffer severe central vision loss, according to Leonardy.
“That’s why patients who experience [a distortion in vision] should really evaluate that quickly because once the wet form develops, central vision can be lost in a matter of days or weeks,” he said.
For more information, call Retina Vitreous Associates at (419) 251-4367 or visit the Web site www.savingvision.org.