Age Related Macular Degeneration
Avastin, Lucentis, Eylea (Aflibercept)
The goal of treatment with these drugs is to prevent further loss of vision. Although some patients have regained vision, the medication may not restore vision that has already been lost and may not ultimately prevent further loss of vision caused by the disease. After the pupil is dilated and the eye is numbed with anaesthesia, the medication is injected into the vitreous or jelly-like substance in the middle of the eye.
Professor Stanga is currently indicating any of these four drugs as anti-VEGF drugs. These drugs restrict the growth of blood vessels. These drugs can slow or stop the progression of wet AMD with improvement of vision in some cases.
You do not have to receive treatment for your condition if you do not want so although, without treatment, these diseases can lead to further vision loss and blindness, sometimes very quickly.
Photodynamic Therapy (PDT)
During PDT a special dye called Vysudine® is injected into a vein of the arm during a ten minute period. Professor Stanga or a member of his team numbs the eye to be treated with eyedrops and a contact lens is placed on the eye. A special non-thermal red laser is applied to the eye five minutes later during 83 seconds. The laser activates the dye within the macular abnormal blood vessels with the aim of thrombosing (occluding) them. As a non-thermal laser is used, there is no heating or burning.
At the end of the treatment the patient is given a green bracelet to wear for the first 48 hours. This is a precaution and is intended to remind you and other health care professionals that you have received PDT as it will cause your skin and eyes to become more sensitive to light. You must therefore avoid direct sunlight and bright lights for 48 hours immediately after treatment.
To reduce this sensitivity please bring with you or wear the following:- a wide-brimmed hat, dark sun-glasses, clothing that will fully cover your arms and legs, socks and shoes.
You do not necessarily need to stay in the dark after PDT. In fact, exposing your skin to indoor light helps to inactivate any remaining drug in the skin.
You may have some blurring of eyesight in the 48 hours following treatment but this is usually short lived.
PDT may need to be repeated. The aim of PDT is to reduce the potential for loss of central vision caused by wet AMD. PDT on its own can slow or stop the progression of wet AMD with stabilisation of vision in some cases. In clinical trials, six out of ten patients experienced stabilisation of vision over two years while some patients (16%) actually experienced an improvement in vision.
All treatments have risks. It can be possible, though unlikely, to experience adverse reactions to PDT and these can include injection-site reactions such as pain, swelling, inflammation, leakage into the area surrounding the vein, bleeding at the injection site and hypersensitivity to the drug or severe anaphylactic shock, blurred vision and other visual disturbances, back pain during infusion (around 2.2% of patients reported back pain). Severe decrease in vision occurred in l%-4% of patients.
If you have had a severe reaction to previous intravenous injections or if you have a strong allergic history, porphyria or severe liver disease, please bring this to the attention of Professor Stanga.
If you think you might have sensitivity (allergy) to any component of PDT or if you feel there is any reason why you should not be treated with PDT, do not hesitate to discuss these matters thoroughly with Professor Stanga.
Some ophthalmologists also use intravitreal steroids “off-label” to treat eye conditions like yours.
Professor Stanga will discuss with you the benefits and risks associated with these other choices of treatment.