Eye Care Blog

For years, the standard treatment for diabetic macular edema (DME) has been laser. The goal of laser treatment is prevention of severe vision loss. In patients who have already lost vision, laser improves vision in only 20-30% of cases. Retina specialists have used intraocular injections of steroids and anti-VEGF drugs to try and reduce swelling further and improve vision. A press release from the National Eye Institute (NEI) yesterday announced the results of a study involving intraocular injections of steroids (triamcinolone) and the anti-VEGF agent ranibizumab (Lucentis) in combination with laser in the treatment of DME. Lucentis injections, often in combination with laser treatment, improved vision at 1 year in almost 50% of patients. Laser treament alone improved vision in 28% of patients. In patients with a history of cataract surgery, those treated with steroids showed a similar improvement to those treated with Lucentis. However, side effects were much more common in the steroid arm of the study. While many retina specialists have been using injections to treat DME, this is the first large study to show a significant improvement in vision in patients treated with Lucentis. However, Lucentis is currently not FDA-approved for this indication.

                             SEVERE DIABETIC MACULAR EDEMA

Fascinating....be sure to watch the animation to get a better understanding of the procedure.

http://www.bpei.med.miami.edu/site/news/news_template.asp?press_id=1171

Age-related macular degeneration (AMD) and cataract are two of the leading causes of vision loss in the United States. Until recently, it was unclear whether some patients with AMD had disease progression shortly after having cataract surgery. A recent study showed that cataract surgery does not accelerate macular degeneration to any significant degree. This was a large (over 4000 patients), prospective, randomized clincal trial with long term follow-up. This should help reassure patients that surgery does not seem to have a direct relationship with AMD progression. 

A study in the current issue of Ophthalmology demonstrated increased patient satisfaction with newer generation intraocular lenses (IOL) implanted after cataract surgery. The ReZoom refractive multifocal and the FDA-approval pending Tecnis multifocal were compared to a first-generation multifocal IOL and a standard monofocal lens. Newer generation multifocal IOL's provided a greater depth of focus and higher patient satisfaction. The Tecnis multifocal provided the greatest long-term spectacle independence. With 90 million Baby Boomers in the United States, the use of these lenses will continue to grow, and this study confirms that the newer IOL's provide superior visual outcomes in most cases.

Preliminary results have shown that an improvement in vision is possible in select patients undergoing experimental retinal cell transplantation. In a study reported in this month's American Journal of Ophthalmology, researchers found measureable improvement in vision in 70% of patients having a retinal transplant for either age-related macular degeneration (AMD) or retinitis pigmentosa (RP). Researchers were successfully able to implant fetal retinal cells into patients and show that measurable vision improvement can be sustained for up to 5 years. While this technology is still far from being available to help patients in a clinical setting, the early results are extremely encouraging.