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HealthFirst-Treating macular degeneration

Monday, July 06, 2009

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Leslie Toldo
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UNDATED (WJRT) -- (07/06/09)-- There is a new way to treat the leading cause of blindness in people over 60.

HealthFirst reporter Leslie Toldo has information about this exciting treatment for macular degeneration.

This procedure may not only save a person's sight, but their time, too.

Judie Janes' handiwork keeps a long list of friends and family in style. Last year, she thought she made her last stitch. "I couldn't thread a needle, couldn't see the needle to thread it on my sewing machine."

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"I thought maybe I should get a magnifying glass. That just wouldn't cut it."

Janes was diagnosed with wet macular degeneration; abnormal blood vessels growing under her retina were bleeding. The picture on the right shows how the condition blurs vision.

"Vision is not something you can take for granted," she said.

Traditionally, doctors inject a drug into the eye that stops the vessels from growing, but it doesn't last.

Dr. Peter Sonkin is a retinal specialist at Baptist Hospital in Nashville, Tennessee. "It's a big impact on lifestyle for the patients. They have to come in once a month, sometimes for a year or two or longer."

In a clinical trial, doctors use a small probe that delivers targeted low dose radiation to the eye. The goal is to damage abnormal the blood vessels without affecting the healthy parts of the eye.

"The amount of radiation exposure to the body from going through this procedure is less than one would get flying from New York to Los Angeles in a plane," claimed Baptist Hospital retinal specialist Dr. Carl Awh.

Surgeons then inject a dose of the traditional medication. They say the radiation-drug combo is more powerful, lasts longer and could eliminate the need for monthly injections.

"Nothing's blurry. I passed the eye test, and you know you can't fake an eye test," Janes said.

Judie checks her vision every morning. Her vision improved from nearly legally blind at 20/100 to 20/20 after surgery. "Every morning after I do my little grid test, I look at that prayer and it lets me know how blessed I really am."

Patients are sedated for the outpatient surgery, which takes about an hour. This technique is in the final stages of approval in Europe and should be available there in August.

If the trial is successful in the U.S., the treatment could also be available here in less than two years.

BACKGROUND: Age-related macular degeneration (AMD) is a disease that affects older adults and slowly destroys sharp central vision. Central vision is needed to see objects clearly and for tasks such as reading and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. The macula is located in the center of the retina, the light sensitive tissue at the back of the eye. The retina converts light (or an image) into electrical impulses, and then sends these impulses to the brain. AMD causes no pain and in some cases progresses so slowly that people notice little change in their vision. On the other hand, the disease may progress rapidly and may lead to a loss of vision in both eyes.

CAUSES: AMD occurs in wet and dry types. In the dry type, the damage to the retina is due to the formation of small yellow deposits under the macula, known as drusen. This leads to a thinning and drying of the macula causing it to lose its function. Wet AMD occurs when abnormal blood vessels begin to grown underneath the retina. These vessels tend to be very fragile and can leak blood and fluid, which raise the macula from its normal place to the back of the eye. Vision loss from wet AMD is faster and more noticeable than the loss due to dry AMD. About 10 percent of patients with dry AMD later progress to wet AMD.

TREATMENTS: Currently there is no cure for AMD. High doses of certain nutritional supplements have been shown to help many people slow or avoid progression from dry to wet AMD, but once wet AMD has developed, it is important to receive medical treatment. The earlier wet AMD is diagnosed the better the patient's chances of preserving some or much of their central vision. Because loss of vision is caused by the growth of new blood vessels, drugs that slow of stop this process can stabilize and often improve vision. Lucentis and Macugen are two drugs approved by the FDA for the treatment of wet AMD.

BETA RADIATION THERAPY: Epiretinal Beta Radiation Therapy uses a common surgical technique to deliver a very precise dose of beta radiation directly to the area of the affected area by wet AMD. Beta radiation is thought to affect wet AMD by destroying existing abnormal vessels and discouraging the growth of new ones. Even though the dose of radiation is strong enough to affect the AMD lesion, its energy does not travel far, which means that surrounding tissues receive only slight exposure. The beta radiation procedure is done on an outpatient basis and usually takes less than an hour to perform, usually requiring only local anesthesia (SOURCE: Cabernet).

http://www.baptisthospital.com
www.tnretina.com