Friday, January 28, 2011

Available Macular Degeneration Treatment

The macular is the central part of the retina and is the area where the fine detail of sight is formed so it is very important. Sometimes the macular degenerates blurred vision occurs. This is often the first sign that something is wrong with the eye. Distorted vision is also a symptom and if either of these conditions occur you should visit your nearest doctor as soon as possible. The condition can be treated, but like all illnesses, the quicker it can be caught the better. If left completely untreated macular degeneration can lead to blindness.

It isn't completely accurate to refer to just one condition known as macular degeneration. In fact there is dry age related macular degeneration, and wet age related macular degeneration. Dry AMD develops very slowly and is caused by the light sensitive cells breaking down as described above. Wet AMD is much rarer and is more serious too as it is more likely to lead to complete blindness if not treated.

This occurs when the blood vessels in the eye begin to grow at an abnormal rate. This growth forces the retina away from the eye wall and this detachment is extremely serious and will eventually lead to blindness. The signs of wet AMD are seeing straight lines as slightly curved and medical attention is vital immediately.

There are treatments available for both these conditions. Dry AMD is the much less serious condition of the two, and even making a few lifestyle changes can go some way to keeping the condition from worsening. Dry AMD occurs through the aging of the eye, so you can slow this down considerably by making your eyes more healthy and strong. This can be done through making healthy lifestyle changes and carrying out special eye exercises too. The condition can be slowed right down with simple changes to your everyday life such as these. Eating plenty of vegetables that are rich in vitamins and minerals is vital too.

If the condition is in the early stages then the eye doctor may well prescribe a course of injections with an anti-vascular endothelial growth drug. If the condition is too advanced or if these drugs do not help the problem then laser treatment may be able to stop the progression of the problem, although it cannot return vision that has been lost.

Eye surgery is quick and painless and the recovery period is short. That makes it a viable option for many people. Whilst the cost of such a treatment was extremely high many years ago, today the price is much more affordable. Because it is able to halt the growth of problems, it is extremely popular and has helped thousands of people across the UK. Regular check ups are absolutely vital if you want to catch any problems such as this early on.

There is a selection of macular degeneration treatment available and your eye doctor will prescribe that which is the most appropriate. Laser vision correction surgery is an effective way to restore sight and prevent the condition from worsening. Laser eye surgery can be used to treat other conditions too for example it is highly effective in cataracts surgery.

Sunday, January 23, 2011

Stargardt Macular Degeneration

By: Macular Degeneration In General

One of the more popular juvenile macular degeneration is the Stargardt Macular Degeneration. This category of macular degenerationi was first reported in 1901 by a German ophthalmologist, Karl Stargardt. It has the common feature of loss of central vision. In 1963, France ophthalmologist Adolphe Fransceschetti used the term Fundus flavimaculatus for a degenerative loss of central vision, but soon to be identified as Stargardt Macular Degeneration by Hadden and Gass in 1976.

This macular dystrophy affects about one in every 10,000 children. The problem may start anytime between the ages 6 and 20, but patients may not notice until they reach their 30s or 40s. First, the children may experience difficulty in reading, and complaining of some blind spots that are often gray, black or hazy at their central vision. They will need more time to adjust between the different lighting of the room too, between light and dark environments.
The dystrophy affects the retina, that sensitive tissue that lies at the back of the eye, focusing especially in the middle region called the macula. The macula is where focus is, that area that is highly sensitive and strong enough to give us the sharp central vision for tasks such as reading, driving and recognising faces.

Stargardt macular degeneration is similar to dry macular degeneration, with the build-up of abnormal yellow pigment substance called lipofuscin building up in cells underlying the macula. Patients will also experience problem with night vision, and it will be difficult for them to move around in places with low lighting. In some others, the patient may also experience colour impairment at advanced stages of the disease.

Vision loss is usually slow, until the 20/40 level. It may suddenly shoot right up to 20/200 where the patient is considered legally blind and forbidden from driving. In some cases, it may even deteriorate to 10/200 within a matter of months.

Genes are a big issue when it comes to Stargardt macular degeneration. A group of genes collectively known as the ABC genes, was found to be the culprit of this juvenile macular degeneration, a discovery made since 1997. The ABCA4 gene, responsible for the production of protein used as an energy transport to and from photoreceptor cells in the retina, mutates and produces dysfunctional protein that cannot perform such transport function. The useless ABCA4 protein then allows the accumulation of yellow, fatty material to accumulate in the retina, slowly covering the macularand ultimately causes the loss of vision. However, more studies had to be done to further understand how the mutated genes affect the biochemistry of the retina.
All is not lost for patients with Stargardt disease. It was found that patients may slow down the progression of vision loss by wearing UV protective sunglasses and avoid exposure to bright light. Although there is not yet any effective treatment for this form of macular degeneration at this moment, it is believed that the identification of the genes behind macular degeneration will help the search for new strategies and therapies. The latest is a study scheduled to begin in 2011, for the injection of embryonic stem cells into the eyes of twelve patients affected by the disease. The Advanced Cell Technology announced in November 2010 that the FDA had approved this injection and study.

Stargardt Macular Degeneration may be either autosomal or recessive trait type. A person may not have prior family history, but may have a recessive gene. If both parents carry a mutated gene, there is always a chance for the child to develop macular dystrophy. In fact, there may be more than one family member who gets Stargardt. For children who did not develop Stargardt, there is again the possibility of carrying the mutant gene, and pass on to their children instead. The chances will be 25%.
Three tests are used to check the presence of fundus flecks and the loss of cones to determine whether a patient has Stargardt Macular Degeneration. It may be fluorescein angiography, electroretinography or electrooculography. Since this problem is rare, it is not a widely studied subject. The discovery of genetic mutation in Stargardt may have encouraged the findings of genetic links for age-related macular degeneration, but further studies on the age-related macular degeneration may also become the contributing factor towards better understanding of Stargardt’s disease and its possible lead to new treatment. Whichever way it may be, it will always remain hopeful for parents and their affected children.

Saturday, January 15, 2011

Can Eye Drops With Pirenoxine Be Used to Treat Cataracts?

by;Dr. Ari Weitzner

For over 60 years, cataracts has been treated in China with eye drops containing the non-prescription drug pirenoxine.

Researchers recently tested the potential effectiveness of pirenoxine as a treatment for cataracts by investigating whether and how pirenoxine interacts with selenite or calcium ions, which have been proven as factors leading to the formation of lens cataracts.

As reported in the journal Inorganic Chemistry, researchers found that pirenoxine reduced the cloudiness of the lens solution containing calcium by 38 per cent and reduced the cloudiness of the selenite solution by 11 per cent.

Researchers concluded that the results may provide a rationale for using pirenoxine as an anti-cataract agent and advocated further biological studies.

Sunday, January 9, 2011

Novartis gains new indication for Lucentis in EU for vision loss due to Diabetic Macular Edema

By:Financial

The European Commission has granted Novartis a new indication for Lucentis (ranibizumab) to treat patients with visual impairment due to diabetic macular edema (DME), a leading cause of blindness in the working-age population in most developed countries.

Laser therapy, the current standard of care, has provided stabilization of vision in many patients, but generally does not improve vision. Lucentis is the first licensed therapy to significantly improve both vision and vision-related quality of life in patients with visual impairment due to DME.

"Similarly to wet age related macular degeneration, diabetic macular edema can cause disabling vision loss. While vision loss as a consequence of diabetes affects only a very small proportion of people with the disease, it is one of the most feared complications," said Don Curran, Chair, AMD Alliance International. "Visual impairment impacts everything from managing social interactions to the ability to work - thus, for most people it means a loss of independence."

The approval of Lucentis was based on data from two Novartis-sponsored clinical trials, RESTORE and RESOLVE, which showed that Lucentis was superior in providing rapid and sustained visual acuity gain versus sham (dummy) therapy or laser therapy, the current standard of care.

"In the clinical trials, Lucentis-treated patients began to recover their vision as early as eight days after the first injection on average, and vision improvement was maintained at one year," said Gabriele E. Lang, Professor, University Eye Hospital, University of Ulm, Germany. "The vision improvement for many of these patients was clinically significant, meaning that they regained the ability to carry out day-to-day activities such as driving."

The RESTORE study showed patients treated with Lucentis alone or with Lucentis plus laser therapy gained an average of 6.8 letters and 6.4 letters, respectively, in visual acuity at 12 months compared to baseline, while laser-treated patients gained an average of 0.9 letters as measured on a standard ETDRS eye chart.

The RESOLVE study showed that Lucentis-treated patients gained an average of 10.3 letters in visual acuity at 12 months compared to baseline while sham-treated patients, some of whom also received laser treatment, lost an average of 1.4 letters.

"Since its first launch in the EU in 2007, Lucentis has become the gold standard treatment of wet AMD and its use has stimulated research into other ocular conditions," said David Epstein, Division Head of Novartis Pharmaceuticals. "Our continued investment in the clinical development of Lucentis means that another group of patients who are at risk of losing their eyesight will have the option of a licensed therapy that could help save their vision."

"The pivotal data from RESTORE and RESOLVE studies are further supported by results of an independent US study examining Lucentis for the treatment of DME compared to standard of care. Conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net), this study showed that at 12 months patients treated with Lucentis plus laser gained an average of nine letters in visual acuity compared to baseline while patients treated with laser therapy alone gained an average of three to four letters. In addition, the study demonstrated superior gains in visual acuity among Lucentis-treated patients up to two years, with a reduced number of Lucentis injections required the second year compared to the first. Specifically, there was a median of only two to three injections required in the second year of treatment compared to a median of eight to nine injections required in the first year," Novartis said.

Diabetic macular edema (DME) is a consequence of diabetic retinopathy, the most common diabetic eye complication. DME is characterized by changes in the blood vessels of the retina, which is the light-sensitive layer at the back of the eye. In patients with DME, leakage from these abnormal blood vessels occurs in the central portion of the retina, called the macula. Because this part of the eye is responsible for sharp central vision, DME can lead to significant visual impairment. Visual impairment due to DME affects approximately 1-3% of patients with diabetes, and DME is a leading cause of blindness in the working-age population in most developed countries.

Lucentis offers an entirely new pharmacological approach to treatment for visual impairment due to DME compared to the current standard of care, which involves the use of laser burns to stop capillary leakage and reduce swelling. Lucentis is an antibody fragment that is injected into the eye and neutralizes vascular endothelial growth factor (VEGF), a protein that is known to increase vascular permeability, resulting in capillary leakage and macular edema in patients with diabetes.

Lucentis was generally well tolerated in DME clinical studies, either when given as monotherapy or when combined with laser treatment. Its safety profile was consistent with the well established profile in patients with wet age-related macular degeneration (wet AMD). There was an incidence of arterial thromboembolic events (<=3.5%) observed in the DME clinical trials, consistent with what was seen in the wet AMD clinical trials, with no significant difference between the groups treated with Lucentis compared to sham or laser therapy. Ocular adverse events were similar to those seen in the wet AMD trials, with an incidence of 1.4% endophthalmitis in the pooled pivotal studies.

Lucentis is currently licensed in more than 85 countries for the treatment of wet AMD. It receives continuous safety monitoring via a systematic pharmacovigilance system and there is more than 750,000 patient-treatment years of exposure to date for Lucentis.

Lucentis was developed by Genentech and Novartis. Genentech has the commercial rights to Lucentis in the United States, where Lucentis is also approved for the treatment of macular edema following retinal vein occlusion (RVO). In addition, Genentech is conducting two Phase III studies, RISE and RIDE, in patients with diabetic macular edema with results expected in 2011. Novartis has exclusive rights in the rest of the world and has filed in the European Union for approval of Lucentis for the treatment of visual impairment due to macular edema secondary to RVO.

Sunday, January 2, 2011

Macular Degeneration Treatments

by:Akler Eye Center

Macular degeneration, or Age-Related Macular Degeneration (ARMD) is a condition related to aging of the eye that causes loss of the central vision. It is the commonest cause of blindness in Americans over 55 years old. Approximately 10 million people in the United States are affected. Smoking, high blood pressure, family history of ARMD, and poor diet are all risk factors for the development of ARMD.

The macula is the center most part of the retina, and is responsible for the sharp vision that allows us to read and drive. In some people, as the eye ages, deposits develop in the retina (dry ARMD). This can cause the macula to function imperfectly, which leads to blurry vision. Only 10% of patients develop the wet form of ARMD. In this more devastating form, abnormal blood vessels grow in the macula, and when they leak or bleed, severe loss of the central vision often results.

The symptoms of macular degeneration are blurring of the vision, which causes difficulty with reading or driving. Macular degeneration does not cause total blindness because the side vision is not affected.

At Akler Eye Center in Dearborn MI, a complete eye examination including dilation of the pupil will allow Dr. Akler to detect both mild and severe forms of macular degeneration. If ARMD is found, further testing may include a fluorescein angiogram and optical coherence tomography (OCT). Fluorescein angiography involves injecting dye into the arm and photographing it as it circulates in the retina. Abnormal blood vessel growth and leakage may be detected. OCT is a computerized picture of the macula that shows if it is swollen with fluid. Both of these tests are performed onsite.

Treatments for macular degeneration are primarily targeted at keeping the retina as healthy as possible and screening for early signs of the wet form of ARMD. A study performed by the National Eye Institute demonstrated that taking special vitamins for the eye that contain anti-oxidants (A, C, E and beta-carotene with zinc) reduces the risk of developing severe vision loss. A home screening tool known as an Amsler Grid allows the patient to check the vision with one eye at a time. If the grid paper lines are wavy or faded, an eye examination is needed urgently.

If the wet form of ARMD is present, the current treatment involves injection of medication into the eye. The medication is targeted at reducing the growth of abnormal blood vessels in the macula.

Dr. Michelle Akler recommends regular eye examinations to screen for macular degeneration, especially in older patients and those with a family history of ARMD. Early detection and treatment allows for the best visual outcome in this difficult condition.