Treatment For ARMD in Mumbai

There is as yet no outright cure for age-related macular degeneration, but some treatments may delay its progression or even improve vision.

Treatments for macular degeneration depend on whether the disease is in its early-stage, dry form or in the more advanced, wet form that can lead to serious vision loss. No FDA-approved treatments exist yet for dry macular degeneration.

Deficiencies in antioxidants (specifically zinc and vitamins A, C, and E, selenium, copper, lutein, and zeaxanthine) have been noted in some people with age-related macular degeneration. Antioxidants may protect against age-related macular degeneration by preventing free radicals or unstable oxygen from damaging the retina. Different treatments of the wet form are available and may help decrease the amount of vision that is lost.

Laser treatment may stop or lessen vision loss in early stages of the disease. It is performed with a specific wavelength designed to cauterize the abnormal blood vessels. A laser beam destroys existing blood vessels and may stop the growth of new ones.

A scar forms after the laser treatment. This produces a permanent loss of vision in that area of the retina, sacrificed in order to preserve the rest of the eye layer. Vision usually does not improve after laser treatment. It works in about half the cases, and only a small number of people meet the criteria for laser treatment. Its limitations have prompted a search for other forms of therapy.

A light-activated drug called verteporfin (Visudyne) is given intravenously, and a specially designed laser is used to close the abnormal vessels while leaving the retina intact. You may need several treatments over one to two years because closed blood vessels can reopen within the treated area. Because Verteporfin is activated by light, exposure to sunlight must be avoided for five days after treatment.

Vascular endothelial growth factor (VEGF) causes new blood vessels to develop and increases leakage and inflammation of blood vessels. Most of these drugs are insoluble and therefore cannot be given as eyedrops. Thus, the ideal form of administration is directly into the eye with a very fine needle. These injection procedures are a form of surgical intervention and should be performed only by an ophthalmologist familiar with the technique, indications, contraindications, possible complications, and alternative therapies. Strict sterile protocols are necessary as with any surgical procedure.

Pegaptanib (Macugen) is a drug approved by the FDA in December 2004 that blocks VEGF and helps stabilize vision. Pegaptanib was found to be beneficial in treating both classic and occult subfoveal choroidal neovascular membranes (the areas of abnormal growth of new blood vessels). The drug is administered by an ophthalmologist as an injection into the eye.

Bevacizumab (Avastin) is another anti-VEGF drug that is currently approved for cancer of the colon or rectum. There is now an NIH-sponsored trial underway to scientifically compare Avastin to Lucentis. Both drugs carry a small risk to the patients of stroke.

Ranibizumab (Lucentis) is a newly approved anti-VEGF antibody for the treatment of wet age-related macular degeneration. It is also approved for cancer when given in systemic (delivered to the entire body) form. It is administered inside the eye via the pars plana. Preliminary studies have shown improved vision in patients with many forms of wet age-related macular degeneration. Lucentis is very costly, and multiple treatments for each eye are often necessary.

Doctor Eye Institute is fully equipped with world class equipments and experienced and well trained retina specialists for diagnosis and treatment of macular degeneration.