Retina Treatment
INTRAVITREAL INJECTIONS : Intravitreal Injections are increasingly important for patients with retinal diseases. Many of these treatments are directed at inhibiting Vascular Endothelial Growth Factor (VEGF). Vascular Endothelial Growth Factor (VEGF) is a substance made by cells that stimulates the growth and leakage of abnormal new blood vessels. VEGF plays a large role in the development of wet age-related macular degeneration (AMD) and other retinal vascular diseases. Multiple new treatments for wet age related macular degeneration that block VEGF are now clinically available. These treatments are given as a series of injections into the eye (intravitreal injection). Intravitreal injections are performed in the office, using an anesthetic to minimize patient discomfort and antiseptic to minimize the risk of infection. Patients are able to continue with all normal activities after an injection. In many cases, repeated injections are necessary to achieve the desired effect.
MACUGEN : Was the first of these agents to become available, gaining FDA approval in December of 2004. Macugen binds and inactivates a VEGF subtype (VEGF-165) thought to be most important in disease progression.
AVASTIN : Is an anti-VEGF treatment that is FDA approved for intravenous use in metastatic colon cancer. Due to its similarity to other anti-VEGF agents used in macular degeneration and its widespread availability, Avastin has become commonly used by retina specialists in small doses as an intravitreal injection. Avastin is used in an off-label (non-FDA approved) fashion for treating wet age related macular degeneration, diabetic retinopathy, and retinal vein occlusions. Although mounting evidence has demonstrated the effectiveness and safety of Avastin, further trials are underway to investigate the use of Avastin inside the eye.
LUCENTIS : Is the newest and most effective anti-VEGF agent approved by the FDA for the treatment of wet age-related macular degeneration (AMD). In 2 clinical trials, a majority of patients receiving monthly injections of ranibizumab maintained their vision. Moreover, approximately one-third of ranibizumab patients had improvements in vision at 12 months. Lucentis is the first treatment for wet macular degeneration to show an average improvement in visual acuity after one year of treatment in clinical studies.
SURGICAL TREATMENT
Vitrectomy : A sophisticated microsurgical technique in which the vitreous gel is removed from inside the eye with a small, specialized cutting device, an operating microscope to look into the eye, and microsurgical instruments. The vitreous gel is then replaced with a clear saline fluid. Vitrectomy is performed for many conditions including retinal detachment, diabetic retinopathy, macular pucker or hole, hemorrhage or infection inside the eye, and ocular trauma. Vitrectomy is usually performed under local anesthesia.
Scleral Buckle : A special plastic material is placed around the outside to help close off (or "buckle") retinal tears in patients with a retinal detachment. We also have specialized equipment that enables us to repair certain retinal detachments in the office without the need for hospitalization or scleral buckling.