New treatment for age-related macular degeneration
Dr. Walter Kaplen was on an airplane flight when, suddenly, his ability to see closely disappeared.
“I lost the ability to read,” the retired 93-yearold optometrist from Melrose Park recalled. “I suspected a number of things,” but “the diagnosis [macular degeneration] surprised me.”
Richard Gerber noticed his vision had changed and thought he might need new glasses, but when his vision got significantly worse a short time later, he realized something serious was wrong.
It wasn’t long before he was sitting in the office of Armstrong Colt George Cohen Ophthalmology unable to read the largest line on the eye chart with his left eye. Dr. Daniel Will, a retinal specialist at the ophthalmology with offices in Abington and Hatboro, explained Gerber had age-related macular degeneration and it was urgent to begin treatment immediately.
“I had a black hole in the vision center … the center of vision was pretty much gone,” the 65-year-old Warminster resident recalled.
It was November 2011 and it marked the first time he received an injection of Avastin in his eye, one of two drugs — the other is Lucentis — on the market used to halt progression of the disease and in some cases restore lost vision. He’s had an injection every month since.
“I’ve had very significant good results,” said Gerber, an Orthodox Presbyterian minister who helps set up new churches throughout the United States. “With wet macular degeneration the sooner you begin treatments the better off.”
Kaplen, who has been getting Lucentis shots for about six months, said Will was “guardedly optimistic” the drug would improve his vision and “within a month or two my ability to read returned and my general vision improved.”
Wet age-related macular degeneration, a leading cause of vision loss in Americans age 60 and older, destroys sharp, central vision needed to do tasks such as read and drive, according to the National Institutes of Health. It occurs when abnormal blood vessels grow under a part of the retina called the macula and leak blood and fluid, raising the macula.
It differs from dry macular degeneration, which generally advances more slowly, but can progress to more severe AMD.
Risk factors include age, smoking, high blood pressure, high cholesterol, being overweight and heredity for light-skinned individuals, Dr. Will said. In the early stages, there may be few symptoms — straight lines may look bent, there may be difficulty seeing things not in high contrast.
It’s important to identify patients who are at risk through a regular dilated eye exam, he said. The condition can then be monitored at home with the use of an Amsler grid.
“Certain vitamins can reduce the risk to a more advanced stage,” Will said, but once wet AMD is diagnosed, “while there is still a window of opportunity it is most important to start treatment.”
“It comes to a point where there is a scar on the retina; nothing gets rid of the scar.”
The newest treatment for wet AMD is the injection of Lucentis or Avastin into the numbed jelly of the eye to halt the abnormal growth of blood vessels. Both Kaplen and Gerber said there is no pain associated with the treatment.
If wet AMC is caught at an early stage, the injections will stabilize the condition in 90 percent of cases, said Will, who was involved in the clinical trials for the treatment and has been using it on patients for the last few years.
“The average person treated does show improvement; the key is catching it before there is scar tissue,” he said.
AMD has become an epidemic due to the aging population, Will said. It is the leading cause of severe vision loss in those 65 and older and poses the greatest risk of blindness in that age group.
“Some don’t realize it; it sneaks up on them,” he said. “It’s important to catch it at an early stage.”
“If you don’t do anything about it, you go blind,” said Kaplen, who said there was no downside to the treatment. “There’s some research going on so in the future we may have something else, but at the moment this is a treatment of choice.”
“For now we’re happy we have these drugs,” Will said. “For a severe cause of vision loss in those over 65 in America, now it’s very treatable.”