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Avastin Eye Injection Treatment for Macular
Degeneration
Macular Degeneration eye doctor in Tampa Bay, Florida
Avastin Eye Treatment
Age-related macular degeneration (AMD) is the
leading cause of blindness in people over 50 years
of age. It is caused by the breakdown of the
central portion of the
retina (the highly sensitive part of your eye
that works like the film in a camera to capture the
picture) called the macula. The macula is responsible for the fine
central vision in the eye that is needed for driving
a car, reading fine print, recognizing faces, etc.
There are two types of macular degeneration: dry and
wet. In the wet form of macular degeneration, abnormal blood
vessels grow in the back of the eye. Sometimes
these vessels leak blood or fluid that causes
blurred or distorted vision. Without treatment,
vision loss may be quick and severe.
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There are other eye conditions that cause loss of
vision due to abnormal growth of blood vessels in
the back of the eye. These can occur even in
young patients, and include, but are not limited to,
conditions such as high
myopia
(nearsightedness),
histoplasmosis,
angioid
streaks, and eye injury. Sometimes there is
no known reason for the abnormal blood vessels.
Without treatment, vision loss may be quick and
severe.
Macular edema,
or swelling around the
macula,,
is edema that affects
vision but does not respond adequately to the usual
treatment methods. It can occur with conditions
such as
central retinal vein occlusion and
diabetic retinopathy. Without effective
treatment, vision loss could progress and become
permanent.
Off-Label Use of Avastin - Benefits
Avastin
was not initially developed to treat your eye
condition. Based upon the results of
clinical trials that
demonstrated its safety and
effectiveness, Avastin
was approved by the Food and Drug Administration
(FDA) for the treatment of
metastatic colorectal cancer. As a condition of
approval, the manufacturer produced a “label”
explaining the indications, risks, and benefits.
The label explains that Avastin
works by blocking a substance known as vascular
endothelial growth factor or
VEGF. Blocking or inhibiting VEGF helps prevent
further growth of the blood vessels that the cancer
needs to continue growing.
Once a device or
medication is approved by the FDA, physicians may
use it “off-label” for other
purposes if they are
well-informed about the product, base its use on
firm scientific method and sound medical evidence,
and maintain records of its use and effects.
Ophthalmologists are using Avastin
“off-label” to
treat AMD and similar conditions
since research indicates that VEGF is one of the
causes for the growth of the abnormal vessels that
cause these conditions. Some patients treated with
Avastin
had less fluid and more normal-appearing maculas,
and their vision improved. Avastin
is also used, therefore, to treat macular edema, or
swelling of the macula.
Possible Avastin Limitations
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Off-Label Drugs
Here are some examples of common drugs
being used "off-label":
1) Eye
antibiotics
2) Botox
3) Zoloft & Paxil
4) Methotrexate |
The goal of treatment is to prevent further loss
of vision. Although some patients have regained
vision, the medication may not restore vision that
has already been lost, and may not ultimately
prevent further loss of vision caused by the
disease. After the
pupil is
dilated and the eye is
numbed with anesthesia, the medication is injected
into the
vitreous, or jelly-like substance in the back
chamber of the eye. Avastin
is administered by an injection into your eye as
needed at regular intervals (about every four to six
weeks); your ophthalmologist will tell you how often
you will receive the injection, and for how long.
Avastin Alternatives
You do not have to receive treatment for your
condition, although without treatment, these
diseases can lead to further vision loss and
blindness, sometimes very quickly. Other forms of
treatment are available. At present, there are three
FDA-approved treatments for neovascular age-related macular degeneration:
photodynamic therapy with a drug called
Visudyne and injection into the eye of two other
VEGF inhibitors drugs
called Macugen™ and
Lucentis™. Although both of these treatments
have been proven to slow down the rate of visual
loss, most people do not get back better vision.
Dr. Deupree will
discuss with you the benefits and risks associated
with these other choices of treatment. In addition
to the FDA-approved medications, some
ophthalmologists use intravitreal KenalogTM—a
long-acting cortisone-like drug—“off-label” to treat
eye conditions like yours.
Avastin Injection Complications
Complications when AvastinTM
is given to patients with cancer
When Avastin
is given to patients with metastatic colorectal
cancer, some patients experienced serious and
sometimes life-threatening complications, such as
gastrointestinal perforations or wound healing
complications, hemorrhage, arterial thromboembolic
events (such as stroke or heart attack),
hypertension, proteinuria, and congestive heart
failure.
Patients who experienced these complications not
only had metastatic colon cancer, but were also
given 400 times the dose you will be given, at more
frequent intervals, and in a way (through an
intravenous infusion) that spread the drug
throughout their bodies.
Risk when Avastin
is given to treat patients with eye conditions
Ophthalmologists believe that the risk of these
complications for patients with eye conditions is
low. Patients receiving AvastinTM
for eye conditions are healthier than the cancer
patients, and receive a significantly smaller dose,
delivered only to the cavity of their eye. While
there are no FDA-approved studies about the use of AvastinTM
in the eye that prove it is safe and effective,
there are ongoing clinical trials of a similar drug
as well as studies of patients receiving AvastinTM
“off-label.” One study of patients who received
Avastin
through an intravenous infusion reported only a mild
elevation in blood pressure. Another study of
patients treated like you will be with intravitreal
AvastinTM
(that is, Avastin
injected into the eye) did not have these elevations
or the other serious problems seen in the patients
with cancer.
However, the benefits and risks of intravitreal
AvastinTM
for eye conditions are not yet fully known. In
addition, whenever a medication is used in a large
number of patients, a small number of coincidental
life-threatening problems may occur that have no
relationship to the treatment. For example,
patients with
diabetes are already at increased risk for heart
attacks and strokes. If one of these patients being
treated with AvastinTM
suffers a heart attack or stroke, it may be caused
by the diabetes and not the AvastinTM
treatment. This possible relationship is the
subject of ongoing clinical investigations.
Known risks of intravitreal eye injections
Your condition may not get better or may become
worse. Any or all of these complications may cause
decreased vision and/or have a possibility of
causing legal blindness. Additional procedures may be
needed to treat these complications. During the
follow up visits or phone
calls, you will be checked for possible side
effects and the results will be discussed with you.
Any medication has the potential to cause
allergic reactions in a small number of people.
Symptoms of an allergic reaction can include a rash,
hives, itching, shortness of breath, and rarely
death. In general, allergic reactions to medicines
are more likely to occur in people who have
allergies to other drugs, foods, or things in the
environment, such as dust or grass. If you have
allergies to other medicines, foods, or other things
in the environment, or if you have asthma, you
should let Dr. Deupree or
his staff know.
Possible complications and side effects of the
procedure and administration of AvastinTM
include but are not limited to
retinal detachment,
cataract
formation (clouding of the
lens of the eye),
glaucoma
(increased
pressure in the eye), hypotony (reduced
pressure in the eye), damage to the retina or
cornea (structures of the eye), and bleeding.
There is also the possibility of an eye infection (endophthalmitis).
You may receive eye drops with instructions on when
to use them to reduce the possibility of this
occurring. Any of these rare complications may lead
to severe, permanent loss of vision.
Patients receiving an injection of AvastinTM
may experience less severe side effects related to
the pre-injection preparation procedure (eyelid
speculum, anesthetic drops,
dilating drops, antibiotic drops, povidone-iodine
drops and the injection of the anesthetic). These
side effects may include eye pain, subconjunctival
hemorrhage (bloodshot eye),
vitreous
floaters, irregularity or swelling of the
cornea, inflammation of the eye, and visual
disturbances. Much of this page's information
provided by: Ophthalmic
Mutual Insurance Company
Eye illustrations provided by
www.JirehDesign.com. |
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