Macular holes and vitreomacular adhesions are conditions that can decrease vision in some patients. Both of these conditions are caused by an abnormal adhesion of the vitreous to the macula. Macular holes rarely spontaneously heal and usually require surgery. Vitreomacular traction will occasionally spontaneously resolve, but it often requires surgery to improve the patient's vision.
Ocriplasmin is a recombinant form of an enzyme called plasmin. It is designed to help dissolve the proteins that help link the vitreous to the macula, thus relieving the vision-reducing traction.
Phase 3 trials were recently published that revealed promising results. After 28 days, following a single administration of ocriplasmin, resolution of vitreomacular adhesion was observed in 26.5% of patients compared to 10.1% in the placebo group. Nonsurgical closure of macular holes occurred in 40.6% of ocriplasmin-treated patients, compared with 10.6% of patients on placebo. While these numbers by no means allow every patient to avoid surgery, they do show that a single injection of Ocriplasmin may help some patients do so.
Ocriplasmin has not yet been approved by the FDA so is not yet available in the US. When it becomes available, NC Retina Associates will be offering this injection at all 5 of our locations.
This blog is for informational purposes only and does not constitute medical advice. Please seek advice of a qualified medical personnel.
Please visit us at www.ncretina.com
Thursday, September 27, 2012
Tuesday, September 25, 2012
Central Retinal Vein Occlusion Treatment
On 9/24/12, the FDA approved Eylea for treatment of central retinal vein occlusion (CRVO). What does this mean for you?
One of the most common causes for decreased vision after a CRVO is macular edema, or swelling of the center part of the retina. Before Anti-VEGF therapy, the options for treatment were limited to steroid injections as laser did not prove to be effetive in the CVOS trial. While steroids do have some benefit, the results were often disappointing.
Avastin (bevacizumab) injections were originally used to treat exudative macular degeneration. Successful use of Avastin for macular edema in patients with a CRVO led to the increasing use of this therapy. A Genentech sponsored a trial, CRUISE, demonstrated that patients receiving Lucentis (ranibizumab) gained 12.7 letters at month 6 compared to a 0.8 letter gain in sham injections.
Eylea (aflibercept), an Anti-VEGF trap medication was approved for the treatment of macular degeneration in 2011. A recent trial sponsored by Regeneron, COPERNICUS, compared the use of Eylea to sham injections. Patients receiving Eylea gained17.3 letters compared to a 4 letter loss in the sham injections.
The treatment options are expanding and patients with a CRVO have more choices than ever for vision restorative therapy.
NC Retina offers Eylea at all five of our locations.
This is not intended to be medical advice. Please seek an eye care professional for diagnosis or treatment.
Please visit us at www.ncretina.com
One of the most common causes for decreased vision after a CRVO is macular edema, or swelling of the center part of the retina. Before Anti-VEGF therapy, the options for treatment were limited to steroid injections as laser did not prove to be effetive in the CVOS trial. While steroids do have some benefit, the results were often disappointing.
Avastin (bevacizumab) injections were originally used to treat exudative macular degeneration. Successful use of Avastin for macular edema in patients with a CRVO led to the increasing use of this therapy. A Genentech sponsored a trial, CRUISE, demonstrated that patients receiving Lucentis (ranibizumab) gained 12.7 letters at month 6 compared to a 0.8 letter gain in sham injections.
Eylea (aflibercept), an Anti-VEGF trap medication was approved for the treatment of macular degeneration in 2011. A recent trial sponsored by Regeneron, COPERNICUS, compared the use of Eylea to sham injections. Patients receiving Eylea gained17.3 letters compared to a 4 letter loss in the sham injections.
The treatment options are expanding and patients with a CRVO have more choices than ever for vision restorative therapy.
NC Retina offers Eylea at all five of our locations.
This is not intended to be medical advice. Please seek an eye care professional for diagnosis or treatment.
Please visit us at www.ncretina.com
Saturday, September 22, 2012
Flashes and Floaters
One of the most common complaints our patients have is flashes and/or floaters. There are many reasons for these symptoms, but the most common is a posterior vitreous detachment or PVD.
The vitreous humor lies between the lens and the retina. Early in life, the vitreous is a jelly-like substance. With age, the jelly-like substance begins to liquefy. This causes vitreous syneresis, one cause of vitreous floaters.
The vitreous is attached to the retina at the optic nerve, the macula, and the peripheral retina. During the liquefication process, the vitreous begins to pull on the retina. The pulling, or traction, on the retina creates flashing which is usually seen by the patient as a bright arc in the temporal visual field.
When the vitreous pulls away from the retina, it is known as a posterior vitreous detachment. Usually this occurs without any consequences for the patient except for pesky floaters. However, it can lead to a retinal tear or detachment. Retinal tears and detachments can be treated but should be addressed quickly. Therefore, we recommend that all patients with new floaters should be seen by an Optometrist or Ophthalmologist.
This post is for informational purposes. It does not constitute medical advice. Please seek the advice of a qualified medical professional.
Please visit us at www.ncretina.com
The vitreous humor lies between the lens and the retina. Early in life, the vitreous is a jelly-like substance. With age, the jelly-like substance begins to liquefy. This causes vitreous syneresis, one cause of vitreous floaters.
The vitreous is attached to the retina at the optic nerve, the macula, and the peripheral retina. During the liquefication process, the vitreous begins to pull on the retina. The pulling, or traction, on the retina creates flashing which is usually seen by the patient as a bright arc in the temporal visual field.
When the vitreous pulls away from the retina, it is known as a posterior vitreous detachment. Usually this occurs without any consequences for the patient except for pesky floaters. However, it can lead to a retinal tear or detachment. Retinal tears and detachments can be treated but should be addressed quickly. Therefore, we recommend that all patients with new floaters should be seen by an Optometrist or Ophthalmologist.
This post is for informational purposes. It does not constitute medical advice. Please seek the advice of a qualified medical professional.
Please visit us at www.ncretina.com
Thursday, September 20, 2012
Lucentis 0.3 and DME
On August 10th, 2012 the FDA approved Lucentis 0.3 mg for use in Diabetic Macular Edema.
What does this mean for you? According to the Centers for Disease Control and Prevention, diabetes (type 1 and type 2) affects about 26 million people in the United States and is the leading cause of new blindness among people ages 20 to 74 years. In 2010, 3.9 million adults diagnosed with diabetes reported trouble with their vision.
In the RIDE and RISE trials, phase 3 treatment trials sponsored by Genentech, patients receiving intravitreal Lucentis for diabetic macular edema experienced a statistically significant increase in visual acuity than patients received focal laser alone.
Prior to the era of intravitreal anti-VEGF, focal laser and intravitreal steroids were the only option for trealtment of diabetic macular edema. While these treatments were effective, recent trials have shown that anti-VEGF injections can be more effective for some patients.
We are now offering this new dose at all 5 of our NC Retina Associates locations.
Not all patients are candidates for anti-VEGF therapy for diabetic macular edema. Please consult with your eye care physician.
Please visit us at www.ncretina.com
What does this mean for you? According to the Centers for Disease Control and Prevention, diabetes (type 1 and type 2) affects about 26 million people in the United States and is the leading cause of new blindness among people ages 20 to 74 years. In 2010, 3.9 million adults diagnosed with diabetes reported trouble with their vision.
In the RIDE and RISE trials, phase 3 treatment trials sponsored by Genentech, patients receiving intravitreal Lucentis for diabetic macular edema experienced a statistically significant increase in visual acuity than patients received focal laser alone.
Prior to the era of intravitreal anti-VEGF, focal laser and intravitreal steroids were the only option for trealtment of diabetic macular edema. While these treatments were effective, recent trials have shown that anti-VEGF injections can be more effective for some patients.
We are now offering this new dose at all 5 of our NC Retina Associates locations.
Not all patients are candidates for anti-VEGF therapy for diabetic macular edema. Please consult with your eye care physician.
Please visit us at www.ncretina.com
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