Macugen: New Treatment for Macular Degeneration

The leading cause of legal blindness among adults over the age of 55 is Macular degeneration, a disease that causes irreversible vision loss. There are two forms known as wet and dry. The wet form is much more severe and while it only accounts for 10% of cases, it causes 90% of severe vision loss. It is a devastating disease that forces many patients to lose the ability to complete simple, everyday tasks and there is no cure. Most treatments are aimed at slowing down the process of deterioration, but once the disease progresses to a certain point, there is nothing that can be done to restore vision. A new treatment option called Macugen has recently made news as a breakthrough treatment that can restore vision in patients with the wet form. While this is a major advancement in treating this disease, patients should heed caution before getting excited about its potential benefit.

In the anatomy of the eye, the macula is located at the center of the retina-it functions to provide clear, precise central vision. It is referred to as the “bulls eye zone.” Macular degeneration causes the sight-sensing cells in the macula zone to malfunction. The wet form is more severe because tiny blood vessels develop under the retina that can begin to leak blood and fluid. As the leakage dries, it forms scar tissue around the macula. It creates black or gray spots in the vision called scotoma. Many patients with the wet form will have multiple episodes of new blood vessel formation, which will cause more leakage and more scar tissue as the disease progresses. Patients will begin to lose their central vision.

Studies have shown that people with Macular degeneration have elevated levels of a protein known as VEGF (vascular endothelial growth factor) in their eyes. This protein contributes to the formation of new blood vessels. Macugen is an anti-VEGF therapy that aids in the prevention of new blood vessel development by blocking this protein. Eyetech Pharmaceuticals conducted a two-year clinical study and presented their findings to the American Academy of Ophthalmology. On December 17, 2004, the FDA approved Macugen.

The Massachusetts Eye and Ear Infirmary is the leading hospital for treatment and research in New England and reports, “Results from two concurrent, prospective, double blinded, clinical trials show that Macugen. . . is an effective treatment for age related Macular degeneration.” The report continues, “Overall, a reduced risk of visual-acuity loss was observed with all patients as early as six weeks after treatment [began] with evidence of an increasing benefit over time up to week 54.” The findings continue to report that Macugen was able to reduce the risk of progression to legal blindness and promoted the stability of vision. This is a major development in the treatment of wet Macular degeneration, however, it will not be available to treat all patients.

Eyetech Pharmaceutical’s study states, “Patients who had previously received therapy or who had significant subfoveal scarring or atrophy were not eligible to participate in trials.” This means that if you have had the disease for a long time and it has progressed to the point where there is significant scarring from repeated episodes of leakage, then Macugen will not help you. They didn’t even test those patients with scarring. When news of Macugen first broke, many reports failed to mention this; unfortunately this may have given many patients false hope.

If you have had Macular degeneration for years, you should consult with your Retina Specialist who can check your eyes and determine if you are a candidate for Macugen. You will find that many Retina Specialists are using Macugen now and it is worth the shot.
Your risk of developing this disease increase with age and researches have discovered a genetic component. If you are over the age of 50 and experience any of the warning signs for Macular degeneration, you must see an Ophthalmologist who is trained to recognize AMD (age related Degeneration). The warning signs would be loss of vision in one eye, cloudy vision, loss of balance, headaches or any change in vision. If you have been diagnosed, you should find a qualified Retina Specialist and begin treatment as soon as possible.

When someone is diagnosed with the wet form of Macular degeneration, they are aware of the progression. It can progress into complete loss of central vision and that is devastating. The good news is that Researches are working diligently to find new treatments for this disease and we can remain hopeful that someday there will be a cure. Also, if you are at risk for the disease, there are steps you can take to decrease symptoms such as early screening, taking nutritional supplements and quitting smoking. There is an abundance of valuable information on this disease that is worth familiarizing yourself with because it is becoming a more widespread issue. If you would like more information about Macular degeneration or Macugen, log onto http://www.meei.harvard.edu or visit the Macular Degeneration Foundation at http://www.eyesight.org/ .

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