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New Treatment for Wet Macular Degeneration
Age Related Macular Degeneration (ARMD) affects more than 10 million Americans. About 10% of these patients will develop wet ARMD which accounts for 90% of the visual loss due to the disease. Visudyne is a drug used in Photodynamic Therapy (PDT), a new treatment for wet ARMD. Conventional therapy of wet ARMD has been laser treatment. These treatments destroy the diseased and leaking blood vessels that are causing the problem, but their intensity also damages surrounding tissue, resulting in some visual loss. This makes laser treatment less optimal for new vessels under the fovea (the sensitive portion of our retina that provides our central vision). The PDT laser treatment reduces the risk of further visual loss compared to non-treated patients. PDT laser operates at a much lower intensity. Rather than burning the blood vessels away, the PDT laser activates a photosensitive dye which then closes the damaging blood vessels, leaving the surrounding tissue unharmed. Patients are given the dye through an IV over a ten minute period prior to the laser treatment. The laser treatment itself is typically painless and only takes a few minutes. The dye is cleared by the body in about 24 hours, so patients must avoid sunlight and bright indoor halogen lights for one day. Overall, Visudyne is well tolerated and has few side effects. Data on PDT with Visudyne have been encouraging. As reported in the October 1999 issue of Archives of Ophthalmology, a study of 609 patients with classic central vessels causing wet ARMD, showed that those receiving PDT treatment had a 72% greater chance of improved or stabilized vision after one year than those receiving no treatment. Specifically, 67% of PDT treated eyes had stabilized vision, compared to 39% of non-treated eyes. Two-year data showed a persistent benefit from PDT. 59.1% of patients receiving PDT had stabilized vision, compared to 31.3% of non-treated eyes. These data are very encouraging, but PDT is not a cure. While visual stabilization certainly compares favorably with the natural course of wet ARMD, most PDT patients do not experience significant visual improvement. The diseased vessel often reopens and resumes leaking after 1-3 months. Most patients require multiple treatments to control the ARMD, with many needing four or more treatments before the diseased blood vessels stay closed. The FDA has recently approved the use of Visudyne for PDT in wet ARMD. Not all patients with macular degeneration are candidates for PDT. Only a subset of patients with wet ARMD are truly candidates and please keep in mind that 90% of patients with ARMD do NOT have wet ARMD. If you have ARMD, ask your eye care specialist if you might be a candidate. The treatment is usually performed by an ophthalmologist who specializes in retinal diseases. Dr. Gersman and Dr. James of Vitreo-Retinal Consults, Inc. are retinal specialists. Their group was involved with early PDT studies. They are now able to provide PDT treatments for our patients. Dr. Gersman and Dr. James are seeing patients at our Parkersburg office location; call 1-800-758-3937 for more information or a consultation with our retinal specialists.
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