Future Macular Degeneration Treatment Could drops replace injections?

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Macular degeneration is a visually devastating disease that primarily affects poeple over the age of 75.  Waste products produced by the retina are normally filtered out of the eye.  In macular degeneration, however, the waste products are not properly filtered from the eye and are left in the retina.  In early stages of the disease, pockets of waste product begin to build up in the outer layers of the retina.  As the disease progresses, those pockets get bigger, leading to distorted vision.  Eventually, the retinal tissue begins to die and tiny blood vessels start to grow into the retina in an attempt to keep the retina alive.  Once these tiny vessels begin to grow, the macular degeneration becomes “wet macular degeneration” as opposed to “dry macular degeneration”.  

Wet macular degeneration is the most visually devastating form of macular degeneration.  It’s thought that if the formation of new blood vessels can be stopped, then vision will be preserved.  So, in an effort to preserve vision, doctors have been injecting anti-growth hormone, called anti-VEGF, into the eyes of wet macular degeneration patients. The anti-VEGF targets the newly growing blood vessels and prevents them from growing more.  Typically, patients will get anti-VEGF injections into the eye once every 1-3 months.  Patients may be getting injections once a month for 1-2 years depending on their specific cases.  Side effects of these injections are relatively low, but some patients report pain or discomfort.  Because a needle is inserted into the eye in order to deliver the drugs, there is a potential risk of a bacterial infection in the eye which can have devastating consequences including blindness.  

One way to avoid these potential complications is to find a drug delivery system that wouldn’t involve injection.  Until now, there hasn’t been any drug that was able to penetrate through the cornea all the way back to the retina.  Recently, there was an exciting study done on rat corneas that could possibly lead to a topical anti-VEGF drop.  Scientists put a new compound onto rat corneas and were able to measure therapeutic quantities of it in the retinal tissue.  While this study only shows that this new compound may be used as a carrier for anti-VEGF in the future, it is still quite exciting to think that one day macular degeneration could be managed with topical drops rather than injections!  Until then, protect your maculas by wearing UV protection, not smoking and eating plenty of green leafy vegetables!

Written by Trevor Miranda

Dr. Miranda was raised in Simcoe, Ontario and graduated from the University of Waterloo with his Doctorate of Optometry in 1995. Following graduation, he moved to beautiful Vancouver Island, where he continues to serve the eye care needs of the Cowichan Valley. Trevor is also an active member of the Third World Eye Care Society and has participated with other professionals to improve the vision of the less fortunate. Dr. Miranda was named Optometrist of the Year by the British Columbia Association of Optometrists in March 2015. This prestigious honour recognized Dr. Miranda’s commitment to providing every patient with exceptional care while mentoring optometrists across Canada. Outside the office, you will find Trevor enjoying hockey, coaching soccer, involved with the South Cowichan Rotary Club, and spending time with his wife Cheryl and their three children. Trevor looks forward to continuing to care for the eyes of the Cowichan Valley and welcomes new patients without a referral. Dr. Miranda is available for appointments in our Duncan and Cobble Hill.
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