Photodynamic Therapy for Macular Degeneration
This macular degeneration therapy can lower the risk of severe vision loss by reducing the growth of and leakage from fragile, leaky blood vessels growing under the retina. By limiting the growth of the abnormal blood vessels under the
macula,
this macular degeneration treatment may help prevent the progression of
wet AMD.
It does not restore vision to eyes that have already been damaged, but it may help prevent further damage to the retina and further vision loss.
By sealing the leaky blood vessels, it slows down: √ The buildup of fluid under the retina √ The growth of scar tissue and the abnormal membrane under the retina, both of which damage the cells in the macula.
√ Central vision loss
Some experts think that this macular degeneration therapy may be more effective and less destructive than laser surgery. Laser treatment almost always causes some immediate, permanent central vision loss (a central blind spot) because it uses a hot laser and damages some healthy tissue in the process. PDT may be better able to target the blood vessels without damaging the nerve cells in the retina and
macula.
It uses a low power or cold laser which does not burn the healthy eye tissue.
Visudyne Therapy
Photodynamic therapy takes about 20 minutes and may be done in a doctor's office or eye clinic.
First a light-sensitive medicine called verteporfin (Visudyne) is injected into the bloodstream. The Visudyne collects in the abnormal blood vessels under the macula. Laser light is then shone into the eye, which activates the Visudyne and causes it to create blood clots that block the abnormal blood vessels.
Visudyne medicine makes your skin and eyes more sensitive to light. After treatment, you should avoid direct sunlight for 2 to 5 days and, when outdoors, wear special dark sunglasses to protect your eyes. Your doctor will want you to return for a follow-up exam about a month after treatment. The effect of PDT in slowing the progress of wet AMD is often temporary, and the abnormal blood vessels begin leaking again after about 3 months. Most people need multiple treatments to get the full benefits of the therapy.
Classic AMD Patients BenefitDry AMD patients do not benefit from it because they have not developed these leaky blood vessels and the treatment may not work for many wet age-related macular degeneration patients.Patients who will benefit from this treatment are those who have new blood vessel growth (neovascularization) under the retina in a well defined, distinctive pattern known as "predominantly classic." To read more about classic AMD click here: Classic AMD About 40-60 percent of new wet AMD patients have this form of macular degeneration, according to Novartis, the company that markets Visudyne (QLT Inc. developed it). Photodynamic therapy has been shown to be effective for only certain types of wet AMD. How well the treatment works depends on where and how the abnormal blood vessels are growing beneath the retina. For some types of wet AMD, the treatment is not beneficial.
Visudyne Side Effects
A severe loss in visual clarity occurs in 1% to 4% of those treated with verteporfin. In some cases, vision partially recovers.
Other side effects that may occur include: √ Temporary visual disturbances (abnormal vision, decreased vision, defects in the visual field). √ Pain, swelling, bleeding, or inflammation at the site where the verteporfin medicine is injected. Some people also experience low back pain related to the injection of the medicine. √ Photosensitivity reactions (such as sunburn). The effectiveness and long-term consequences are still being studied. Citations 1. Martidis A, Tennant TS (2004). Age-related macular degeneration. In M Yanoff et al., eds., Ophthalmology, 2nd ed., pp. 925–933. St. Louis: Mosby. 2. Arnold J (2006). Age-related macular degeneration, search date March 2005. Online version of Clinical Evidence (15). 3. Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Study Group (2001). Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: Two-year results of two randomized clinical trials-TAP report 2. Archives of Ophthalmology, 119(2): 198–207.
Macular Degeneration Treatment Breakthrough
Macular degeneration treatment breakthroughs come in small "victories." Macular degeneration studies often use current therapies but in new and different combinations such as the one listed below. They are combining PDT therapy with Lucentis injections or comparing one treatment against another.1) Combination Lucentis and Ocular Photodynamic Therapy With Visudyne, With Evaluation-Based Retreatment (CLOVER) 2) Transpupillary Thermaotherapy Versus PDT for Treatment of Choroidal Neovascularization in Age-Related Macular Degeneration 3) Bevacizumab and Photodynamic Therapy in Neovascular Age Related Macular Degeneration "The purpose of this study is to determine if the combination therapy of intravitreal bevacizumab 4 days after the application of photodynamic therapy could improve the visual outcomes of patients with neovascular age related macular degeneration." 4) Efficacy of Ranibizumab(Lucentis) in Combination With Photodynamic Therapy for Wet Age-Related Macular Degeneration
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