Avastin macular degeneration treatment – a shot in the eyeball – has been available for a number of years now, and we have had a very positive personal experience with it. I thought it may be useful to share our experience with those facing a decision or facing possible treatment. Or those who may just be interested in general.
As we’ve discussed, age-related macular degeneration is one of the more serious and common elderly issues that we face. It affects the central macula area of the eye and can cause blindness.
This is an account of our personal experience.
It may be different for other patients, so this should not be taken as the standard for all. (And on a positive note -- we did learn all kinds of tips about macular degeneration help, to still live a satisfying life).
When my father was in his late 80s, he was diagnosed with wet macular degeneration, or bleeding in the macula area of the eye -- for which Avastin is used. He’s now almost 95, and the injections were not available to him until he was 93. He lived on his own in another state, and was not able to consistently go in for treatments. After he moved near us, we were able to help him with appointments. And it was at this time that we got more of a sense for Dad's macular degeneration causes.
The purpose of the Avastin macular degeneration treatments is to stop the bleeding behind the retina in the center of the eye, which is what happens with the wet type.
If left unchecked, the eye is damaged, scarring can occur, and central vision is permanently lost. This is what happened with Dad’s left eye. Often periphery vision is maintained however. The Avastin macular degeneration treatments help stop the bleeding, which then may be re-absorbed into the body.
Although some permanent damage had occurred with Dad’s right eye by the time we got him in, the current issue is now under control. And in fact the vision in that eye has improved slightly. (He can, for instance, now read the numbers on the Vikings’ football jerseys on his giant screen TV).
He’s been having the shots for almost 2 years now, and has had several treatments in each eye. His retina specialist said if he had been able to get them right away, much of his vision may have been spared. He currently only has periphery vision in both eyes, but he can basically see, and is not totally blind. We want to preserve what he has.
Why Avastin macular degeneration treatment? It is more cost effective, at about $75 per injection as compared to Lucentis, which can be $2200 to $2700 per injection where Dad goes. Between his Medicare and supplementary insurance, thus far all costs have been covered. Avastin, the staff has explained to us, was originally used for colon cancer. It was also interestingly noted that many of the patients also exhibited improved vision.
After much research, it was used for treatment for macular degeneration. The nurse told us they use only about 1/400 of the amount for the eyes, as is used for cancer treatment. And it is injected in a small amount only locally in the eye; whereas, with the cancer treatment, it’s given intravenously.
I'll describe here how a typical treatment goes.
Dad was referred to a retina specialist by his eye doctor, explaining that it’s important to get treatment from someone with advanced specialization.
It’s like a heart condition. You could certainly see a physician who is a general practitioner, and he/she could help you with many issues. But if you want serious treatment, you’d see a heart specialist. Same thing here. An eye doctor has to take special training for this type of Avastin macular degeneration procedure.
This is a typical visit for Dad.
First, the technician takes him into an exam room and has him read the standard vision chart with alphabet letters. Any health and medication updates are also taken.
Numbing drops are then put in the eyes, which work immediately. Then his eyes are tapped with an instrument to measure pressure.
Dilating drops are also given. Afterwards, Dad sits in a waiting room for about 15 to 20 minutes while his eyes dilate.
If an eye scan needs to be done during this visit, that's the next procedure. The scan is called an OCT (optical coherence tomography) and scans and measures the eye such as the thickness of the retina, notices any swelling, and any other pathology.
The technician said it’s like an ultra sound, but uses light instead of sound.
This is a totally painless procedure. You simply sit and put the chin on the chin rest of an optical machine, which looks much like the typical machine you see in any eye doctor’s office.
He looks through the little hole, and the tech takes a series of pictures. The tech then prints out the scans for the doctor. This helps determine if an Avastin macular degeneration treatment does need to be given.
Next we go into the exam room to see the retina specialist. Another tech asks more questions and makes notations on the chart. He/she verifies which eye will be receiving the Avastin macular degeneration treatment, then puts a large piece of tape above that eye to mark it. A tray is then brought in with the injection equipment.
Dad’s blood pressure is also taken. Abnormal blood pressure could relate to vascular problems in the eye. Blood clots occasionally do occur in the eye for some patients with these issues. If blood flow is cut off from the eye and the retina, the retina can die within a couple of hours. Then that’s it. Vision loss is irreversible.
When the retina doctor comes in, he looks at the scans and then has Dad put his chin in the eye exam machine and takes a look into both eyes. He confirms the eye that needs treatment. Before the Avastin macular degeneration procedure, he puts in more numbing drops and also sterilizing drops to prevent infection.
Next, Dad’s eye is propped open with a lid holder. He’s told to lean all the way back in the chair to the head rest, and not to move. The doctor takes the syringe and says he will count to three, then do the shot.
When he does do the shot he says "one thousand, two thousand" – and that’s how fast it's over. It's very quick. The needle goes into the white part of the eye, only a little ways beneath the surface. (And needles these days are very small and fine.) The Avastin then flows to the retinal area on its own.
Before going home, the technician again checks the eye pressure. If the pressure should be up, as in the case of glaucoma, and does not go down, then the doctor must remove the fluid from the front of the eye. This, she assured us, is rare.
Dad has always said it is a very easy procedure and doesn’t bother him at all. At least it didn’t after the first time. Most of the discomfort, he said, was psychological – not knowing what would happen and knowing you’re going to get a shot in your eye. But he basically does not feel any actual pain because his eye is numb, and it's over very quickly.
Afterwards, he sees spots for a few hours to a day, which the doctor says are only sterile air bubbles. Dad’s eye may water a little and is sensitive to light. He feels mostly like sitting with his eyes closed off and on for the rest of the day. But he would be able to resume normal activity if he wanted to. By the next morning everything is pretty much back to normal. There may be a few more spots.
Only once has he had a scratchy, achy discomfort for about a week. But that was because he rubbed his eye. I took him to the local eye doctor, who checked to make sure nothing was wrong, such as an infection.
In the beginning, Dad’s Avastin macular degeneration treatments were done about every two or three weeks to get on top of the bleeding. Then they were done at intervals of a month to six weeks, then about three months apart.
The doctor did not recommend doing both eyes at the same time, so we have a separate series of appointments for each eye.
Macular degeneration is becoming more common as the population
ages, and as life spans lengthen. At this time the Avastin macular
degeneration procedures (or other medication in the injection) are what
is recommended, as no other treatments have as of yet been fully developed. But there is some interesting research being done with delivering medication to the eye via eye drops (and no shots!).
Our retina specialist has also mentioned that stem cell research is under way, but is taking place in Europe.
I also asked Dad's specialist about the well-known macular degeneration nutrition recommendations (including special supplements), and if it really helped. He did say it may indeed help prevent vision loss (of many types). But once eye disease has set in, the nutrition program can somewhat help maintain eye health, but is not then preventative.
So if you or someone you know is experiencing this eye disorder,
do see a specialist immediately. You may be a candidate for Avastin
macular degeneration treatment. But time is of the essence. And the
injections are not at all as scary as they sound.