“I have type one diabetes,” says Ava Hodous, “and I
developed it after forty, which is very unusual.
“I was living in Cleveland at the time, and I went to the
eye doctor up there every six months.”
After moving to Florida, Ava developed a heart condition
that caused her to be hospitalized. “I ended up in the hospital in 2008,” she
explains. “It was heart-related, so the doctors were very concerned about my
heart and lungs, but I was also concerned because I couldn’t see well.”
The problem: diabetic retinopathy, a leading cause of
blindness in adults. If the disease proceeds unchecked, the bleeding vessels
and resulting scar tissue can destroy the retina.
“My vision was extremely blurry,” Ava describes. “I’d
always had really good eyesight, but all of a sudden I couldn’t read my
computer, couldn’t read a newspaper.
“I was pretty much panicked.”
Ava consulted board-certified ophthalmologist and retina
specialist Allison V. Menezes, MD.
“I had my husband drive me to Dr. Menezes’ office when I
was released from the hospital,” continues Ava, “and I was really struck by her
compassion. She is very caring and very thorough, and she’s been there for me
ever since.”
Diabetes and the eyes
“According to the American Diabetes Association, the
number of people in the United States with diabetes is about twenty-three
million,” reports Dr. Menezes. “Eighteen million have been diagnosed and
another five million are still undiagnosed.
“Diabetic retinopathy is the most common cause of vision
loss between the ages of twenty-five and sixty-five. Anyone who has diabetes is
at risk to develop diabetic retinopathy, and the risk increases with the
duration of having the disease.”
The main reason, explains the doctor, is that high glucose
levels affect blood vessels and make them unhealthy. “Diabetic retinopathy causes
blood vessels to leak and new blood vessels to grow, and these new blood
vessels in turn cause bleeding, scarring, and vision loss.
“So, there are several points to consider: first, diabetes
affects the eyes; second, with treatment we can reduce the risk of vision loss
by about fifty percent; third, if we find diabetic retinopathy before the
patient loses vision, we have a much better chance to protect that patient’s
vision. That’s why people with diabetes need to schedule regular eye exams,
even if their vision is great.”
Avastin and Lucentis
Fortunately, even for patients like Ava who have developed
diabetic retinopathy, there is hope.
“In terms of treatment, there is a four-pronged approach,”
notes Dr. Menezes. “First of all, if patients keep their sugars, blood pressure,
and cholesterol under good control, then they can significantly decrease their
risk of vision loss by about fifty percent. Second is laser treatment for
either the fluid leaking or new blood vessel growth, and that reduces the risk
of vision loss by fifty percent.
“Third, we can also do injections of the newest generation
of medications, Lucentis® and Avastin®,” says Dr. Menezes. “These are antibodies against a chemical
that stimulates new blood vessels to grow and leak. However, these medications
only work for a few months and need to be repeated or given with laser
treatment for a longer lasting effect.”
By preventing the growth of fragile, redundant blood
vessels beneath the retina, Avastin and Lucentis can effectively eliminate the
formation of scar tissue where those new blood vessels would break and bleed.
“Both Lucentis and Avastin are delivered by injection, and
we think they work similarly in terms of efficacy,” adds Dr. Menezes.
“Ninety-nine percent of patients report little or no discomfort involved in the
treatment. The complication rate is extremely low, even less than that of safe
and predictable cataract surgery. If there are still blood vessels in the eye
that do not go away, the fourth and final treatment approach is a surgery
called a
vitrectomy
.
“The most
important thing to remember,” emphasizes Dr. Menezes, “is that early detection
and early treatment are the keys to better vision. Treatment is most effective
if applied soon after the development of redundant blood vessels or leakage of
fluid.
“It’s important for diabetic retinopathy patients to keep
all their appointments, even if they are not noticing changes in vision. Regular,
thorough eye exams can detect a number of ophthalmic conditions in their
earliest stages,” she reminds, “and can help a person preserve healthy vision
for many years to come.”
“Miraculous” recovery
Ava says she truly appreciates the care and concern of Dr.
Menezes and her staff.
“Dr. Menezes explains everything, and she’s both
professional and caring. That’s so important to a patient. I’ve had numerous
laser and injection treatments,” she adds, “and they are such a compassionate
group. They could just numb my eye and do the injection and be done, but they
don’t do that. They numb the eye, wait about twenty minutes, and then numb it
again. They always make sure I’m comfortable.”
She adds that the results have been well worth the effort.
“I feel that Dr. Menezes helped me regain my eyesight,
which would not have happened if I hadn’t gone to her,” reflects Ava. “The
treatments have been totally successful, which is just fabulous. She really
brought my vision back.
“To me, it’s a miracle.”
FHCN – Michael J. Sahno