Eye Injections Thwart Macular Degeneration

Vision preserved with early detection and treatment of wet AMD.

Kenneth reading a book

Treatment for macular degeneration has Kenneth seeing clearly again.

As Kenneth Leroux can attest, there is a lot of truth in the old adage, “It’s not what you know, it’s who you know.”

While transitioning out of a job in electrical wiring many years ago, Kenneth found work as the head custodian for the Central Islip Public School system near his home on Long Island, New York. Were it not for his wife, Kenneth might have never landed that job coordinating the maintenance of a half-dozen schools.

“She worked for the school district and helped me get the job,” Kenneth confirms. “I went on to work in that position for 21 years.”

When he and his wife retired 16 years ago, they fulfilled a long-standing dream and moved to Florida, where Kenneth says “relaxing” has become his daily objective.

A couple of years ago, Kenneth’s relaxation was interrupted when he learned during a routine eye exam that the blurred and diminished vision he was experiencing in his left eye was the result of an issue that needed a specialist’s attention.

Kenneth was encouraged by his eye doctor to visit Thomas A. Barnard, MD, a board-certified, fellowship-trained retina specialist at Florida Retina Institute, with locations in Titusville, Daytona Beach, Orange CityLake Mary and elsewhere around the state.

During his initial examination, Dr. Barnard confirmed the eye doctor’s fears that Kenneth’s problem was being caused by macular degeneration, a progressive breakdown of the macula, or center portion of the retina.

Two Forms: Dry and Wet

The retina is the light-sensitive layer of nerve tissue that lines the back of the eye. Like other parts of the body, the retina changes as people age. Sometimes, these changes can have negative effects on vision.

“These changes generally occur in people over the age of 40,” Dr. Barnard informs. “That’s why the condition Kenneth was diagnosed with is also referred to as age-related macular degeneration, or AMD.

“Genetics account for at least half of all cases of AMD, so people with family members who have AMD are at higher risk for developing it. That said, certain lifestyle factors such as sun exposure, diet, activity level, cholesterol and blood pressure can increase risk.”

“The injections are not as bad as you would think. They numb the eye, so you never even feel it.” – Kenneth

There are two types of AMD: dry and wet. Most people diagnosed with the disorder, about 85 percent, have the dry form, which occurs due to natural degenerative changes to the retina and typically causes blurry or sometimes distorted vision. It begins with the formation of small protein deposits under the retina called drusen.

There is no known cure for dry AMD, but its progression can be slowed with a special formulation of vitamins called AREDS2, which were determined by National Eye Institute researchers in a six-year clinical trial called Age-Related Eye Disease Study 2.

In rare cases, dry AMD can progress to the wet form, which is the more serious.

“With wet AMD, the body tries to grow new blood vessels to help nourish the degenerating tissue in the back of the eye,” Dr. Barnard explains. “However, these blood vessels are abnormal and leak into the retina, destroying central vision.

“In addition to blurry or distorted vision, wet AMD can also cause dark spots to form in the field of vision. The good news is that the wet form can be treated, and further vision loss can be prevented as long as we catch it
early enough.”

Treatment of wet AMD typically involves injections into the eye of medications that block vascular endothelial growth factor, or VEGF, a protein that makes the body grow new blood vessels.

Anti-VEGF medications suppress the formation of blood vessels that become abnormal with wet AMD,” Dr. Barnard reports. “But these medications only stay inside the eye for a certain amount of time before the body flushes them out. As a result, anti-VEGF injections must be given continually at certain intervals. Each person is different, so the interval between injections is specific to each patient.”

There are three FDA-approved anti-VEGF medications used by the specialists at Florida Retina Institute: bevacizumab (brand name AVASTIN®), ranibizumab (LUCENTIS®) and aflibercept (EYLEA®).

Doing Great

Dr. Barnard determined that Kenneth was suffering from wet AMD. To combat that, Dr. Barnard prescribed monthly injections of EYLEA. As Kenneth’s symptoms eased and his vision improved, Dr. Barnard altered that prescription.

“Once we get the AMD to settle down a bit, we gradually increase the interval between injections,” Dr. Barnard explains. “Kenneth is now getting an injection in his left eye once every three months, and he’s been very stable.”

Dr. Barnard says Kenneth was fortunate that his regular eye doctor discovered the issue early and referred him to Florida Retina Institute. Early detection and proper treatment are critical to retaining vision in patients with wet AMD.

“When we catch this problem early, we’re usually going to do very well with the vision, and that has been the case with Kenneth,” Dr. Barnard remarks. “He’s now seeing 20/25 out of his left eye.”

Dr. Barnard later discovered evidence of dry AMD in Kenneth’s right eye. Dr. Barnard says he will monitor that condition and treat it accordingly should it develop into wet AMD.

“I’d say the chances are good that Kenneth will not develop wet AMD in his right eye,” Dr. Barnard states. “He does have to be watched, but we’re seeing him frequently, so if wet AMD does develop in that eye, we’ll catch it early. But the odds are in his favor.”

Kenneth says the odds have been in his favor ever since he was sent to see Dr. Barnard.

“He’s a very, very good doctor, and I highly recommend him,” Kenneth states. “And the injections are not as bad as you would think. They numb the eye, so you never even feel it, and it’s over before you know it.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb
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    • Florida Retina Institute

      Founded by James A. Staman, MD in 1979, Florida Retina Institute has 19 locations throughout Central Florida, North Florida, and Southeast Georgia. They have proudly delivered Excellence in Vitreo-Retinal Diseases and Surgery for 40 years. T... Read More

    • Thomas A. Barnard, MD

      Thomas A. Barnard, MD, is certified by the American Board of Ophthalmology. He earned a Bachelor of Science degree from Stetson University in DeLand and a Doctor of Medicine degree from the University of South Florida in Tampa. After g... Read More