Telescope Implant—Changing Visual Expectations and Evolving the Standard of Care for End-stage Age-related Macular Degeneration Patients

2015 ◽  
Vol 08 (02) ◽  
pp. 116
Author(s):  
Charles C Wykoff ◽  
Keyword(s):  
Macular Degeneration ◽  
Daily Living ◽  
Standard Of Care ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Visual Rehabilitation ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Age Related ◽  
End Stage

End-stage age-related macular degeneration (AMD) affects approximately 1.8 million Americans and limits older adults’ ability to perform activities of daily living. No current pharmaceutical options exist for visual improvement in these patients. The telescope implant is the only Food and Drug Administration approved intraocular device for visual rehabilitation in end-stage AMD patients, with either bilateral geographic atrophy or disciform scarring, who are phakic (in at least one eye) with best spectacle-corrected visual acuity of 20/160–20/800 or worse in both eyes.

scholarly journals To determine functional visual improvement after cataract surgery in eyes with age related macular degeneration

2022 ◽  
Vol 7 (4) ◽  
pp. 655-658
Author(s):  
Deepika Joshi ◽  
Sourav Shristi
Keyword(s):  
Cataract Surgery ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Age Related ◽  
Retinal Pathology ◽  
Group A ◽  
Group B ◽  
A Prospective Study

To determine whether patients with Age related macular degeneration (ARMD) benefit from cataract surgery in terms of best corrected visual acuity (BCVA) and to assess impact of surgery on progression of ARMD.: A prospective study was carried out of patients with and without ARMD undergoing cataract surgery at our department. Patients were divided into two groups- Group A (cases) with ARMD and Group B (controls) without ARMD and other retinal pathology. BCVA of cases was recorded on day 1, day 14, 1 month and 1/month and compared to that of controls.: BCVA significantly improved but markedly less than that experienced by control eyes. No increased incidence in progression to wet form of ARMD. Cataract surgery is safe in ARMD patients with no evidence of increased complications or rates of disease advancement.

scholarly journals Follow-up in Dry-Form (Non-Neovascular) Age-Related Macular Degeneration and Change to Wet Type

2017 ◽  
pp. 128-134
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Foveal Avascular Zone ◽  
Antioxidant Vitamin ◽  
Age Related ◽  
Avascular Zone ◽  
Amsler Grid ◽  
End Stage

In the early and mid-term period of age-related macular degeneration (AMD), macular drusens and pigmentary changes are seen. Neovascularization and/or atrophy are seen in the late-term. RPE and photoreceptor loss in the macular area causes retinal atrophy or geographic atrophy (GA). About 20% of legal blindness is due to GA. This condition develops slowly according to foveal avascular zone involvement over the years. Progression of AMD is variable according to genetic factors, age, and clinical features of macular lesions. Large, central located, and in a large number of drusens are risks for the progression of AMD in the end-stage period. In general, about 10% of dry-type AMD patients show progression to wet type (neovascular) AMD. In AMD, measuring of the atrophy with imaging methods is used to better determine its properties and to monitor the progression. So it is recommended to take images at regular intervals. It is necessary to educate AMD patients and their families about these diseases, risk factors, and prevention. It is suggested to make regular consultation according to phase symptoms of AMD patients (use Amsler grid test and monitor visual acuity). Antioxidant vitamin and mineral support usage also recommended.

scholarly journals New and Innovative Treatments for Neovascular Age-Related Macular Degeneration (nAMD)

2021 ◽  
Vol 10 (11) ◽  
pp. 2436
Author(s):  
Prem Patel ◽  
Veeral Sheth
Keyword(s):  
Macular Degeneration ◽  
Randomized Clinical Trials ◽  
Vision Loss ◽  
Standard Of Care ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Current Standard ◽  
Combination Strategies ◽  
Age Related

Age-related macular degeneration (AMD) is one of the most common causes of vision loss. Advanced forms of AMD are seen in primarily two types—neovascular AMD (nAMD) with the presence of choroid neovascularization and non-neovascular AMD (nnAMD) with geographic atrophy. Neovascular AMD is characterized by choroidal neovascularization (CNV), which leads to a cascade of complications, including exudation, leakage, and ultimately fibrosis with photoreceptor loss. Inhibition of VEGF represents the current standard of care. However, there is a tremendous gap between the outcomes in randomized clinical trials and real-world settings. New agents for nAMD might offer the potential to improve treatment outcomes and reduce treatment of frequent intravitreal injections. We summarize all the newer molecules, their pivotal clinical trial results, and their unique mechanisms of action; these include longer-acting agents, combination strategies, sustained release, and genetic therapies.

scholarly journals Follow-up in Dry-Form (Non-Neovascular) Age Related Macular Degeneration and Change to Wet Type

2017 ◽  
pp. 1-1
Keyword(s):  
Macular Degeneration ◽  
Disease Risk ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Foveal Avascular Zone ◽  
Antioxidant Vitamin ◽  
Age Related ◽  
Amsler Grid ◽  
End Stage

In early and mid-term period of age-related macular degeneration (AMD), macular drusens and pigmentary changes are seen. Neovascularization and/or atrophy are seen in late term. RPE and photoreceptor loss in the macular area causes retinal atrophy or geographic atrophy (GA). About 20% of legal blindness is due to GA. This condition develops slowly according to foveal avascular zone involvement over the years. Progression of AMD is variable according to genetic factors, age and clinical features of macular lesions. Large, central located and in large number of drusens are risks for progression of AMD in end stage period. In general, about 10% of dry-type AMD patients show progression to wet type (neovascular) AMD. In AMD, measuring of the atrophy with imaging methods, is used to better determine its properties and to monitoring the progression. So it is recommended to take images at regular intervals. It is necessary to educate AMD patients and their families about these disease, risk factors and prevention. It is suggested to make regular consultation according to phase symptoms of AMD patients (use Amsler grid test and monitor visual acuity). Antioxidant vitamin and mineral support usage also recommended.

scholarly journals Proportion of and Reason for Bevacizumab Usage in the Treatment of Wet Age-related Macular Degeneration

2021 ◽  
Vol 62 (8) ◽  
pp. 1076-1083
Author(s):  
Yi Sang Yoon ◽  
Won Tae Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Common Reason ◽  
Vascular Endothelial ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Wet Amd

Purpose: To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD).Methods: Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified.Results: During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%).Conclusions: Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.

scholarly journals Evidence-Based Practice and Trends in Visual Rehabilitation for Patients with Age-Related Macular Degeneration

2021 ◽  
Author(s):  
Luis Leal Vega ◽  
Irene Alcoceba Herrero ◽  
Adrián Martín Gutiérrez ◽  
Joaquín Herrera Medina ◽  
Natalia Martín Cruz ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
The Elderly ◽  
Developed Countries ◽  
Functional Independence ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Evidence Based ◽  
Visual Rehabilitation ◽  
Evidence Based Practices ◽  
Age Related

Age-related macular degeneration (AMD) is a common, chronic, and progressive eye disease that is considered the leading cause of visual loss among the elderly in developed countries. Advanced AMD, including choroidal neovascularization (CNV) or geographic atrophy (GA), is associated with substantial and progressive visual impairment that can lead to a significant reduction in functional independence and quality of life (QoL) for affected individuals, whose number is expected to increase in the coming years in line with population growth and ageing. In this context, while an important part of medical care is focused on preventing the progression of the disease, Visual Rehabilitation (VR) aims to address its consequences by providing these patients with a number of strategies to achieve their goals and participate autonomously, actively and productively in society. This chapter aims to provide an update on evidence-based practices in the field and how modern technologies play an important role in the development of new VR approaches.

scholarly journals A Review of Completed and Ongoing Complement Inhibitor Trials for Geographic Atrophy Secondary to Age-Related Macular Degeneration

2021 ◽  
Vol 10 (12) ◽  
pp. 2580
Author(s):  
Omar A. Halawa ◽  
Jonathan B. Lin ◽  
Joan W. Miller ◽  
Demetrios G. Vavvas
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Western World ◽  
Complement Factor ◽  
Complement Protein ◽  
Pivotal Phase ◽  
Complement Inhibition ◽  
Exudative Amd ◽  
Age Related

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness among older adults in the Western world. While therapies exist for patients with exudative AMD, there are currently no approved therapies for non-exudative AMD and its advanced form of geographic atrophy (GA). The discovery of genetic variants in complement protein loci with increased susceptibility to AMD has led to the investigation of the role of complement inhibition in AMD with a focus on GA. Here, we review completed and ongoing clinical trials evaluating the safety and efficacy of these studies. Overall, complement inhibition in GA has yielded mixed results. The inhibition of complement factor D has failed pivotal phase 3 trials. Studies of C3 and C5 inhibition meeting their primary endpoint are limited by high rates of discontinuation and withdrawal in the treatment arm and higher risks of conversion to exudative AMD. Studies evaluating other complement members (CFB, CFH, CFI and inhibitors of membrane attack complex—CD59) are ongoing and could offer other viable strategies.

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