In a recent news release by the FDA, it was indicated this tiny telescope will replace the natural lens in the eye and magnify items more than two times.

Macular Degeneration patients over 75 years of age who have blind spots associated with the eye disease is who this device is aimed at.

Candidates will have to be trained with an external telescopic device to determine if they will benefit from the implanted telescope.

Macular Degeneration attacks the central vision and results in a severe visual impairment in about 25 percent of those patients suffering with the eye disease.

This new tiny eye implant will come with a warning indicating the device puts users at a greater risk of injury to the eye’s cornea.

Macular Degeneration attacks the central vision of those with the eye disease and macular translocation surgery can be used to lift the macula away from the underlying blood vessels and attach it to a new and more healthier portion.  This will restore the central vision that is damaged by macular degeneration.

Macular translocation surgery is only meant to treat patients with wet macular degeneration.  In this form of macular degeneration leaking blood vessels have formed beneath the retina and moving the macula to a more healthier spot will improve central vision.  This eye surgery is not recommended for every patient who has macular degeneration and best results have been shown for those people who are in the early stages of the eye disease.

In macular translocation surgery, the eye surgeon will pinch the outer part of the eye called the sclera.  With the sclera pinched, the surgeon will place a suture into the wall of the eye to keep it pinched.  This will shorten its length as well as buckle the retina.

Once the suture is in place, the eye surgeon will inject a saline solution into the eye under the retina, causing it to lift up, allowing it to be moved approximately 0.3 and 0.4 mm without detaching it.  After the retina is moved, a gas bubble is injected into the eye to hold the retina in location until it heals.

Another side benefit of relocating the retina during macular translocation surgery is it provides access to the previously covered blood vessels thus allowing treatment without harming the retina.

Duke Eye Center have refined macular translocation surgery into a technique called macular translocation surgery with 360 degree peripheral retinectomy (MT360).  This is a two-stage surgery that involves rotating the retina to move the macula away from the abnormal blood vessels associated with macular degeneration and then correcting the tilted visual field by rotating the eye.

Macular translocation surgery does have some risks associated with it including retinal detachment, bleeding, double vision, and residual tilting of vision.  All of these risks can be either corrected surgically or with special glasses.

Avastin® (bevacizumab) came into the market as a drug that could reverse the damage caused by wet macular degeneration. Until the approval of Lucentis as a treatment for macular degeneration, many doctors recommended Avastin® (bevacizumab). In fact, many doctors still prescribe and use Avastin as a treatment for macular degeneration because of its relatively low cost when compared to Lucentis.

How Viable is Avastin as a Treatment for Macular Degeneration?

According to the specialists, this prescribed medication is suitable to the eyes and within short span of time; patients will regain their vision and the damage caused by abnormal blood vessels associated with wet macular degeneration is reversed.

Traditionally, Avastin was used for those macular degeneration patients who had previously shown poor results with Visudyne® or Macugen®. In actuality, comparing to Visudyne or Macugen, Avastin will perform brilliantly and accurately to add more clarity and brightness to the vision, and patients shown considerable improvement in reversing the damage caused by wet macular degeneration.

It must be noted that Avastin as a treatment for macular degeneration will have no effect on Drusen deposits generally associated with dry macular degeneration. Avastin is a treatment for wet macular degeneration only, and patients who have availed of this treatment have shown a dramatic improvement in their central vision.

However, the doctors are still uncertain whether there is any negative impact resulting from the use of Avastin when treating macular degeneration. The abnormal growth of cells associated with the eye disease is for all intensive purposed reversed, but there are still questions of safety surrounding the use of this cancer drug in the eye.

While many studies have shown that Avastin is safe to use in the eye, its use for treating macular degeneration is still considered off-label.

As a treatment for wet macular degeneration, Avastin is injected into the eye. Because Avastin is an anti-VEGF drug the series of intravenous injections stops the growth of abnormal blood vessels associated with wet macular degeneration.

The normal dosage of the Avastin is 1.2mg, the same as other macular degeneration treatments such as Macugen.

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Avastin as an Anti-VEGF Medication

Approved by the FDA as a treatment for cancer, Avastin is classed as an anti-VEGF drug in that it shrinks the abnormal blood vessels typically associated with cancer tumours. However, because wet macular degeneration is caused by abnormal blood vessels behind the retina, Avastin has shown to improve the damaged blood vessels and at the same time enhance the flow of the nutrients through blood stream.

Wet macular degeneration can be reversed using Avastin but not in the same dosage as associated with cancer treatments. A single dose of Avastin is broken down into smaller doses for use in the eye.

Avastin is a viable treatment for wet macular degeneration, costing less than other treatments and showing similar results afterwards.

According to Maureen MacDonald, Nova Scotia’s health minister, the province may pay for Lucentis treatments for macular degeneration payments if it can afford the drug.  Lucentis treatments for Novia Scotians is estimated to have a cost of $5 million annually.

MacDonald has indicated “We’re reviewing that drug as part of the budget process.”

For those people in Nova Scotia diagnosed with macular degeneration having access to Lucentis treatments would be a major step forward in treating the degenerative eye disease.  Lucentis treatments are typically injected into the eye of macular degeneration patients suffering from the rapidly progressing version of the eye disease – wet macular degeneration.

Currently the cost of Lucentis treatments for Nova Scotians costs approximately $1,600 per month.  People who are now diagnosed with macular degeneration must pay for these Lucentis treatments themselves while other provinces such as Newfoundland, Ontario and Quebec provide funding for Lucentis.

There is growing support throughout Nova Scotia for the government to provide coverage for Lucentis treatments for macular degeneration.  People are advocating use of the sight saving treatment for the eye disease.

According to Dr. Benjamin Reubinoff, the study’s lead author “Although there are a variety of therapeutic approaches under development to delay the degenerative process, the grim reality is that many patients eventually lose their sight. (Stem) Cell therapy to replenish the degenerating retinal cells may potentially halt disease progression.”

Stem cell treatments are not the only macular degeneration and eye disease treatment being explored.  In 2001 a study released by the National Eye Institute suggested that high doses of antioxidants, beta-carotene and the mineral zinc reduce the risk of vision loss associated with advanced macular degeneration.  Other nutritional supplements containing omega-3 and omega-6 fatty acids have been shown to have benefit at reducing the risk of diseases such as macular degeneration and restore conditions associated with other eye diseases.

However, many are placing hope in the ability of stem cell therapy to provide an eventual cure for degenerative eye diseases such as macular degeneration.  The potential of stem cell treatments have been clearly demonstrated in studies similar to those conducted by the Jerusalem researchers.

The dry macular degeneration eye drop MC-1101 delivered through Mystic’s VersiDoser delivery system successfully reached the back of the eye and modulated blood flow in the choroid.  The delivery system allowed patients suffering from dry macular degeneration to self-administer the eye drop to the front of the eye.

VersiDoser regulates the dosage level and frequency of the eye drop in those patients suffering from dry macular degeneration.  The regulation of MC-1101 dosing allows for the delivery of a preservative-free formulation of the drug.  This precise delivery of the eye drop facilitated the absorption of the drug to the back of the eye affected with dry macular degeneration.

According to MacuClear president and CEO Philip G. Ralston Jr., “We are very pleased with the groundbreaking results of this study.  We have confirmed the safety of MC-1101 in humans, a primary endpoint for the study.”  Mystic president Timothy Sullivan said that “An overwhelming majority of trial participants expressed a strong positive preference for using the VeriDoser delivery system over traditional eye drop delivery.”

Further studies in the dry macular degeneration eye drops are expected to continue later in the year.rop

Avastin (bevacizumab) and Lucentis (ranibizumab) were compared in a double-masked, randomized controlled trial.  Lucentis is the preferred macular degeneration treatment and is approved by the FDA.  Avastin is an off-label macular degeneration treatment and was originally approved to treat colo-rectal cancer.

Until this recent study, there was no data supporting which macular degeneration drug was effective.

In this study, the Veterans Affairs Boston Healthcare System funded a study where patients were enrolled by a 2 to 1 randomization to either the Avastin or Lucentis treatment.  Patients were given intravitreal injections of either Avastin or Lucentis every month for the first three months of the trial and evaluated after the third injection to determine if subsequent macular degeneration treatments were required.

It was shown that at six months, there was no difference in those patients treated with Avastin or Lucentis.

This adds fuel to the debate over which of the two drugs should be used to treat macular degeneration.  Genentech refused to conduct any trials of Avastin as a macular degeneration treatment stating that Lucentis is the FDA approved treatment for the eye disease.

However, Avastin costs approximately $40 per treatment while Lucentis costs approximately $2000 per treatment.  With some patients requiring multiple injections to treat their macular degeneartion, the costs associated with Lucentis treatments can be enormous.

 Tachyphylaxis, or the densensitization of the body to the drug being used, results in a loss of effectiveness of the drug over a period of time. When drugs such as Avastin have to be used over a prolongued period of time. It is thought that this desensitization will occur more frequently when drugs are used with a single target in mind. This is the case with using Avastin to treat macular degeneration. Avastin is used to target the growth of abnormal blood vessels associated with the eye disease.

The researchers reviewed a series of 59 patients whose macular degeneration was treated with the drug avastin. The study took place over a 14-month period and identified those patients that had demonstrated a loss of effectiveness of the drug avastin. Patients were treated with the drug and the effectiveness measured using an OCT.

5 patients were identified to have developed a decreased effectiveness to Avastin when it was used to treat their macular degeneration. Increased dosage did not restore the effectiveness of the drug, and it was apparent that these patients had developed some degree of resitance to Avastin.

It was noted that the median time to develop tachyphylaxis was 100 weeks and the medium number of Avastin treatments to develop the reistance was 8 treatments. This leads to great concern because typically macular degeneration patients require prolongued treatments with anti-VEGF drugs such as Avastin and Lucentis. This means an increased drug resistance over a period of time and eye specialists must ensure that injects of drugs such as Avastin are kept to an absolute minimum.

Further research into the development of a a drug resistance to Avastin when used to treat macular degeneration is ongoing. It is hoped that this desensitization can be reduced by combining Avastin with na intravitreal steroid.

Researchers have identified that blocking the protein known as CCR3 can reduce the abnormal blood vessel growth that causes macular degeneration.  Targeting this new protein may prove both safer and more effective than current macular degeneration treatments.

Current macular degeneration treatments are directed at a protein called vascular endotheilial growth factor (VEGF).  Current macular degeneration anti-VEGF drugs may pose risks of blocking the growth of healthy blood vessels in healthy areas of the body, not just the abnormal blood vessels associated with the eye disease.

The new discovery may enable physicians to detect macular degeneration in its earliest stages before abnormal blood vessels have fully affected the macula and cause vision loss.  Preventing macular degeneration at this early stage would be much better than treating the eye disease with drugs.  According to Mary Elizabeth Harnett, M.D., a professor of ophthalmology in the UNC School of Medicine, “An exciting implication of this study was that CCR3 protein could be detected in early abnormal blood vessel growth, giving us the opportunity to prevent structural damage to the retina and preserve vision.”

With macular degeneration estimated to affect 30 to 50 million people worldwide with the number expected to double in the next 10 years, early detection and prevention of the eye disease is crucial.

Macular degeneration is currently treated with anti-VEGF drugs such as Lucentis, Macugen, and Avastin.  However, as previously stated, blocking the VEGF protein can also damage healthy blood vessels in healthy portions of the body.  Using the CCR3 protein to detect and develop new macular degeneration treatments that specifically target the eye disease.

The presence of the CCR3 protein is detected in people with macular degeneration but not in people who do not have the eye disease.  When researchers blocked the CCR3 protein there was a reduction in the generation of abnormal blood vessels.  Drugs targeting the CCR3 protein associated with macular degeneration were significantly more effective than those targeting the VEGF protein.  This could signal an increase in treatment options for patients suffering from the eye disease where approximately two-thirds of macular degeneration patients do no respond to existing VEGF treatments.

Researchers are now determining whether the levels of the CCR3 protein in the bloodstream can be used to assess risk associated with developing macular degeneration.

Fenretinide is an oral vitamin A binding protein that has been used in patients with advanced dry macular degeneration.  It is believed that the accumulation of retinol or vitamin A toxins can be halted by Fenretinide, thus slowing the formation and accumulation of toxic by-products typically associated with dry macular degeneration.

Patients in the Phase II trial were either treated with a placebo or fenretinide.  Patients treated with 300 mg of oral fenretinide showed slower growth and slower progression of their dry macular degeneration, 22.7 percent versus 41.6 percent in the placebo growth.

Based on the results, Sirion plans to continue its study to its conclusion and will meet with its scientific advisors and FDA to design an an appropriate Phase III trial for fenretinide.

With the results of Fenretinide at slowing the progression of dry macular degeneration, this may offer hopes to those patients diagnosed with the eye disease.  Currently, there are few treatment options for dry macular degeneration.