New York Times (July 19, 2011)-This week on the Consults blog, Stephen Rose of the Foundation Fighting Blindness took reader questions about macular degeneration and related diseases. Here, Dr. Rose responds to questions about macular degeneration. See, too, his responses in “Vitamins for Vision Loss.”
Wet vs. Dry Age-Related Macular Degeneration
What’s the difference between wet and dry A.M.D.?
Johnny E., Tex.
Dr. Stephen Rose responds:
Wet age-related macular degeneration occurs when abnormal blood vessels behind the retina start to grow under the macula, a small spot where vision is sharpest. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye, and loss of central vision can occur quickly. If it is not treated quickly, retinal cells that provide vision can degenerate, as well. An early symptom of wet A.M.D. is that straight lines appear wavy.
Dry A.M.D. occurs when the cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry A.M.D. gets worse, you may see a blurred spot in the center of your vision. You may also have difficulty recognizing faces. You may need more light for reading and other tasks. Dry A.M.D. generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.
Approximately 85 percent of people with severe vision loss from A.M.D. have the wet form. However, having dry A.M.D. greatly increases the chance of developing the wet form.
Avastin vs. Lucentis for Macular Degeneration
What do you think of Avastin as a therapy for wet macular degeneration?
Maria, Hastings-on-Hudson, N.Y.
The decision to use Avastin or Lucentis for treating wet age-related macular degeneration is one that you and your ophthalmologist need to make together. Lucentis is the Food and Drug Administration-approved treatment for wet A.M.D., whereas Avastin, which is F.D.A.-approved for treating certain cancers, has been used “off-label” to treat wet A.M.D.
The final results of the “head-to-head” clinical trial of Lucentis vs. Avastin (the CATT study financed by the National Eye Institute) remain to be seen. A one-year interim analysis of the two-year study was reported this spring in The New England Journal of Medicine. The interim report states that Lucentis and Avastin have been equally effective thus far in maintaining or improving visual acuity.
To read entire the interview with Dr. Stephen Rose, please click the above title.
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