Intravitreal Injections In Brooklyn, NY
At Brighton Eye we offer professional intravitreal injections for both wet macular degeneration and diabetic macular edema. Our highly trained, board-certified ophthalmologists specialize in these procedures as well as many other eye and vision treatments.
Wet Macular Degeneration
Eleven million Americans have age-related macular degeneration (ARMD). This condition has two forms: dry ARMD and wet ARMD. Wet ARMD is the leading cause of blindness in the elderly. Miraculously, there are now three different drugs that can be used to treat this condition and many more coming down the pipeline in the near future.
The drugs most commonly used are Avastin, Lucentis, and Eylea. As recently as a decade ago, most patients with wet ARMD were legally blind within two years. Today, when these medicines are injected into the eye, vision can be restored in at least one-half of the patients receiving treatment. Not only that, but the disease process stopped in most patients. At Brighton Eye, we have many patients that we’ve treated with these intravitreal injection medications who continue to read, drive, and conduct their normal daily activities. In some patients, we are even able to achieve 20/20 vision.
All three medications are anti-vascular endothelial growth factor (anti-VEGF) drugs and are known to be safe and effective. Two of these drugs, ranibizumab (Lucentis) and aflibercept (Eylea), were designed specifically for the treatment of ARMD and are FDA-approved. The third medication, bevacizumab (Avastin) was originally developed to treat cancer, but can be specially prepared to treat patients with ARMD.
How Do These Drugs Work?
Patients with wet-ARMD have a chemical released in their eyes called VEGF. This chemical induces abnormal blood vessels to grow under, or into, the retinal tissue. These blood vessels are fragile and often leak fluid and blood causing distortion and scar formation of normal retinal structures. Anti-VGF intravitreal injection drugs block this toxic compound causing regression of the growth of these abnormal vessels allowing vision to be stabilized and improved.
How Do We Administer This Medication?
These medications are injected into the eyes of patients with wet-ARMD. The patient’s eye is first numbed with anesthetic drops and gels. An antiseptic drop is then used to prevent an infection. Both Drs. Fell and Brookner are board-certified in treating medical retinal diseases and both perform these injections routinely.
“When I tell my patients that I will inject the medication into their eye, they are initially scared,” says Dr. Fell. The procedure, however, only takes a fraction of a second and is well-tolerated by patients. To be effective, this procedure is repeated in intervals and scheduled on a patient by patient basis. Patients are closely monitored and evaluated for treatment every few weeks.
How Do These Drugs Differ from One Another?
The biggest difference is cost. While Lucentis and Eylea cost about $2000/injection, Avastin costs about $50. Not all insurers cover the more expensive drugs and some only partially cover the cost.
Lucentis and Eylea are FDA-approved, and the drug companies state that seeking this approval was costly and thus justifies the cost of the drugs. Genentech makes both Avastin and Lucentis, but only sought FDA-approval for Lucentis. Avastin is the most commonly used drug by most ophthalmologists and is successfully used to treat this condition.
Diabetic Macular Edema and Other Retinal Vascular Conditions Involving Macular Edema
Diabetic Macular Edema (DME) is the leading cause of blindness in working-age diabetics. In this condition, abnormal blood vessels are formed due to the release of VEGF. These blood vessels leak fluid (edema) into the macula. It is also possible for VEGF to induce abnormal blood vessels to form, causing bleeding and a vitreous hemorrhage to form in the eye.
All three anti-VEGF drugs are effective in treating DME and vitreous hemorrhages. Intravitreal steroid drugs may also be used in cases of DME that don’t respond to the anti-VEGF drugs. These patients are carefully monitored for glaucoma and cataract formation.
These drugs are also useful in patients with macular edema secondary to branch retinal vein occlusion and central retinal vein occlusion.