Changing to Avastin could save NHS £100m a year

The drug Avastin has been in the newscalling for its use in the UK in a bid to save millions each year.

eye-care

Popular in the US, Avastin is used for patients with age-related macular degeneration (AMD). It has been on the market for years, gone through all the testing and has been proven to be as effective as Lucentis, the NHS approved drug for the same condition. The difference is cost. Lucentis typically costs around £700 per treatment, compared to Avastin which is about £70. Yet red tape seems to be halting its use.

It is currently unlicensed in the UK so should anything go wrong with its use, the practitioner may not be legally covered. However, in times of austerity and it is perhaps time for the NHS to move forward and license its use.

The Eye Diet

food

Since the New Year the Sunday papers have been packed full of articles on the ‘latest’ diet.  Sugar seems to be the buzzword for 2014 and it is encouraging to see more focus on simple healthy eating than the usual range of gimmicks and fads from companies selling weird and usually not wonderful, diets.

Most people are inspired by their desire to lose some weight and look better. However few realise how beneficial a good diet can also have on eyesight. Here are some tips for a diet that will leave your eyes looking healthy.

Dark green, leafy vegetables
Eating spinach and kale for example, could help reduced your risk of macular degeneration. They contain lutein and zeaxanthin, two important nutrients that have antioxidant functions in the body and help prevent cell damage. Lutein also helps protect the retina.

Bright orange fruit and vegetables
The likes of sweet potatoes which have a rich source of beta carotene, a natural precursor to vitamin A, the vitamin most commonly associated with healthy eyes. And fruits like oranges are a great source of vitamin C which some evidence has suggested may slow the affects of macular degeneration and the formation of cataracts.

Beans
Adding zinc to your diet by eating zinc-rich foods such as beans, lentils, eggs and turkey will help the liver release vitamin A.

Oily fish
Fish such as salmon and tuna are rich in source of omega-3 which studies have found may also help protect eyes from age-related macular degeneration and dry eyes.

Wheat germ and sunflower seeds
Great sources of vitamin E which can help protect the eyes from free radical damage.

Eating a balanced diet with plenty fruit and veg of all colours will ensure your eyes receive the nutrients they require. Foods like those mentioned above will benefit you in many other ways too, so forget the fads, focus on foods packed full of nutrients and you will notice the benefits both inside and out.

Dame Judi Dench’s fading eyesight

I was very sorry to read of Dame Judi Dench’s declining vision. Up for an Oscar this Sunday, the 79 year old is suffering with age-related macular degeneration (AMD). She has said she can no longer read and struggles to paint and watch films.

Judi Dench

Sadly the condition affects over 500,000 people in the UK to varying degrees, most of those being over the age of 60. The genetic element of the condition is well known and in Dame Judi’s case her mother also suffered from AMD. Visiting your optometrist regularly will ensure early signs are detected allowing the condition to be most effectively managed. Early signs can include blurred and distorted vision and straight lines looking wavy. Using our latest OCT scanners we are able to see cross-sections of the retina to find the earliest signs of AMD which helps us get you access to treatments as soon as possible.

Lenses and glasses will help, certainly in the early stages, and there are some medications and nutrients available that can also slow the degeneration, depending on which variety you have (wet or dry). Because the disease only affects the middle of the eye, sufferers will never experience total blindness. Dame Judi has said she has no plans of retiring, showing that even at its more advanced stages, the disease should not mean a complete change to current lifestyle.

Encouragingly there are many ongoing studies into the disease so we hope that some day soon a cure will be found.

www.macularsociety.org

Potential cure for Dry AMD

There has been a breakthrough in the treatment of the previously untreatable form of macular degeneration (‘dry AMD‘).

Kentucky vision Scientists have discovered the complex chain reaction of proteins and enzymes that happens in the retina causing dry AMD. They demonstrated that using drugs to selectively block these proteins and enzymes halted the process in various disease models.

There has been no trial on humans yet but this gives hope to millions suffering from dry AMD. Usually taken to be the unstoppable ageing process of the retina, dry AMD can get progressively worse with no effective treatment options. This new breakthrough could open up a whole raft of drug therapies to halt or prevent the condition developing.

AMD increases risk of stroke

People with AMD are at a increased risk of having a stroke, new research has suggested.

Following over 12,000 patients over 13 years, the study found that those with any AMD were about 50% more likely to have a stroke than others even adjusting for other factors.

New AMD treatments called Anti VEGF drugs like Lucentis and Avastin are thought to increase risk of stroke in themselves but this latest research finds people with AMD are already at an increased risk and treating AMD could potentially increase the risk.

There were some limitations with the study and further research is needed.

Avastin challenges Lucentis dominance in wet AMD

The leading wet AMD treatment used in the NHS, Lucentis, is under pressure from a cheaper version called Avastin.

Both compounds are from the family of AntiVEGF drugs (anti-vascular endothelial growth factor). In wet AMD, the degeneration causes the retina to make tiny new blood vessels in response to damage. These blood vessels are very fragile and break and bleed into the retina causing scarring and eventually vision loss.

AntiVEGF drugs stop and even shrink the growth of these new blood vessels preventing the damaging bleeding. Until now Lucentis has been the only approved drug for use in the eye and costs over £700 per injection (used in multiples of 3 injections normally). Avastin is in the same family of drugs and currently used to treat heart conditions. Costing only £60 per injection, many specialists in other countries have been using it ‘off label’ in the eye to great effect.

Avastin is now being used to treat 50% of AMD cases in the US and there is increasing pressure on the NHS to approve the use of this drug enabling far more access to the sight saving treatment.

At Cameron Optometry, we’re experts in all forms of macular disease and have the latest OCT technology which is used by specialists to diagnose and monitor the effects of treatment on wet AMD. If you are concerned or have a family history of the condition, come and see us for some expert advice.

Immune system could stop AMD

Researchers in Ireland have found that part of the immune system is involved in the development of Age-related macular degeneration (AMD) and by controlling it, could prevent the progression of the disease.

Using animal and donor human eyes, the team found that the part of the immune system that initiates the inflammatory response in cells leading to conditions like AMD (the fantastically named ‘inflammasome’) could be controlled and doing so prevented the progression of dry AMD to wet AMD.

This opens up a whole new avenue of potential treatment options for AMD. Currently dry AMD can be influenced by nutritional supplements whilst wet AMD requires injections of special types of drugs known as anti-VEGF.

At cameron optometry, we really know our stuff when it comes to AMD and we have the most advanced macular scanning OCT available to give you the most accurate assessment of your macula particularly if you have a family history of AMD.

AMD prevalence increases 4x per decade

A recent meta analysis of journal articles has found the prevalence of Age Related Macular Degeneration (AMD) increases 4 times for every decade of age beyond 50.

retina46 papers from 1950 onwards were analysed by researchers. Due to the differences in the way each of the studies was written, comparison was difficult and among the many interesting details, this key finding emerged: the prevalence of AMD (that is the total number of people with the condition at a given time) increases by a factor of 4 every decade after 50 years old.

At 50 the prevalence of AMD is low at 0.04% but rises to an alarming 12% at age 90 making it a leading cause of registrable visual impairment in older adults.

These findings highlight the benefit of a thorough examination of the eye. Cameron Optometry is one of a handful of practices in the UK with an OCT (Optical Coherence Tomographer) which is the gold standard testing method of AMD. Combining this with our unparalleled expertise in macular disease means we can give the most reliable and accurate advice regarding treatment options.

Stem cell injection improves vision

The Lancet is reporting on an important new breakthrough in the fight against sight loss. Embryonic stem cell transplants have restored vision to patients registered blind as a result of AMD and Stargardt’s macular dystrophy.

Two patients in the US and one Briton were operated on as part of a global trial by US biotech firm ‘Advanced Cell Technology’ carried out at Moorfields Eye Hospital. Although promising, the researchers said such treatments could still be 10 years away from being available on the NHS.

New laser technique for early AMD

A new non-invasive laser surgery technique is being developed at King’s College London that may delay the onset and development of Age-Related Macular Degeneration (AMD).

retinaThe technique rejuvenates the thin layer that lies behind the retina called Bruch’s membrane which provides nutrients to the retina’s light-sensitive cells, improving the removal of waste created as retina cells renew themselves. The procedure can be carried out in 10-15 minutes by and it is suggested that it could be used as a pre-emptive treatment for people in their 30s from families with a history of AMD.

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