Vitreoretinal and Laser Surgery, Pharmacologic Retinal Treatment
Over the past decade, medications have emerged as the preferred treatment for many retinal conditions such as exudative macular degeneration, diabetic retinopathy, and retinal vein occlusions. These include FDA approved medications such as anti-VEGF inhibitors Lucentis and Eylea and off label use of Avastin. Steroid medications approved for intravitreal usage include Ozurdex and Iluvien. Off label FDA approved drugs such as Triescence, a form of dexamethasone are also used in the eye. These medications are administered in the office using topical anesthetic agents on a routine basis by retinal specialists and are generally safe and effective for many conditions. They are injected in the vitreous cavity with little discomfort as frequently as monthly. Steroid medications last for at least 3 months and some have a duration of action as long as 3 years. Many companies are developing longer-lasting medications or long-term delivery systems.
Uveitis patients can sometimes avoid complications of long term systemic steroid use with steroid implants surgically inserted into the eye such as Ozurdex and Retisert for some inflammatory conditions. Immunosuppressive therapies used in the treatment of uveitis includemethotrexate, azathioprine, and mycophenolate mofetil. More recently, options available to treat people with severe uveitis that does not respond to other therapies include tumor necrosis factor (TNF) blockers such as adalimumab (Humira) (injected under the skin. Acthar, an FDA approved medication since 1952 may help uveitis patients via stimulation of the body’s own endogenous steroid production and potential direct anti-inflammatory and immunomodulatory properties.
"Since 2005, we have experienced a dramatic improvement and change in treatment for a variety of ophthalmic conditions using medications in the eye. These medications have revolutionized treatments of macular degeneration, retinal vein occlusions and diabetic retinopathy. Miraculous anti-VEGF medications have enabled us to stabilize 90% of eyes or even improve vision in about a third of patients with exudative or the "wet" form of macular degeneration for years. Medications are effective in stabilizing or improving vision for patients with diabetic macular edema."
James M. Maisel, M.D.
Doctors in the Retina Group of New York serve on the medical advisory board and lecture to patients and physicians in pharmaceutical sponsored events that are monitored and regulated closely by the FDA. We do this because we believe in the medications, want to understand everything possible about them and their uses and keep abreast of the latest innovations and future treatments in development. We work with top retinal physicians from around the country and strive to educate other retinal doctors with our knowledge and experience. We have no incentive to pick one medication over another and always act in the best interests of our patients.