Diabetes over a period of time can severely affect vision of a person through an ailment called 'diabetic retinopathy'. Normally ophthalmologists burn retina's leaking blood vessels that cause this disease using lasers. Patients who do not respond to the laser treatment are then injected a drug called 'avastin'. A city eye surgeon Dr Ajay Ambade has now successfully tested a newer two-drug therapy to treat these patients as a part of a scientific study. Normal vision could be restored in about 23% of the patients.
The study recently presented at the Joint Congress of American Academy of Ophthalmology and European Society of Ophthalmology at Geneva received good response from the experts in the field. After about five years of onset of diabetes, most persons suffer vision impairment when fine blood vessels supplying to retina leak due to increase in blood pressure in them. The accumulated blood clots start affecting the vision. In medical terms, condition is called 'residual macular edema'. If untreated, patients can go completely blind.
Laser is used to burn these leaking vessels but some patients do not respond to laser. Conventionally, avastin is injected inside the eye (intra-vitreal) to correct the problem. "In last few years, doctors have been trying other drug combinations. I did a sample study using two drugs that showed good results and this was well accepted by world experts," Dr Ambade told TOI.
He claimed that the two drug therapy was used for the first time in India at least as per published information. He used a low dose of the two drugs, avastin or bevacizumb (0.05ml/1.25 ug) and triamcinolene acetomide (0.05ml/12ug), a steroid. The study was conducted on 49 patients (32 males and 17 females) with mean age of 58 years with support from Dr Sunil Gupta, a diabetologist. There was near normal vision restoration in 23% cases while in remaining, the vision improved reasonably well. The drug therapy, however, cannot restore vision completely. The side effects like glaucoma and cataract were also minimal. Vision improvement was much better in younger patients.
Dr Ambade admitted that to optimize the dose some more studies with a bigger sample of patients were needed. In the present study, in two patients the intra-ocular (eye blood pressure) was raised and needed anti-glaucoma medicine in second month.
GIFT OF VISION
Vision restored to near normal in 23% patients
Vision 6/60 in others
Due to very low dose, the side effects minimal
Onset of glaucoma and cataract could be prevented
What is diabetic retinopathy?
It is most common eye disease among diabetic patients. It affects both eyes. In some patients, blood vessels may swell and leak fluid. In others, abnormal new vessels grow on the surface of the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
What is macular edema?
Normally the image formation (vision) takes place in the macula, the most sensitive part of retina in the eye and the image is sent to the brain by the optic nerve. In diabetic eye, the macular portion is affected. The blood vessels supplying the retina portion swell and leak, causing clotting of blood in the area. The light cannot penetrate the area affecting image formation.
What are the treatment options?
The disease comes quietly with almost no symptoms. Standard treatment option is burning leaking blood vessels with laser. Among those who do not respond to this, injecting medicines is the only option. It can be detected early with preventive and regular check ups. In the last few years, use of anti-vascular endothelial growth factor (VEGF) or hormone therapy is being used to treat the disease.
The study recently presented at the Joint Congress of American Academy of Ophthalmology and European Society of Ophthalmology at Geneva received good response from the experts in the field. After about five years of onset of diabetes, most persons suffer vision impairment when fine blood vessels supplying to retina leak due to increase in blood pressure in them. The accumulated blood clots start affecting the vision. In medical terms, condition is called 'residual macular edema'. If untreated, patients can go completely blind.
Laser is used to burn these leaking vessels but some patients do not respond to laser. Conventionally, avastin is injected inside the eye (intra-vitreal) to correct the problem. "In last few years, doctors have been trying other drug combinations. I did a sample study using two drugs that showed good results and this was well accepted by world experts," Dr Ambade told TOI.
He claimed that the two drug therapy was used for the first time in India at least as per published information. He used a low dose of the two drugs, avastin or bevacizumb (0.05ml/1.25 ug) and triamcinolene acetomide (0.05ml/12ug), a steroid. The study was conducted on 49 patients (32 males and 17 females) with mean age of 58 years with support from Dr Sunil Gupta, a diabetologist. There was near normal vision restoration in 23% cases while in remaining, the vision improved reasonably well. The drug therapy, however, cannot restore vision completely. The side effects like glaucoma and cataract were also minimal. Vision improvement was much better in younger patients.
Dr Ambade admitted that to optimize the dose some more studies with a bigger sample of patients were needed. In the present study, in two patients the intra-ocular (eye blood pressure) was raised and needed anti-glaucoma medicine in second month.
GIFT OF VISION
Vision restored to near normal in 23% patients
Vision 6/60 in others
Due to very low dose, the side effects minimal
Onset of glaucoma and cataract could be prevented
What is diabetic retinopathy?
It is most common eye disease among diabetic patients. It affects both eyes. In some patients, blood vessels may swell and leak fluid. In others, abnormal new vessels grow on the surface of the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
What is macular edema?
Normally the image formation (vision) takes place in the macula, the most sensitive part of retina in the eye and the image is sent to the brain by the optic nerve. In diabetic eye, the macular portion is affected. The blood vessels supplying the retina portion swell and leak, causing clotting of blood in the area. The light cannot penetrate the area affecting image formation.
What are the treatment options?
The disease comes quietly with almost no symptoms. Standard treatment option is burning leaking blood vessels with laser. Among those who do not respond to this, injecting medicines is the only option. It can be detected early with preventive and regular check ups. In the last few years, use of anti-vascular endothelial growth factor (VEGF) or hormone therapy is being used to treat the disease.
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