A Patient’s Perspective on:

Macular Degeneration Treatment with Avastin…

Here is a note from a patient demonstrating their perspective on the long term treatments for this blinding problem. The initial diagnosis was made in 2009 and the treatments are on going today in 2023 (14 years or >120 injections). The patient nor the doctor gave up on the continuous treatment regimen. After 14 years, the vision has been maintained in the 20/30 to 20/40 range with documented blood vessels in the center of the vision (macular center or reading vision). This alone should have cost the reading vision to be gone in the first 3 months preventing the patient from driving or reading ever again. Treatments consist of monthly injections but as it was both eyes, they initially alternated every 2 weeks, first the right then left eye. As things settled down, longer intervals could be done (now 6 weeks between injections). The long term data like this to guide the physician has not been researched or published. Our own analysis has shown that you never quite stop injecting but you can slow down significantly. Some patients have stopped and about a year later, on average, the blood vessels grow back causing permanent vision loss that cannot be recovered with starting the therapy again. So you never quite stop getting treatments! The first drug used was Avastin and for years that was our best choice. Drug companies copied the drug, changed the name and the price but they did not do as well as Avastin (double dose) performs.

The eye injections sound horrible, however, how it is done makes all the difference in the world. Using only topical drops to numb the eye gets the superficial layers but not the deeper layers so most of the patients tend to feel the injection. If Lidocaine is injected at the site after the drop is put in, that numbs the deeper layers and most patients are surprised that they did not feel the injection at all. They do not mind coming back to get more shots on time and therefore the outcome is superior. The down side of injecting lidocaine is that people taking aspirin or blood thinners tend to get a red eye after injections. This can be treated with a warm washcloth to hold warm heat to the closed eye for 5 minutes two times a day for a week and the blood on the white part of the eye will resolve. It cannot get into the eye.

With any injection even cleaned with Betadine, there can be an infection getting into the eye either at the time of injection or at home. Instructions to the patient consist of washing the face and eye lids with soap and a warm washcloth two times a day for 4 days after each injection to keep the eye clean. The risk of infection is extremely rare and will be treated. Please inform the doctor if you have increasing pain or decreasing vision right away. If you cannot communicate with the doctor, go to the emergency room at Vidant Hospital where it will be evaluated.

Here is the patient’s letter:

(Published with permission)

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