The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eyes and is called the retina. It has arteries that provide it blood flow and veins which drain the blood. Diabetic changes are characterized by abnormally leaky blood vessels. This may allow fluid to accumulate in the retina and decrease the quality of vision.
Fortunately, this condition is very treatable. The average person experiences a 2 line improvement in their vision within the first three months of therapy.
Avastin is a medication which is injected into the eye that causes the blood vessels to become less leaky, and the accumulation of fluid to resolve.
Avastin is injected every month until the accumulation of fluid is resolved. Most patients will notice a significant improvement in vision following 3 treatments. The typical patient will require 10 injections during the first 12 months of therapy and 6 injections during the second year of therapy. The number of injections continues to decrease as time goes on.
There are some patients who do not have an adequate response to Avastin. Should this occur, there are other medications available which are typically quite effective.
The alternatives to an intravitreal injection are no treatment or an in-office laser procedure.
Avastin is the most commonly used medication for the treatment of diabetic macular edema worldwide.
This medication is not FDA approved, but is widely accepted to be safe and effective.
The main risk inherent to this medication is the development of floaters. This is uncommon but can occur due to silicone oil within the medication. If this occurs, it is typically temporary. It is very uncommon for patients to notice these floaters after the first few days.
The main risk of the procedure is the development of an infection called endophthalmitis. Fortunately, the risk of this infection is very low, occurring in approximately 1 in 3000 injections. Patients can decrease their risk of developing an infection by avoiding rubbing, touching their eyes, or allowing water into their eyes for at least one week.
Please review information on the intravitreal injection procedure for more helpful details. There will be no graphic photos or images.
Most patients undergoing this treatment note a significant improvement in their vision and are surprised that the injection may be administered in a painless manner.
What should patients watch out for?
The new onset of worsening blurry vision may be a sign of increased swelling in the macula. We ask patients to contact their eye care specialist if they note worsening vision as this may be a sign that treatment is needed sooner than the next scheduled visits.
The onset of many new floaters or decreased vision may be a sign of new bleeding. This is treatable but does require you to contact your eye care specialist.
Why is it important to follow-up with your eye care specialist?
Untreated swelling in the macula can cause permanent vision loss if present for weeks to months without treatment.
Abnormal new blood vessels can return following treatment. They may bleed and temporarily decrease vision. Your eye care specialist may be able to detect these in the early stage and initiate treatment to decrease the risk of vision loss.
Treatment at the correct duration helps to maximize vision.
I hope you found this information helpful.
Please reach out to your eye care specialists if you have additional questions or concerns.