Beating diabetic blindness

Diabetes affects 26 million people in the US and is the leading cause of new blindness in adults. Now, for the first time in a long time, the FDA has approved a drug to help save diabetics' vision.

Tax accountant John Dunn has had diabetes for 20 years, but he had no idea it was hurting his eyes.

"I was having a lot of headaches and I thought it was the stress of tax season," said Dunn.

A routine eye exam showed he had diabetic macular edema, or DME.

"I think I could have lost my vision," he said.

Instead, Dr. Allen Ho was able to save Dunn's sight with Lucentis, a drug used for years to treat macular degeneration. The drug was recently FDA approved for DME.

"It's the first new treatment for patients with diabetes and diabetic macular edema in 25 years," said Dr. Ho, Director of Retina Research at Mid-Atlantic Retina.

Traditional laser treatments focused on stopping a patient's sight from getting worse, but could not restore vision. Dr. Ho said Lucentis can.

"This drug is really a miracle drug," said Dr. Ho.

It is injected directly into the patient's eyes. Dr. Ho said the number of injections needed varies patient-to-patient.

"It usually feels like a little pinch. Patients are nice and numb," said Ho.

The injections have restored Dunn's vision to almost 20/20. Now he is grateful for the gift of sight and focused on managing his diabetes.

Dr. Ho said far too many diabetics have no idea that diabetes can affect the eyes. He recommends diabetics get an eye exam at least once a year, whether they are having vision problems or not.

BACKGROUND: Diabetic eye disease refers to a group of eye problems that people with diabetes may face as a complication of diabetes. All can cause severe vision loss or even blindness. Diabetic eye disease may include: Diabetic retinopathy-damage to the blood vessels in the retina; Cataract-clouding of the eye's lens. Cataracts develop at an earlier age in people with diabetes; Glaucoma-increase in fluid pressure inside the eye that leads to optic nerve damage and loss of vision. A person with diabetes is nearly twice as likely to get glaucoma as other adults. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina. In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. (Source: healthproblems101.com)

SIGNS: Often there are no symptoms in the early stages of the disease, nor is there any pain. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year. Blurred vision may occur when the macula-the part of the retina that provides sharp central vision-swells from leaking fluid. This condition is called macular edema. If new blood vessels grow on the surface of the retina, they can bleed into the eye and block vision. At first, you will see a few specks of blood, or spots, "floating" in your vision. If spots occur, see your eye care professional as soon as possible. You may need treatment before more serious bleeding occurs. Hemorrhages tend to happen more than once, often during sleep. Sometimes, without treatment, the spots clear, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be effective. (Source: http://www.nei.nih.gov)

TREATMENT: During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding. If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye. (Source: http://www.nei.nih.gov)

NEW TECHNOLOGY: The FDA has just approved of a new drug called Lucentis that has shown to save diabetics' vision. The drug is injected into patients eyes, but patients often don't even feel it. Commonly reported side effects of Lucentis include bleeding of the eye's conjunctiva tissue, eye pain, floaters and increased pressure inside the eye. Lucentis, marketed by San Francisco-based Genentech, was approved previously for wet age-related macular degeneration, and another form of macular edema.
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FOR MORE INFORMATION, PLEASE CONTACT:

Cathy Moss
Media relations
Wills Eye Hospital
(215) 928.3000
cmoss@willseye.org


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