Seeing Eye To Eye

Aspirin Use and Advanced AMD

Written By: Nancy Holekamp | October 11, 2011

Recently in the press there was an article warning of the “dangers” of taking aspirin daily if you have age-related macular degeneration.  Before we stop a practice that has been validated over and over again in large clinical trials with thousands and thousands of patients (ie. Elderly individuals minimizing their risk of heart disease by taking aspirin on a daily basis) because of a single 839 patient epidemiologic study, let us look at the facts.

Researchers led by Paulus de Jong in the Netherlands collected health from nearly 4,700 people over age 65.  Of the 839 people who took aspirin each day, 36 had an advanced form of the disease called wet macular degeneration — or about four out of every 100 daily aspirin users.  In comparison, roughly two out of every 100 people who took aspirin less frequently had wet macular degeneration.  So…..we are comparing 4% of people to 2% of people.  Perhaps we should call for a larger study.  Actually, that is what Paulus de Jong has said:  “Larger studies that follow people over time and document their aspirin use and vision will help resolve aspirin’s role in macular degeneration.  He then added, “For people with cardiovascular disease who take aspirin to prevent the condition from worsening, the benefits of the drug outweigh the risks to visual health.  A healthy eye with full visual capacities is of no use in a dead body.”  I agree with Dr. de Jong.  Actually, he and I are members of the same international research society called the Macula Society and I hold Dr. de Jong in high regard.  I think his advice is worth taking on a daily basis.

Women and Eye Health

Written By: Jay Pepose | May 12, 2011

Did you know that each year, more women than men are diagnosed with vision threatening conditions? For example, of over 2 million Americans over age 50 with macular degeneration, over 1.3 million are women. Women account for 2.3 million of the 4 million Americans age 40 or older with diabetic retinopathy. Overall, women comprise 2.3 of the 3.6 million Americans age 40 or older who are visually impaired to the point where they do not qualify for a driver’s license.

Another common example is the finding that dry eyes are twice as common in women than in men. Underlying theories for these observations vary. For example, some have postulated that decreasing levels of androgens around the time of menopause may play a role in the development of dry eye syndrome.

Women are so involved in caring for their families, that often they may ignore their own health issues. I strongly encourage women to make eye health a priority both for themselves and their families, as many of these conditions can be effectively treated if detected early.

Avastin & Lucentis Clinical Study Results

Written By: Nancy Holekamp | May 6, 2011

CATT Trial Injections for Treatment of
Wet Age-Related Macular Degeneration
Reported in the New England Journal of Medicine

On Friday April 29, 2011 the results of the head-to-head trial comparing Avastin injections to Lucentis injections for treatment of wet age-related macular degeneration or AMD were reported in the New England Journal of Medicine. The study was a large, randomized, prospective clinical trial. In other words, it met the gold standard for research. The study found that Avastin and Lucentis were essentially equivalent. This is big news because the cost of Avastin is about $50 and the cost of Lucentis is about $2,000. We are all concerned with cutting healthcare costs. The study also found that monthly monitoring and receiving injections only as needed was essentially equivalent to receiving routine monthly injections. However, it is important that patients with wet AMD keep to a monthly schedule of visits with their retina specialist for the best results.

Ways You Can Reduce Your Chances of Getting Macular Degeneration

Written By: Jay Pepose | January 29, 2010

As the baby boomers are getting older and living longer, we may be seeing more and more age-related eye problems—one of which is age-related macular degeneration. This conditions affects the part of the retina called the macula, which, like the film of a camera, “develops” the central visual image and sends the signal onto the brain where we perceive sight. Many of my patients who have members of their immediate family with macular degeneration become concerned with their own risk and have asked me what they can do to reduce their chances of acquiring this condition.

While we cannot alter our genes, there are a number of things that can do in an effort to modify and reduce the risk of macular degeneration or having mild forms of the disease progress to more advanced forms.

• Stop smoking or, if not possible, cut back on cigarettes
• Eat more fish per week
• Take vitamin supplements which contain lutein, zeaxanthin, zinc and/or omega-3
• Reduce your Body Mass Index: try to lose weight
• Protect your eyes from sunlight: wear UV-protecting sunglasses when outdoors
• Control your cholesterol level
• Control your blood pressure level
• Increase your macular pigment level, which may be possible through consumption of egg yolks

Bausch and Lomb has a useful website, where you can estimate your own personal risk of macular degeneration and also the impact of changes in diet or lifestyle that may reduce the risk. It is available at www.bauschjoyofsight.com. There are new treatment options for the wet form of macular degeneration and many potential drugs in the pipeline. It is important to do everything we can in regard to diet and lifestyle modifications to reduce the risk of macular degeneration as much as possible. Further information about macular degeneration is available on our website at http://www.peposevision.com/3deye.php. While there is no substitute for a thorough eye examination, some patients monitor for changes in their central vision at home by the use of Amsler grid testing. The Amsler chart can be printed out for home use, and is available at http://www.macular.org/chart.html.