Is there a fly in your eye?
Can you imagine looking at the world with a fly persistently hovering at the center of your eye? This must be how it’s like for someone with AMD or age-related macular degeneration, a degenerative eye disease associated with aging. Norminda Daño, 73 years old, relates in her testimony, “Every time I watched my favorite teleserye, there was always a black spot in the center of the television. I was also having a hard time chopping the ingredients whenever I cook.” Besides the development of scotoma or a dark spot in the center of a visual field surrounded by a distorted image, other symptoms of AMD include: distortion of objects that look an unusual size or shape and straight lines appearing wavy or fuzzy, blurring and reduced visual acuity, increased glare sensitivity resulting from sensitivity to changing light conditions, and decreased color vision. Have you ever wondered how it might feel like to live in a world where everything you see is in sepia?
In AMD, the macula is gradually destroyed. The macula is the central part of the retina at the back of the eye that is responsible for the “straight ahead”central vision necessary for identifying faces and doing everyday activities like reading, driving, and sewing. When left untreated, AMD progresses and increases in severity, finally leading to blindness. According to the World Health Organization (WHO), AMD is now the leading cause of severe vision loss in people over the age of 50 in Western countries. It is more likely to cause loss of vision than glaucoma, cataract, or diabetic retinopathy. An estimated 25 to 30 million people worldwide are said to be affected by AMD.
“There are two types of AMD, usually referred to as ‘wet’ and ‘dry’,”Dr. Harvey Uy of the Asian Eye Institute explains. While dry AMD is most common, accounting for approximately 85 percent of all AMD cases, wet AMD accounts for the majority of vision loss. Both wet and dry AMD may affect both eyes, although the onset may not occur at the same time.
When patients start to lose their ability to perform everyday activities independently, such as pouring coffee, shopping, doing housework, using the telephone, or managing their money, working with spreadsheets or using the ATM, their emotional stability may also be affected. People with AMD reportedly feel anxious and depressed, and can suddenly become dependent on caregivers.They are unable to function and prefer to stay home, afraid that they might fall or meet an accident. They stop socializing or even traveling.
“They cannot do the activities that they had been looking forward to doing on their retirement,” Dr. Uy observes. “AMD changes how a patient lives his life. It also has a high economic impact on society and health care.”
The loss of vision due to AMD is potentially as debilitating as other chronic disabling diseases such as arthritis, chronic obstructive pulmonary disease, and even cancer. “The burden of AMD is even greater than that of cancer,” says Dr. Arnold Salud of the
The exact cause of AMD is not known, but a number of risk factors have been identified. These include smoking, obesity, family history or genetics, as well as gender. Women seem more likely to develop AMD than men.
“The best treatment is prevention,” Dr. Salud remarks. “You can lower the risk through lifestyle modification.” Quit smoking if you are a smoker; exercise and maintain a healthy weight; lower cholesterol; increase the antioxidant level in your body by eating more fish and vegetables; take vitamins and dietary supplements.” Dr. Salud adds, “Twenty years ago, there was no treatment for AMD. More recently, available wet AMD therapies have only slowed the decline of vision but have not improved it. Ranibizumab (Lucentis) is the first and only drug shown in controlled clinical trials to improve vision in a significant number of people suffering from the wet form of AMD. It also demonstrated a consistent improvement in the patient’s quality of life due to their renewed ability to perform everyday activities such as reading or telling time.”
Dr. Salud stresses, “Ranibizumab is uniquely designed for the eye. It quickly and fully penetrates all the layers of the retina to reach the affected areas. It is also rapidly eliminated from the body, thus avoiding side effects. With Ranibizumab, patients gain and sustain vision.”
Ranibizumab is the generic name of Lucentis, which is marketed by Swiss drug maker Novartis. It was recognized as a medical breakthrough of the year in 2006 by the editors of Science magazine, the widely respected journal of the American Association for the Advancement of Science.
“We are committed to delivering innovation,” says Novartis president and CEO Peter Goldschmidt. With its strong research base, Novartis was recognized as number one among the top 10 most admired companies in 2007. Novartis, with headquarters in
“With our aging population, the incidence of AMD is increasing,” says Dr. Francis Domingo, Novartis medical director.
Aging cannot be avoided, but it does not necessarily have to be accompanied by vision loss. Ranibizumab (Lucentis) not only halts the progression of the disease but also restores vision. At least three injections into the eye, administered on a monthly period, are needed. There is no down time. A patient who is injected in the morning can go to the mall on the same day. The patient can also do regular activities immediately after treatment, like take a bath.
To help patients meet the high cost of treatment (one vial costs P100,000), Novartis has devised various schemes such as the Kaagapay discount card, the “leap program” where the patient gets a free vial on the third treatment, the deferred payment at zero interest rate, and easy access payment scheme.
For more information about AMD, call Novartis Healthcare Philippines’ patient hotline at 815-9385.
