The symptoms of some eye diseases remain virtually invisible for a long time. A patient suffering from this disease most often consults a doctor only when certain complications occur, for example, when visual acuity decreases. One such eye disease is age-related maculopathy (synonymous with age-related macular degeneration, abbreviated as AMD). The pathology refers to chronic progressive eye diseases and is manifested by a gradual loss of visual acuity, up to irreversible blindness.
Maculopathy can occur in a dry or wet form and is most often detected in people over 50 years of age. In 90% of cases, patients with AMD are diagnosed with the dry form of AMD; it has a more favorable prognosis and a lower risk of vision loss. In 10% of patients, the wet (exudative) form of AMD is detected, and it is this form that very often causes irreversible vision loss in old age.
The main complaints with the wet form of maculopathy are fogginess, blurred vision mainly in the central zone, the appearance of distortions or spots in the center of the visual field, and the ability to distinguish shades of color also decreases. At the same time, at the periphery of the field of view, clarity of perception and color rendition is preserved.
To prevent irreversible vision deterioration, if any of the symptoms described above appear, it is necessary to undergo an urgent eye examination. In our clinic you can undergo an eye examination and receive advice from a qualified specialist. Reception is carried out by appointment, at a convenient time, without tiring waiting and queues.
Video of drug administration
The main cause of visual impairment in AMD is damage to the macula, the central area of the retina that is responsible for normal visual acuity. The macula, or macula, is made up of several layers of cells. To put it simply, it is represented by a layer of photoreceptors, followed by a layer of pigment cells and a thin membrane that separates the macular tissue from the blood capillaries located deeper. The vessels deliver nutrients to the retina and provide its cells with oxygen. With age, so-called drusen form in the retinal tissue - yellowish thickenings, which are accumulations of cell metabolism products. If drusen are detected in the fundus of the eye, the patient is diagnosed with the dry form of AMD. As they accumulate, drusen can provoke inflammation, which is accompanied by the formation of a special pathological protein, vascular endothelial growth factor (VEGF). This protein, in turn, causes the growth of new defective blood vessels (neoangiogenesis). Abnormal vessels are a source of hemorrhages in the retina of the eye, causing irreversible changes in the retinal tissue, including in the macula area. The accumulating fluid detaches the photoreceptor layer from the adjacent membrane and causes retinal detachment. As it progresses, zones of detachment and rough scar tissue appear on the fundus, and the nerve fibers responsible for normal visual acuity are affected.
A feature of the wet form of AMD is rapid progression and irreversible loss of central vision. Therefore, it is so important to begin treatment of the disease as early as possible. Today, in addition to traditional laser coagulation of defective fundus vessels, drugs from the group of angiogenesis inhibitors (anti-VEGF), of which Lucentis is a representative, are used in the treatment of wet AMD.
Lucentis is a drug for pathogenetic therapy of the exudative form of AMD, the mechanism of action of which is associated with blocking pathological vascular endothelial growth factor (VEGF). To obtain a therapeutic effect, Lucentis is injected into the vitreous body as an intravitreal injection (injection into the eyeball). The main active ingredient is ranibizumab.
A prerequisite for the procedure is that it is carried out under sterile conditions; injections must be given by a qualified ophthalmologist who has undergone appropriate training. At the Retina Treatment Center, Lucentis injections are performed under strict aseptic conditions, the procedure is performed by certified specialists who have extensive experience in performing intravitreal injections.
Suppressing the growth of abnormal blood vessels using Lucentis injections reduces swelling of the retinal tissue. As the drug acts, the defective vessels become empty and disintegrate, and the fluid in the fundus resolves. This is accompanied by some improvement in visual acuity and prevents further damage to the macula.
The optimal therapeutic dose of Lucentis is 0.5 mg. To achieve a therapeutic effect, the first three injections should be carried out once a month, after three months the treatment is suspended and the patient’s visual acuity is checked. During one session, Lucentis is injected into only one eye. Within one hour after the injection, the patient's intraocular pressure may rise, which requires timely diagnosis and appropriate treatment.
The expected effect of Lucentis administration is improvement of vision; the duration of the remission period varies from person to person. If during the examination a visual impairment of 1 line according to the Snellen tables is detected, treatment is resumed. The duration of treatment and the number of injections of Lucentis are determined individually by the attending physician. In any case, the patient will need to undergo a visual acuity test and fundus examination 2-3 times a year.
If the rules of asepsis and intravitreal injection technique are not followed, the administration of Lucentis may be accompanied by severe complications such as endophthalmitis (inflammation of the inner membranes of the eye), retinal detachment, cataracts, increased intraocular pressure, and vitreous hemorrhages. Other complications include nausea, nasopharyngitis, anemia, headache, joint and muscle pain, and an increased risk of stroke.
The effect of using the drug Lucentis has been well studied and has been repeatedly confirmed by relevant scientific studies. In the course of large scientific trials, it was found that Lucentis injections not only prevent the progression of pathological changes in the retina in patients with exudative AMD for a long period of time, but also improve its condition, thereby increasing visual acuity.
Therapy with Lucentis
Lucentis is a solution for intravitreal administration, a revolutionary remedy that allows one to preserve and improve the vision of patients with serious eye diseases, who until recently were considered doomed to complete loss of vision.
The drug is based on the substance ranibizumab, which is a substance made from antibody fragments that can prevent cell proliferation and stop the appearance of new blood vessels. Treatment with the drug is intraocular injections performed no more than once a month. Therapy is carried out until the maximum level of visual acuity is achieved, which is determined through monitoring at three consecutive monthly visits to the attending physician.
Lucentis injections can be prescribed as monotherapy or in combination with other treatment methods. Their effectiveness is confirmed by numerous studies proving that vision loss stops during treatment with the drug and even significantly increases its sharpness.
Other reviews after Lucentis injection
Veronika Yakovleva with her mother Anastasia Petrovna
We already had our second injection of the drug. There's a third one coming up in a month. We do it because of diabetes, a spot appeared in front of the eye, as it turned out during the examination, the diagnosis was “wet form of macular degeneration of the right eye.” Vision began to noticeably improve about a week after the first injection, not quickly, however, but we are happy about it.
The injection itself is not painful, there is a slight discomfort after the frost “releases” + you need to drip antibacterial drops for several days. Of course, one cannot say that all this is “pleasant,” but what can you do? You have to be patient in order to preserve your vision.
We are quite satisfied with the treatment of doctors and administrators - everyone is friendly and, which is very important for us, they explain everything “on their fingers” so that ordinary people can understand it: they show videos and draw diagrams on pieces of paper, answer our “stupid questions” - they are very patient (there are What to compare with - we were observed for a long time with diabetic retinopathy in the district clinic.
View the official instructions for Lucentis (PDF)
Intravitreal injections
Lucentis injections are performed exclusively into the vitreous body. Its administration requires appropriate disinfection of the area around the eyes and the eyelids themselves. The procedure is performed under aseptic operating room conditions, with mandatory disinfection of the hands of medical personnel, the use of sterile materials and instruments, including: gloves, napkins, eyelid dilators, everything necessary to perform paracentesis.
Before the injection, antimicrobial agents and drops are instilled into the eye to anesthetize the conjunctiva. In preparation for an intravitreal Lucentis injection, antimicrobial eye drops are started daily three days before the procedure and continued for three days after.
The volume of the injected solution is 0.05 ml, the injection is carried out in one eye only.
Precautions when using the drug
The drug should only be administered by an ophthalmologist with sufficient experience in intravitreal injections. Injections require compliance with the rules of asepsis and antisepsis.
Within a week after administration of the solution, the patient needs medical supervision to prevent possible complications. If any undesirable changes occur, you should immediately consult a doctor.
Lucentis is not administered to both eyes at the same time to avoid the development of serious side effects. During treatment with the drug, you should give up alcohol.
During treatment with the drug, some visual impairments are possible, which negatively affect the patient’s ability to drive vehicles and work with moving mechanisms.
Side effects and contraindications
An injection of the drug can cause an increase in IOP that lasts at least an hour. Therefore, doctors monitor it and control the perfusion of the optic nerve head, providing the necessary treatment according to indications. In addition, headaches, increased anxiety, and the occurrence of flu-like conditions cannot be ruled out.
Possible complications of the procedure include inflammation, trauma, hemorrhage, retinal detachment, and persistent increase in IOP.
Intravitreal injections of Lucentis are not prescribed for:
- Infectious inflammations of the eyes
- Intolerance to ranibizumab
- Risk of stroke
In addition, the drug is not used in children, as well as in women during pregnancy and breastfeeding.
As practice shows, some patients refuse intravitreal injections of Lucentis. This is due to two reasons: fear of intraocular infusion and the high cost of the drug.
However, according to reviews from those who have undergone the procedure, the insertion is absolutely painless, and the pain that occurs over the next few days is quite tolerable. Another thing is the price of the drug, it is really quite high. But when it comes to complete loss of vision in the absence of necessary treatment, the cost is quite comparable to the potential risk. Moreover, the effect of using Lucentis has been proven, and vision improvement is guaranteed.
Lucentis. Price and cost of treatment
The price of treatment with Lucentis includes not only the cost of the drug, but also the intravitreal injection procedure itself. This procedure, despite its apparent simplicity, is no less important manipulation than other types of interventions in ophthalmology. There is a risk of developing infectious complications after administration of the drug into the cavity of the eyeball. Therefore, such manipulation should be carried out only by a highly qualified specialist under sterile conditions. The need for intravitreal injection of Lucentis in a specialized operating room, as well as the use of a large number of consumables, determines the cost of using Lucentis. The price of Lucentis in the Russian retail pharmacy network is 50,000-52,000 rubles. The cost of intravitreal administration of the drug ranges from 18,000-25,000 rubles. It is also necessary to remember about control visits to the ophthalmologist during the treatment process, as well as about diagnostic procedures prescribed by the doctor.
Effect of the drug
The active component of the solution, ranibizumab, is a humanized antibody fragment of endothelial growth factor A expressed by Escherichia coli (a recombinant strain) that inhibits angiogenesis.
There is a selective connection between the substance ranibizumab and isoforms of vascular endothelial growth factor, VEGF-A and others, which prevents their interaction with receptors on the surface of endothelial cells. This helps to suppress the process of neovascularization and vascular proliferation. The use of Lucentis solution stops the growth of newly formed vessels and inhibits the development of age-related macular degeneration.
With the use of the drug, a persistent decrease in the thickness of the retina is observed, which is confirmed by coherence tomography data.
Monthly injection of the solution into the vitreous helps to achieve maximum concentration in the blood plasma, which is sufficient for a long-term therapeutic effect.
Makugen
Macugen is a drug intended for intravitreal injections. The procedure must be performed by an experienced doctor. Therapy lasts approximately 12 months. During this time, the doctor performs 9 injections. After the procedure, a short-term increase in intraocular pressure is observed.
Macugen is contraindicated in patients with hypersensitivity to the components included in the composition and for periocular injection. Treatment during pregnancy is not recommended.
Among the adverse reactions, endophthalmitis is most often observed. If the results of therapy do not show the desired result, then you should stop taking Macugen. In such cases, the ophthalmologist must choose a different treatment method. The price of the drug is within 40,000-43,000 rubles.
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