Tag Archives: Lee Eye Centre (LEC)

Eye Chat – Eye injections for the treatment of retinal diseases

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ipoh echo issue 140, Dr Lee Mun Wai, Lee Eye Centre, Stem Cells in Retinal Disease
Dr Lee Mun Wai

From a Retinal Surgeon’s Perspective

Intravitreal injections are a very effective way of delivering drugs for treatment of certain serious diseases in the eye and particularly the retina. This has been done for many years when used to treat severe infections or inflammation of the eye but it was not until recently that a ‘revolution’ in the treatment of age related macular degeneration (AMD) led to the very routine use of these injections and has now become a very important part of the armamentarium of a retinal surgeon.

What exactly is an intravitreal injection?

Lee Eye Centre Ipoh - Dr Lee Mun WaiAs shown in this image, it involves “sticking a needle” into the eye and releasing specific drugs into the vitreous cavity. It is used for the treatment of a variety of eye diseases but in recent years, it has revolutionized the management of retinal diseases and has a significant impact not just on affected patients but also on retinal surgeons’ lives!!

The “Revolution”

The rise of intravitreal injections started in 2004 when intravitreal Macugen was first used in the management of AMD. This drug was developed to inhibit vascular endothelial growth factor (VEGF) which is a growth factor involved in the development of blood vessels. This had modest effect on the disease but the following year when Avastin (another inhibitor of VEGF) was first used to treat AMD, the revolution truly took off!

This was the first time there was any treatment that could actually improve vision in people with wet AMD. From Avastin, another drug came into the market in 2006 – Lucentis. This was a designer drug specifically manufactured to treat VEGF driven eye diseases as compared to Avastin (which was a cancer drug for metastatic bowel cancer).

The impact of this ‘revolution’ extended beyond its positive effects on patients but also the increased workload for retinal surgeons as these injections had to be given every month in order to maintain its efficacy. There were also far reaching consequences for healthcare services in some countries as reimbursement for this very expensive drug burned very large holes in the healthcare budget!

What conditions are treated with intravitreal injections?

The anti-VEGF drugs (Avastin & Lucentis) were initially used to treat wet AMD. However, it’s use has extended to many other retinal diseases which all have a common association; i.e. the blockade of VEGF would result in a positive impact on the disease. Aside from wet AMD, other diseases would include diabetic retinopathy, retinal vein occlusions (or eye stroke), neovascular glaucoma and even retinopathy of prematurity.

So far, I have mentioned only anti-VEGF drugs which have resulted in an exponential increase in the number of intravitreal injections in recent years. In actual fact, this technique of drug delivery is not at all new. We have been giving antibiotics (in cases of severe eye infections), anti-virals (in patients with AIDS) and steroids (for inflammatory eye diseases) for a long time. This mode of drug delivery allows for a good amount of drug getting to the intended target without having large amounts in the body (when taken orally or through a vein) and giving unwanted side effects.

The Future of intravitreal injections?

More drugs are being developed to treat these retinal diseases – some which can last longer and would therefore, reduce the frequency of injection. Other techniques are being researched i.e. different ways of storing and releasing the active drug in a gradual and controlled manner could mean even less frequent injections. Safe to say however, intravitreal injections will continue to play a big role in the treatment of retinal diseases in the near future or until the next “revolution”. I leave you with a link to a nice video clip which describes the intravitreal injection process from a lay person’s point of view.

http://www.lec.com.my/youcare-eyecare/the-rise-of-intravitreal-injections

For more information about this topic or other eye health subjects, please visit my blog at:
www.lec.com.my/youcare-eyecare. Or call Lee Eye Centre: 05-254 0095.

Wavelight Refractive Suite – First In Asia Launched

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Lee Eye Centre (LEC) launched their WAVELIGHT Refractive Suite which is the first commercial suite of its kind in the Asia Pacific Region. Dato’ Dr. Lee Yooi Chyun, Cha

 

irman of LEC, informed that the suite is the world’s fastest laser vision correction platform for disorders that include short-sightedness, long-sightedness and astigmatism. He added that the advanced technology is a cost-effective and convenient option for those who want to dispense with wearing spectacles and contact lenses and also for those who do not wish to be burdened with repeated corrective procedures.

Medical Director of LEC, Dr. Lee Mun Wai explained that the state-of-the-art suite with the integrated computer network provides a high level of safety when performing laser vision correction. The procedure is quick, less than ten minutes, safe and painless and requires only the use of eye drops as anaesthesia. Visual recovery is very fast and patients will be able to resume normal activities like driving, reading and computer usage within a day or two.

Dato’ Dr. Mah Hang Soon, State Exco member for Health officially launched the suite by unveiling the plaque and signing it.

AJ