Allies Voice: You put that needle where?!? Anti-VEGF shots
It doesn't sound sexy, by any stretch of the imagination. Believe me when I tell you - it's worth the 5 seconds of slight discomfort! I'm talking about the ground-breaking anti-VEGF treatments. They have been shown to significantly improve vision in patients with diabetic retinopathy. After several months of treatment (yes - an injection in the eye) patients vision improved as much as 2 lines on the standard eye chart. I'll take it...and I did! I share my experience with you because a year ago - I was curious about anti-VEGF eye injections, too.
Don't be fooled by the needle in the eye delivery. The shot of Avastin in my eye did a world of wonder! For an eye I thought was officially on the DL - 5 seconds of slight discomfort gave me back a line on the eye chart I never thought I'd see again. This is only 1 month after my injection.
When I met with my new retinologist, Dr. Weber, the appointment went down pretty cut-and-dry. She performed the "nice to meet you" fluorescein angiogram - it's standard procedure for new patients. Waste not want not - no sooner did they inject the dye, it seems, we were meeting in her office discussing the possibility of an anti-VEGF treatment.
VEGF stands for vascular endothelial growth factor. These growth factors are important signaling proteins that affect diabetes retinopathy. An anti-VEGF treatment inhibit the growth of blood vessels in the eye. Diabetic retinopathy is occurs when the retina tries to pop out new cells. Unfortunately the integrity of these cell membranes are weak. These new cells become leaky, the vision gets blurry, and the cells are prone to hemorrhage. Here's why anti-VEGF treatments like Lucentis and Avastin may be a better treatment for diabetic retinopathy.
What does a shot in the eye feel like anyway? For those who have experienced laser treatment - let me assure you a shot in the eye is a cakewalk compared to the merciless flashing laser beams into the retina. In fact, now that I've been through the song-and-dance a few times…should my MD ever suggest it again… I'm going to overrule.
Don't be fooled by the reputation of needles. C'mon - you've got diabetes! Needles are par for the course. So what if this shot goes in your eye? It does amazing things for your vision. Don't take my word for it - ask your doctor if a shot in the eye is right for you.
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Allie—
Having had a few shots in the eyes, along with a ton of laser, I can wholeheartedly agree with your assessment. Can you tell me what the theory BEHIND increased visual acuity when the treatment by laser arrests the proliferation of blood vessels to the extent there is no more hemorrhaging? Why would a shot of this material increase visual acuity, if there is no miscellaneous blood in the vitreous? Is this procedure recommended ONLY for active diabetic retinopathy (proliferation of blood vessel tissue)? How does the cost compare with laser treatment? Is it covered by insurance?
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You do realize that Avastin is made by Genentech, the biotech company who has continued to receive licensing fees for synthetic rDNA "human" insulin, don't you? I think many people have not-so-positive experiences with that product, although its worth noting that the FDA regulates this as a biopharmaceutical, whereas insulin is considered a small-molecule drug like aspirin even though its a much more complex protein. The bottom line is that Avastin is probably made under better conditions -- including mandated batch testing -- than synthetic insulin. Now, I am trying to file a citizen's petition with the FDA to reclassify insulin as a biopharmaceutical, obliging good manufacturing processes.
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Given that the injection sometimes given near the optic nerve to dull the pain of laser treatment has been known in rare cases to cause permanent blindness, taking Avastin in the eye seems a preferable route. I had laser photocoagulation treatment with no anesthesia just to avoid the small risk of blindness from the injection, and even though the pain was enormous, I am glad I endured it.
Sir Isaac Newton during the course of his experiments on light actually stuck an unsterlized pin into his eye and touched his retina with it to test whether vision was caused by some mechanical effect. This was extremely risky since he could have hit the fovea, but he was lucky to hit a part of the retina not essential to vision.
Avastin was first suggested for use to inhibit the process of neovascularization in diabetic retinas in the early 1990s, and it has taken absurdly long to bring this treatment to clinical use in that area of medicine, especially since it was already well established as an agent to inhibit growth of cancerous tumors.
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I've had diabetes since i was 8 years old. I’m 22 now and suffering the aftermath of being a non compliant diabetic for most of life. I've been diagnosed with diabetic gastroparesis, Diabetic neuropathy, diabetic cataract, and most recently diabetic retinopathy where I’ve now had the pleasure of Diabetic macular edema. They told me about a treatment that wasn’t yet FDA approved but has had incredible results (the needle in the eye). I decided to go with this new treatment and so far I’ve had it done twice (supposed to get it done every 6 or so weeks) I must say it's great!!! So very happy I did it - By day 3 things were looking allot better!!! Love the website! Please keep speaking! Learning a lot about diabetes and I really do appreciate this website and how it’s helping me open my eyes a bit wider.
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Panjo—
I read your recent comments. I’m glad that the new protocol for retinopathy has offered you some hope to regain/retain your eyesight. After a period of reflection, I wondered why you don’t take the GUILT you feel about being a ‘bad’ diabetic and turn this scenario around. Considering that bad medical care, bad insulin protocols, bad advocacy organizations (that don’t stand up for you) and bad government (which doesn’t regulate for the best possible drugs and paraphernalia to manage a disease) . . . you can easily see where your focus and your anger . . . but not GUILT should reside.
Diabetics are one of the few disease-victims where the patient receives the blame for not only causing his/her disease, but also any complications that may arise from poor management which, as I said above, relates directly to poor medical care. The day our advocates actually speak up for US, listen to US and understand that life is not normal walking around with diabetes, maybe then, we can make progress.
I can’t imagine what your life has been like over the last 14 years, including the pressures of family . . . but I am happy to see you have joined Allie’s Voice to at least be able to recognize you are not alone . . . and you are not a bad diabetic.
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