Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5394_Библиотеки_им_академика_М_И_Перельмана

The greatest success in treating diseases of the posterior segment have been through intravitreal injection or intravitreal implantation of slowly eroding mate­rials to release a drug. Most other methods (topical eye drops, systemic oral, subconjunctival, and parenteral) have not been as effective in drug delivery due primarily to dilution. Because of the rapid rate of increase and the already large number of intravitreal injections for treating wet AMD, there are concerns on several fronts that this approach might warrant improvement or change to reduce risks of complications, changes in protocol to reduce health care cost, and modi­fication to reduce burdens on patients and their caregivers. Drugs such as Ranibizumab (Lucentis) and Bevacizumab (Avastin) are remarkable in that they halt neovascularization and improve visual acuity in wet AMD. These two drugs appear to improve the quality of life for the patient, though these drugs handcuff the patient to the doctor and present logistical nightmares for relatives and care­givers because of the high frequency of treatment and continued need for repeat treatments. Ranibizumab is expensive. Treatment with either drug raises costs including physicians’ services and imaging services (cf., OCTs to judge the effec­tiveness of these treatments). Clearly, these drugs have become the standard of care despite these limitations, because of their apparent superiority over previous treatments such as macugen, PDT, laser photocoagulation, or forms of combina­tion therapy.