Continuing in any situation: Treating retinal diseases

Chronic disease management can be adversely affected during emergencies for various reasons, such as patients' fears of leaving their homes. However, in retinal diseases, missing just one treatment can lead to deterioration in vision.

The central vision area, known as the 'macula,' is where vision is sharpest. Damage to this area results in decreased visual acuity, impaired color differentiation, difficulties in reading and writing, and challenges in facial recognition.

One retinal disease is AMD, or age-related macular degeneration. This chronic, progressive disease can impair central vision and is the leading cause of visual impairment in individuals over sixty. Approximately 8.7 percent of global blindness cases are linked to AMD. In the initial, dry stage of the disease, a process of destruction occurs in the light receptors of the retina, leading to degeneration. In some cases, the disease progresses to the second stage, the wet stage, where abnormal blood vessels begin to grow in the macula. These unstable blood vessels can leak, bleed, and scar, potentially causing irreversible damage.

Another retinal disease is DME, or diabetic macular edema. This condition occurs in diabetics and is caused by damage to the small blood vessels of the retina located in the central vision area.

In both AMD and DME, when blood vessels in the eyes are damaged and blood supply to the eye is disrupted, there is a release of proteins, including VEGF, or Vascular Endothelial Growth Factor. This protein encourages the production of new, abnormal blood vessels in the eyes.

"VEGF inhibitors are medications administered through intravitreal injection. Treatment with VEGF inhibitors allows for the slowing and sometimes even halting of the growth of abnormal blood vessels. Additionally, these medications reduce leakage from these vessels," explains Dr. Shiri Shulman, head of the Assuta Eye Institute in Ashdod and head of the ophthalmology department at Assuta Medical Centers. She adds that in addition to VEGF inhibitors, retinal diseases can be treated with steroids via injections or laser therapies, depending on the type of disease.

Typically, patients dealing with either DME or AMD require monthly to bi-monthly visits to a specialized clinic for treatment and monitoring. Maintaining a continuous treatment regimen and persistence in therapy is crucial for preserving vision and preventing further deterioration. However, many who have had to evacuate from conflict zones in recent months have experienced significant disruptions in their treatment routines.

It’s worth noting that there are now innovative medications that can be administered at longer intervals. These treatments are significant for patients' ability to adhere to their therapy since they require fewer clinic visits without compromising treatment efficacy. "These innovative medications have a long duration of action, meaning that for many patients, it will be possible to gradually increase the interval between injections, sometimes extending to one injection every three to four months," Dr. Shulman explains. She adds that in most cases, these medications can be obtained through the health basket or supplementary insurance, depending on the indication.

In any case, the choice of treatment is determined by the professional judgment of the treating physician.

For more information on retinal diseases, visit the "See and Know" website >>

It should be emphasized that the choice of possible treatment is at the discretion of the prescribing clinician in consultation with the patient. The information is accurate as of March 2024. For further information, consult your treating physician. Presented as a public service sponsored by Roche Pharmaceuticals (Israel) Ltd.

In collaboration with Roche Israel.