Author Archive for: ‘Ian McLeish’

An eye with late stage exudative AMD

Avastin vs Lucentis

Recently studies have found that there is little difference in the success in treating Wet AMD between Lucentis (Ranibizumab) and Avastin (Bevacizumab). This may allow the heath services to save an awful lot of money, as Lucentis costs £741 per vial compared to £40 for Avastin. This could mean that many more people could be treated.

One of the recent most successful treatments for Exudative (Wet) Age Related Macular Degeneration (AMD), is a drug called Lucentis. This is an Anti VegF drug, which inhibits the growth of new blood vessels in the eye, which is the cause of Wet AMD. Injected directly into the Vitreous – the jelly at the back of the eye, it also causes the new vessels to become less leaky.

Lucentis was conceived because doctors tried Avastin, an anti cancer drug and another Anti VegF, to see if it would help Wet AMD, and found that it worked!

Avastin was “designed” on the basis that a tumour must acquire a blood supply to grow, and if this blood supply could be reduced or prevented, then the tumour would (hopefully) die, or at least it’s growth would be hampered. It has shown much success as an anti cancer drug. Because this “off label” use of a drug to treat another disease is not licenced, it leaves the treating doctor with increased risks of lawsuits should there be a problem- drugs are licenced to treat specific diseases.

Both Lucentis and Avastin were developed by Genentech, a California based company owned by Roche pharmaceutical. Avastin is marketed by Roche, but Lucentis is marketed in the UK and Ireland by Novartis.

Recently studies have found that there is little difference in the success in treating Wet AMD between Lucentis and Avastin. There was a slight suggestion in the increase in risk of serious complications, such as heart attacks in using Avastin, but as the dosage in treating the eye is so much less that when used as a cancer treatment, and there seem to be few worries in the Oncology reports, the study thinks that this may have been an incidental finding because of the relatively small trial size- as ever more research may be required there.

It does seem incredibly unfair that there is such a difference in prices between these two drugs, both manufactured by the same company, both similar in their method of working, but it is not as you might suspect down to company greed. It has been estimated that it can cost up to a $Billion* to get a drug licenced with the FDA in America, so the release of Lucentis required another FDA approval at another $Billion*, and the company has to be able to recoup this investment, before its patent expires. FDA approval only covers USA, so there will be similar costs in achieving European licencing. Some countries are much less regulated than ours- it seems that Doctors in India have been using Avastin to treat AMD for years.

Medical trials cost a lot of money, and most people would agree that they are necessary to ensure drug safety, the cost of Lucentis is the flip side.

The report can be viewed here– you may need to register or log in to view it, but registration is free.

*Forbes

 

Vacation

Bank Holiday Opening Hours

Gone to the Beach

Gone to the Beach

Please remember that there is a bank holiday this weekend, and as usual we are taking a much required long weekend – we usually take the Saturday when there is a bank holiday Monday.

We will be open as normal on Friday 2nd until 5.30pm, but will then be closed until 10.00am on Tuesday.

We hope you have a great weekend.

Ian

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Waterford AMD Trial

There is a study ongoing at the Waterford Institute of Technology investigating the effectiveness of various combinations of MultiVitamin and Mineral supplements to slow down the development of AMD- a gradual decline in central vision which can cause difficulty reading, driving and watching the television.

The study is based unsurprisingly in Waterford, which is a bit of a distance from our base in Cavan, but if you, or a friend or family member has recently been diagnosed with AMD, sometimes referred to “age changes at the back of the eyes”, and you might be interested in taking part, more details are available here. Anyone accepted for the trial will receive a supplement proven to help slow down the progression of these age changes, but unfortunately not in every person. The investigation is looking to see what other additional ingredients are more useful, and which are less (or not) useful.

Again, more information is available here.

Blue Eyes

Blue Eyed Men Prefer Blue Eyes

Natural selection gave blue eyed men a preference for blue eyed women.

Blue eyed partners will almost always have blue eyed children – the gene for blue eyes is recessive to brown, which means that is a blue eyed man and a blue eyed woman have a brown eyed child, there has probably been some infidelity, and the child is likely not his.

Eighty-eight male and female students were asked to rate facial attractiveness of models on a computer. The pictures were close-ups of young adult faces, unfamiliar to the participants. The eye color of each model was manipulated, so that for each model’s face two versions were shown, one with the natural eye color (blue/brown) and another with the other color (brown/blue). The participants’ own eye color was noted.

Both blue-eyed and brown-eyed women showed no difference in their preferences for male models of either eye color. Similarly, brown-eyed men showed no preference for either blue-eyed or brown-eyed female models. However, blue-eyed men rated blue-eyed female models as more attractive than brown-eyed models.

That may mean there is a place or set of places in the genome where genetic variations give some of us our pronounced preference for blue eyes.

In a second study, a group of 443 young adults of both sexes and different eye colors were asked to report the eye color of their romantic partners. Blue-eyed men were the group with the largest proportion of partners of the same eye color.

According to Bruno Laeng and colleagues, “It is remarkable that blue-eyed men showed such a clear preference for women with the same eye color, given that the present experiment did not request participants to choose prospective sexual mates, but only to provide their aesthetic or attractiveness responses…based on face close-up photographs.”

“Blue-eyed men may have unconsciously learned to value a physical trait that can facilitate recognition of own kin.”

So there you go!

An eye with Microbial Keratitis.

Microbial Keratitis – Again

There is a Facebook page called DangerInContactLenses, highlighting, obviously the danger in contact lenses. The lady who set up the page had a very unfortunate experience with soft contact lenses, which caused her to be in hospital for many weeks, and eventually, after 22 operations she had to have one of her eyes removed.

An outcome like this is the worst case scenario possible, but it is up to each individual contact lens wearer to minimise their risk.

Always wash and thoroughly dry your hands before applying and removing contact lenses, and whenever possible before touching them at any other time.

Use the solutions recommended by your eye care practitioner, and use them properly. Do not reuse contact lens solutions- the case must be emptied each and every morning and allowed to air dry. Even if the solution you use says that it is a “No Rub” formula, rub them!!! A ten second rub and rinse will reduce the contamination on the lens one hundred thousand fold, meaning that the solution has less microbes to deal with overnight.

Never use tap water with contact lenses, it is not clean enough. For the same reason, swimming, hot tubs, baths and showers should be done without contact lenses.

There have been studies investigating the efficacy of contact lens solutions against various types of microbes, and some do perform better than others- that is why we would always recommend Alcon solutions, as there has never been any question marks hanging over this brand.

It is as well to point out that own brand solutions, be they from the supermarket or elsewhere, will advise that they were manufactured by, or for the chain. But who actually manufactures the solution??

Contact Lenses are safe, but care is required.

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