today’s problemsightthat are likely to be found more clearly in Thailand are: macular degenerationinelderly (Age-related Macular Degeneration (AMD), which affects up to 18,700 people per year; anddiabetic retinopathy (Diabetic Macular Edema: DME), which sees up to 536,700 cases per year.
which is caused by stepping intoaging societyCompletely aged society since 2021, the health problem of the aging population is inevitable from eye degeneration.
coupled with the way of life of the working-age population that may be less active Loves sweet food and beverages. causing high blood sugar levels diabetes way problem sight It may affect vision and daily life. Therefore, understanding the risk factors. Watch out for early warning signs. and regular visits to an ophthalmologist for eye exams therefore it is necessary
What are eye diseases?
“Dr. Thanaphong Somkitrungroj” Ophthalmologist in Retina and Iritis Chulalongkorn Hospital, Thai Red Cross Society and Chairman of the Cataract and Refractive Surgery Club of Thailand has shared information about eye diseases, the latest treatment guidelines. Including tips on how to take care of just one pair of eyes to have good vision quality and stay with us as long as possible.
Symptoms and effects of both diseases macular degeneration (AMD) and diabetic retinopathy (DME) is a disease caused by the presence of abnormal blood vessels in the retina. and make vision worse
macular degeneration in the elderly Age-related Macular Degeneration (AMD) is caused by abnormal blood vessels beneath the retina. There are two types of macular degeneration: dry (Dry AMD) and wet (Wet AMD or nAMD). The wet type is more common in people aged 55 years and over.
diabetic retinopathy (Diabetic Macular Edema or DME) is caused by high blood sugar levels. causing the blood vessels in the retina to be abnormal resulting in swelling of the retina It is found at any age and is also the number one cause of vision loss in people with diabetes.
disease risk factors
risk factorsof macular degeneration in the elderly There are both inevitable factors such as increasing age. and factors that can be adjusted, such as quitting smoking Risk factors for diabetic retinopathy include duration of diabetes, high blood sugar levels, high blood pressure, obesity, or gestational diabetes.
medical evolution
About 10 years ago Treatment guidelinesFundamentals of retinal diseases These include macular degeneration in the elderly and diabetic retinopathy. laser use Such methods often cannot improve vision much. But using lasers can help slow down the progression of the disease.
However, later on, when advances in medical technology have enabled new treatment approaches, the results can be greatly improved. In particular, the drug is injected into the vitreous. The drugs, called anti-VEGF drugs, have a mechanism of action to reduce the proliferation of retinal blood vessels. As a result, the patient’s vision quality can be improved.
Efficiently improved vision Patients need to be injected into the vitreous, with the frequency of each injection being different. Some patients require frequent injections every 1-2 months, which causes consequences for both the patient and the caregiver. especially those whose distances from homes and hospitals are very far apart. or in different provinces As a result, patients with poor vision need to rely on the assistance of their caregivers who may need to take time off from work.
Innovations in treating eye diseases with injections
Dr. Thanapong Explain that innovations in the treatment of macular degeneration in the elderly and diabetic retinopathy with injectable drugs have been developed. recently New drug with mechanism of action approved by the Food and Drug Administration (FDA) as a dual pathway inhibitor (inhibits both VEGF and ANG 2, which play an important role in disease pathogenesis).
which in addition to reducing the proliferation of blood vessels It also helps to reduce the leakage of blood vessels. reduce inflammation of blood vessels and make the blood vessels that supply the retina to be stronger From the point of view of an ophthalmologist This mechanism of action is regarded as a major therapeutic change. coupled with the ability to work longer than the original drug thus reducing the frequency of injections.
Based on clinical trial results, 80% of subjects were injected every 12 weeks (every 3 months), while another 60% received injections every 16 weeks (every 4 months). In other words, this innovative treatment can help improve patient care.
Are there any side effects?
As for safety and side effects Based on clinical trials in more than 2,300 patients and patients who have experienced real-world drug exposure in the United States for approximately 70,000 doses7 since the drug was approved by the Commission. The U.S. Food and Drug Administration (US FDA) has yet to find any difference in side effects between innovative drugs and traditional injectable drugs.
“Recently, a number of elderly macular degeneration patients in Thailand have had the opportunity to use this innovative drug. but there are not many Because the drug has just been approved in the country. Patients who can use this innovative drug There were both diagnosed patients who had not received any medication before. and in patients unresponsive to the original drug or patients who want to reduce the frequency of injections It is a new hope for patients in these retinal diseases.” Dr. Thanapong added.
diabetic eye Can it be treated with new innovations?
case ofdiabetic retinopathy If the patient is treated with new innovations along with controlling blood sugar levels Symptoms tend to improve within 3-5 years, and there is a high chance that patients will be able to stop taking the medication. For patients with macular degeneration in the elderly Although the likelihood of discontinuation of the drug was less than in patients with diabetic retinopathy. But drugs that can reduce the frequency of injections. It helps to make the quality of life of patients much better.
In the future, it is believed that there will be continuous innovations and new technologies in the treatment of this disease, such as longer-acting drugs, drugs with a different mechanism of action than existing drugs, surgery to insert tools that help. in drug release This made it possible to reduce injections to one to two times a year, using treatment planning technologies such as AI (Artificial Intelligence) to see which patients would respond to which drug classes. All of which result in a better quality of life for patients.
Eye diseases that can be prevented
Dr. Thanapong said that both diseases are caused by abnormalities in the blood vessels in the retina. This is likely to happen suddenly and may only occur in one eye. Some patients may not feel pain or pain in the eye area. And if observed from the outside, they may not be able to notice abnormalities in the eyes. Therefore, eye disease is considered a silent threat. Because most patients understand that blurry vision is a result of a change in eye or eyeglass settings.
For those with risk factors for macular degeneration in the elderly and diabetic retinopathy Behavior and disease control should be adjusted as well. Avoid eye rubbing or eye massage, refrain from smoking, maintain a healthy weight, control blood sugar levels.
Self-assessment for visual impairment
“Anyone can easily screen for visual impairments by themselves just by closing their eyes one at a time. Then look at the edge of the door or window frame. If you see distorted lines or blurry spots Should consult an ophthalmologist immediately. If over 45 years old, should have regular eye exams with an ophthalmologist at least once a year to have access to treatment in a timely manner andreduce vision loss Because clear vision is crucial to quality of life,” Dr. Thanapong concluded.