Centrasight Intraocular Telescope Improves Vision for Macular Degeneration

The implantable telescope for macular degeneration continues to be successful.

For the last few years we have talked about the implantable miniature telescope. This incredible devices has been used to give patients with end stage macular degeneration improved vision. Marc Levy, M.D.  has been involved with the telescope since the early FDA trials and is currently the only surgeon in our area preforming the surgery.

Implantable Telescope Improves Vision

Recently a long term study of patients with the telescope was completed and published. This study followed 129 patients over 5 years after implantation of the telescope. The results showed that most patients got significant improvement of vision at about 2 years after the telescope was placed, and this improvement appeared to continue for at least 5 years.

The study was used to by the FDA to allow all patients 65 and older with end stage macular degeneration to be eligible for the telescope. It is now the only FDA approved surgical device to treat most advanced forms of macular degeneration. With macular degeneration affecting over 15 million people in this country the telescope gives some hope to patients that are in the advanced stage of this disease.

What is the Implantable Telescope?

The implantable telescope, by CentraSight, is a tiny telescope inserted in the eye.  In qualified patients with macular degeneration, the telescope has successfully improved vision and the quality of life for its recipients.

The “telescope” projects images onto the retina outside of the degenerated macula.  The images are larger, perhaps 2.2x or 2.7x, and projected to the healthier retina near the macula.  This enlargement enables the less sensitive, but healthy, retinal tissue to replace central vision.

Qualifications for Implantable Telescope

To be a potential candidate, your eye doctor must confirm;

1.  You have End-Stage Macular Degeneration from either Wet or Dry AMD

2.  You no longer will need treatments such as anit-VEGF injections

3.  You have not had cataract surgery in the eye with AMD.

4.  You meet the age, vision and corneal health requirements.

If you or someone you know is affected with macular degeneration please contact our office for an evaluation at 941-921-5335.

 

New Opportunity for Dry Macular Degeneration Patients

Over the last year we have talked about an incredible device that can be used for patients with dry macular degeneration. The implantable miniature telescope (IMT) has been placed in numerous patients around the country giving them increased independence. In the past the patients had to have advanced dry macular degeneration, not had cataract surgery yet, and be over the age of 75. Well needless to say that was a very limited group of patients with macular degeneration.

The Government Changes

Just recently the rules for who can get a implantable miniature telescope has changed. The patient still has to have advanced dry macular degeneration, have not had cataract surgery, but now the age limit is 65 and older. Dr Levy is very excited with this change in the rules. This now allows him to offer the treatment to a much larger group of patients that previously had little options for improvement in their vision

What is the Implantable Miniature Telescope?

In patients with dry macular degeneration they lose their central vision. The center of the back of the eye is damaged, but the side or peripheral areas is usually left untouched. Regular glasses focus light on the center part of the eye, and  with macular degeneration the light information can not be used no mater how good the glasses. The implantable miniature telescope is placed inside the eye during cataract surgery. This specially designed lens then enlarges the image in front of the patient and projects it onto areas of the peripheral retina. This can have significant improvement in the patients overall vision.

Where Can Patients Get Evaluated For a Telescope Procedure?

If you or a loved one has advanced dry macular degeneration, has not had cataract surgery in at least one eye, and is over the age of 65 there are a limited number of centers in the country that can offer you some hope by putting in an implantable miniature telescope into the eye. We are lucky in the western coast of Florida to have Dr. Marc Levy performing this procedure. Dr. Levy has been involved with the telescope and its surgical procedure since the original FDA trials since 2002.  He is currently the only physician in this area who it qualified to preform this life altering procedure.

Please watch the below videos for more information on the telescope.

Sarasota Florida ABC7 News WWSB (may be slow to load) 11/5/14

Detroit Michigan Local4 News WDIV 11/6/14

South Bend Indiana / Notre Dame NBC16 WNDU 11/6/14

Flint Michigan ABC12 WJRT aired 11/5/14

Beaumont Texas CBS 6 Nov 7, 2014 KFDM

If you notice Dr Levy is presented in these videos from around the country. This is due to his long experience and expertise with the IMT.

If you or a loved one wants to learn more about what the implantable miniature telescope can do for people with dry macular degeneration, please call 941-921-5335 to make an appointment with Dr Levy.

 

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Talking Macular Degeneration

Recently Drs. Levy, Torres, and Rivero were asked to speak at the local Macular Degeneration Group meeting. They were happy to inform the group of recent changes in the treatment of macular degeneration.

If you were unable to attend this lecture, never fear. Through the incredible power of the web you can see the presentations here .

Dr. Torres gave a great update on emerging treatments for macular degeneration.

Dr Rivero presented what optical options are available for patients with macular degeneration for visual rehabilitation

Dr. Levy gave an update on the implantable miniature telescope. This little device is bringing incredible hope to patients with macular degeneration.

If you would like to learn more about any of these presentations, please contact our office at 941-921-5335

 

Sarasota Retina Institute Doctors’ Lecture Locally

Our doctors will be speaking at several meetings this weekend.

Macular Degeneration and Telescope

We have been asked to speak at two separate events this upcoming weekend. Drs. Levy, Torres and Rivero will be speaking at the Macular Degeneration Awareness Society meeting in Sarasota.

This is a wonderful event to help provide information on macular degeneration, the current therapies for it and what might be coming out in the future. Our doctors will be presenting information on the miniature implantable telescope that is giving so many of our patients a new outlook on life.

If you would like to attend call 1-800-253-0985, or  email danielle@maculardegenerationassociation.org to reserve your seat.

Parkinson’s Disease and the Eye

Dr. Abrams will be presenting at the the Neuro Challenge Foundation Meeting at the  Sarasota Memorial Institute for Advanced Medicine. The talk is about the Non-Motor Aspects of Parkinson’s disease.  Dr. Abrams will be talking about how Parkinson’s disease affects the eyes and visual system.

Dr. Andy Keegan from the Roskamp Institute will be talking about memory loss and dementia in Parkinson. This will be a very informative morning for both patients and their family/caregivers on aspects of the disease they might not often think of.

Registration is online at the Neuro Challenge Foundation website.

Doctors Reaching Out to Community

We hope that be going out to these lectures we can help educate the community. Our goal is not only to help our patients, but to help people understand what is going on with their diseases.

If you would like one of our doctors to talk at a local group on any of the disease we treat, please contact us at 941-921-5335 and we will be happy to help.

If you can not make the lectures do not fear. We will be posting our PowerPoint lectures online this week for everyone to view.

 

Jody Abrams, MD, FACS
Oculoplastics/Neuro-ophthalmology
Sarasota Retina Institute
Sarasota, Florida 34239

Dr. Levy’s Board Presentation

Last week Dr. Levy gave a presentation to the Sarasota County Public Hospital board on the implantable minature telescope. The meeting is going to be rebroadcast-ed on Access Sarasota (Channel 19 on Comcast and Channel 32/34 on Verizon) tonight at 730. Other show times are scheduled through out the week and can be found on Access Sarasota. We are delighted that the telescope has been meet with such enthusiasm. It has given hope to patients with a terrible disease where none existed before.

 

 

The Latest on Vitamins for Macular Degeneration and Cataracts

AREDS2: Most Recent Results on the Use of Vitamins and Their Effect on Cataract and Age-relate Macular Degeneration

This study was proposed because of the increasing prevalence of both age-related macular degeneration (AMD) and cataracts in the United States.  Both conditions have become major health issues impacting the overall cost of medical care. There has been a lot of hype to find out what vitamins help for these patients to possible reduce the prevalence of these diseases.

What is AREDS 2?

On May 5, 2013 the AREDS2 results were reported in Seattle, Washington at the Association for Research in Vision and Ophthalmology (ARVO) by The National Eye Institute.  This 5 year study looked at the effects of adding omega-3 and the antioxidants, lutein and zeaxanthin, in different combinations with the original ingredients of the AREDS formula currently recommended for high risk AMD.  The objective of the study was to determine if a new formulary could be found that would be more beneficial for AMD and whether the new ingredients, or different combination of ingredients, could be beneficial against the development or progression of cataract.  Additionally, there were some adjustments within the AREDS formula to determine if there was a difference in the absorption of ingredients in the presence of others.

Do Vitamins Help ?

The final results showed that the addition of omega-3 did not improve the results of the AREDS formula for AMD; neither did the addition of lutein and zeaxanthin.  Further, the use of or non-use of lutein and zeaxanthin did not have any effect on the development and/or progression of cataract in the study group as a whole.  However, it was pointed out that in the original AREDS and another randomized study the use of multivitamins did appear to retard cataract formation, particularly in the less well-nourished population.

There was also noted in AREDS2 that the absorption of lutein and zeaxanthin was reduced in the presence of beta carotene.

The Final Word On Vitamins (For Now)

From the AREDS2 the final conclusion is that the AREDS formula continues to be the nutritional supplement of choice for those with high risk AMD, and that there has yet to be a good nutritional recommendation for the prevent of or retardation of age-related cataract. Smokers can not take beta carotene since it can increase their risk of lung cancer, there was some indication that these patients should take lutein as it might help in these patients.

If you would like more information on this study or about getting vitamins made to these new findings please contact one of our doctors at Sarasota Retina Institute at 941-921-5335.

 

Mel Chen, MD

Vitreo-retinal Surgeon 

Sarasota Retina Institute

Sarasota, Florida 

New Hope For Dry Macular Degeneration Patients

We are pleased to announce  that the Florida medicare provider has now approved the implantation of the Implantable Miniature Telescope (IMT). This is wonderful news for our patients with advanced dry macular degeneration. The telescope can be put in people that are over the age of 75 and who have not had cataract surgery, with stable dry macular degeneration. Here at Sarasota Retina Institute we are proud to have Dr. Marc Levy involved with this device. Dr. Levy was one of only a handful of surgeons in the country to be involved with the original FDA trials to get the IMT approved. He was able to work with the company to fine tune the device and the surgical insertion of it. He also brought together and has kept and a top notch team of  a low vision specialist  and an occupational therapist to help patients get ready for the telescope and adjust to their new improved life after the surgery. He is currently the only surgeon approved in the southern Florida area to preform the surgery. The first approved telescope was implanted on February 4, 2013.

THE IMPLANTATION SURGERY

The surgery involves removing the patients natural lens (the cataract) at inserting the telescope into the eye. The telescope, which is smaller then a pea,  goes into the eye behind the pupil so there is minimal cosmetic change to the patients eye. The surgery is longer then standard cataract surgery but is still an out patient procedure.  The telescope is designed to enlarge the image and use the retina surrounding the macular defect. This can lead to great visual independence for the patient. They are able to participate  in their activities of daily living more. Unfortunately at this time they still can not qualify to drive in the state of Florida.

For More Information

If you or a loved one is interested in learning more or being evaluated for the telescope please call Sarasota Retina Institute to setup an appointment to come see Dr. Levy and his team. 941-921-5335

 

Jody Abrams, MD 

Oculoplastics/Neuro-ophthalmology

Sarasota Retina Institute

Sarasota, Florida 

Therapy for End Stage Age-Related Macular Degeneration

End stage age-related macular degeneration may result in several presentations. Those with the extreme form may have had extensive hemorrhaging both under the retina and into the central cavity of the eye, or may have chronic leakage from abnormal blood vessel, which can not be closed off by any of the current treatments.  In those cases, there is very little that can be offered in the way of improving vision or aiding the patient in maximizing the use of their remaining vision.

There are, however, patients with age-related macular degeneration who have significant loss of central vision, but have been stabilized through treatment or, are dry and progressing very slowly.  These patients, in the past, have benefited from low vision devices. Such devices included very strong reading glasses, magnifying glasses, loupes, telescopes, and closed circuit television.  Many of these devices were cumbersome and/or impossible to carry around and were not effective under certain lighting conditions.

To this end, a device has recently been FDA approved which will overcome many of the shortcomings of previous low vision devices.  This new addition, to the assist those with stabilized poor central vision, is the Implantable Miniature Telescope (IMT). However, not all patients with stable low vision will qualify for the use of this device.

What is the IMT?

The IMT is a very small telescope which is implanted inside the eye, similar to having an intraocular lens implant for those who have had cataract surgery.  The difference is that the IMT is a much larger implant than the intraocular lens used in routine cataract surgery, nor is it as flexible, so it can not be implanted, folded, through a small incision.  This consequently would require the use of sutures to close the eye and a somewhat longer post-operative recovery period.

Does the Use of the IMT Require Any Special Adjustment?

Unlike normal cataract surgery where vision is restored to “normal”, there is a difference in image size and visual field.  Before the surgery, every patient is placed through a “simulation trial” to determine if they can adjust to the “new vision”.  If they pass this trial and they still desire to have the IMT, the surgery is performed similar to cataract surgery, and usually, under local anesthesia.  But even after the surgery there is a period of visual rehabilitation training in order to achieve the full benefits of the IMT.

Are There Special Criteria to be Fulfilled?

Before a patient can be considered for the IMT, there are currently certain conditions which must be met.  These include:

  1.   ARMD which is irreversible, end stage, and stable
  2.   No longer on any drug therapy for ARMD
  3.   Have not had prior cataract surgery
  4.   Have a clear cornea with normal endothelial count
  5.   75 years of age or older
  6.   Best corrected vision between 20/80 and 20/800
  7.   Prior vision correction: less than -6.0 and less than +4.0

Where is the Surgery Being Performed?

Currently there will only be a select few practices within the United States which have been approved to do IMT surgery.

These facilities are multi-disciplinary and have been setup in such a manner that they have ophthalmologists who have experience in determining the eligibility criteria and performing the surgery, optometrists who are trained in low vision evaluation, and visual occupational rehabilitation therapists who are experienced in assisting patients in adapting to the use of the IMT.

For further information, inquire at:  Sarasotaretinainstitute.com

 

 

 

Macular Degeneration: Who’s at Risk?

Risk factors for developing macular degeneration include both environmental and hereditary components.  The actual cause of this disease is not known, but is multi-factorial.

Age-related macular degeneration (aka ARMD) is the most common cause of blindness in the United States of adults, particularly those approaching the age of retirement.   Until relatively recently, the actual cause was not entirely known, and it still is not fully understood.

Hereditary/genetic factors which are uncontrollable

  • Age is the number one risk factor to consider when discussing ARMD.  It is the most common cause of blindness in those over the age of 60, and affects one third of adults over the age of 70.
  • Gender is a factor in that females are more likely to be affected, but this is most likely due to their longer life expectancy.
  • Those with a family history of macular degeneration are at greater risk, especially if the relative is in the immediately family.
  • Caucasians are more at risk than any other races, most likely due to genetic background and pigmentation.
  • Light colored eyes have an increased risk of developing macular degeneration because the lesser amount of pigment in the eye exposes it to greater damage from UV radiation.
  • The presence of the disease in one eye increases the likelihood of getting the similar condition in the fellow eye.

Risks factors which are controllable:

  • Smoking increases the chances of developing macular degeneration by a factor of 2 to 5 times.  It is most likely associated with a decrease in oxygen made available to retinal tissue which has a high oxygen demand.
  • Prolonged exposure of ultra-violet and blue light damages retinal tissue directly and leads the production of metabolic byproducts which are detrimental to eye function and lead to macular degeneration.
  • Diets high in fat and cholesterol, and low in antioxidants and nutrients have a higher risk in developing macular degeneration.  Fats and cholesterol ultimately affect blood vessels and flow, and nutrients and antioxidants are important for retinal tissue function and the removal of free radicals detrimental to cell metabolism.
  • Obesity is a risk factor in that an individual with a body mass index (BMI) greater than 30 is 2.5 times more likely to have macular degeneration.
  • Individuals with high blood pressure have an increased risk for macular degeneration due of its effect on the blood vessels, in that there is narrowing and therefore, less circulation to the retina.
  • Exercise improves cardiovascular health, therefore improves eye circulation, and is felt to decrease the risk for macular degeneration.

What Should I Do If I am at High Risk for Macular Degeneration?

If you have determined that you are at an increased risk for age-related macular degeneration, it would be important to first get a complete eye exam to include a thorough retinal evaluation.  This would determine if you are truly at high risk and should take appropriate steps in changing your life style and be placed on nutritional supplements with high antioxidant content.  You may also be advised as to how to monitor yourself in order to detect the onset of the more sight threatening form of macular degeneration, which is more successfully treated in its early stage.

To get a thorough eye exam, you should contact you local ophthalmologist/retinal specialist.