All posts by RVRC Staff

For Our Patients Receiving Avastin (Bevacizumab)

We are certain our Avastin (bezacizumab) is not counterfeit due to the following:

  1. We only order our Avastin (bezacizumab) from a local compounding pharmacy, accredited by the Professional Compounding Accreditation Board, who receives their supply directly from Genentech, the manufacturer of Avastin (bezacizumab). Each order is shipped in FDA-approved cartons directly from the manufacturer with the words “Genentech” or “Genentech – A Member ofthe Roche Group” printed on the packaging.
  2. FDA-approved Avastin (bezacizumab) contains a six-digit lot number on the product’s packaging and all packaging is printed in English. All lot numbers are logged and confirmed with Genentech as the product is received by the compounding pharmacy.
  3. Counterfeit A vastin (bezacizumab) has letters in the lot numbers and is printed in multiple languages instead of English. Authentic Avastin (bezacizumab) does not have letters in the lot numbers.
  4. The counterfeit product packaging does not come close to looking similar to authentic A vastin (bezacizumab) packaging.

We are certain that our local compounding pharmacy is giving us only FDA-approved Avastin (bezacizumab) direct from the manufacturer.

If you have any further questions, concerns or comments, we will be happy to discuss this matter further with you.

Page

Preliminary CATT Results

The Preliminary CATT (Comparison of AMD Treatment Trials) results are in and they support the use of either Avastin or Lucentis for the treatment of neovascular AMD. The May 2011 edition of the New England Journal of Medicine contained an editorial written by Philip J. Rosenfeld, M.D., Ph.D. which stated, “The CATT data support the continued global use of intravitreal bevacizumab as an effective, low-cost alternative to ranibizumab.”

Page

FDA Approves Telescope Implant for Age Related Macular Degeneration

FDA Approves Telescope Implant for Age Related Macular Degeneration

Purpose

To magnify images in eyes central blind spot that are blocked by disciform scars from wet age related macular degeneration or geographic atrophy caused by dry age related macular degeneration.

Eligibility

  • Patient must be 75 years old or older.
  • Severe vision impairment in both eyes secondary to the end stage of age related macular degeneration.
  • Can not have had cataract surgery.

Cost

$15,000.00
Medicare does not cover this.

Additional Aspects

Patients must receive post-surgical rehabilitation with low-vision specialist. Meeting with the patients requires more time and patience than many physicians are accustomed to spending.

For more Information, please call Dr. Singer at Medical Center Ophthalmology Services in San Antonio, Texas at (210) 697-2020.

Page

Treatment Update For Retinitis Pigmentosa

Vitamin Palmitate A

The recommendations from the clinical trial are that most adult patients with the common forms of RP take a daily 15,000 IU supplement of vitamin A palmitate under supervision of an ophthalmologist and avoid the use of high dose supplements of vitamin E, such as 400 IU. Consult with your physician regarding dosage for children.

A limited review of sources for vitamin A palmitate indicates that each supplier currently known to us (see below) is a company of good business standing that adheres to generally accepted good laboratory practices for manufacturing their products. The Retina Vitreous Resource Center can make no recommendation of one supplier over another regarding the quality of their product. Comparison and selections are your responsibility. You should call the listed companies for more information. The Retina Vitreous Resource Center has no further information to provide regarding these suppliers. (The prices are subject to change without notice.)

Disclaimer

The product described below have not been tested or evaluated by the Retina Vitreous Resource Center to determine their safety or effectiveness. Listing here of these suppliers and their products should not be misinterpreted as a recommendation or indication of proprietary interest in any of these companies.

Sources of Vitamin A Palmitate 15,000 IU

J.R. Carolson Laboratories Inc.
Attn: Customer Service – 1-800-323-4141
Pricing:
10 gel-caps is $8.90
240 gel-caps is $15.50 (shipping and handling $10.00)

Freeda Vitamins Inc.
1-800-777-3737 or 1-212-685-4980
Pricing:
100 tablets is $7.95

What Should You Do To Begin Vitamin A Treatment?

This is a serious undertaking. First consult with an ophthalmologist or another medical doctor. Do not start taking the vitamin A supplements on your own. Your doctor will want to do initial and subsequent annual evaluations, including tests to measure your blood level of vitamin A and to assess liver function. If these tests show that you have a pre-existing liver disease or abnormally high blood levels of vitamin A, your doctor may need to decrease your vitamin A intake accordingly. If you are not going to an ophthalmologist now, we suggest that you seek one who is willing to advise you regarding your eye care.

Since vitamin A in the palmitate form was used in the clinical trial of RP, the recommendations derived from that study apply specifically to the palmitate form. Although some other forms might be effective, that is not known because it was not studied. However, beta carotene, a natural precursor of the active form of vitamin A, is not a suitable substitute because it is not a predictable source of the vitamin.

Other Sources That May Help Retinitis Pigmentosa

1) Lutein 12mg Per Day
Puritans Low price at www.puritan.com
or 1-800-645-1030.
Pricing:
Lutein 6mg 100 caps (buy 1 get 1 free) total $13.59 Take (2) per day. Item #003481.

2) Omega 3 DHA 200mg Per Day
Puritans Low price at www.puritan.com
or 1-800-645-1030.
Pricing:
Omega 3 DHA 100mg soft-gels 120 soft-gels per bottle (buy 1 get 1 free) total $17.59. Take (2) per day item #001032.
– and –
Walgreens.com
or 1-877-250-5823
Pricing:
Omega 3 DHA 100mg, soft-gels #30 Take (2) per day. $13.99

Omega 3 DHA can also be found in Salmon and Tuna (1) or (2) 3 ounce servings per week.

If you go to your local pharmacy to purchase Lutein or Omega 3 DHA, be sure the dosage is correct. As stated for the vitamin A, Retina Vitreous Resource Center can make no recommendation of one supplier over another regarding the quality of their product.

Page

AAO Guidelines for Screening for Chloroquine and Hydroxychloroquine Retinopathy

Dear Reader:

The most up-to-date guidelines from the AAO for screening for chloroquine and hydroxychloroquine retinopathy have just come out. The recommended new objective tests are:

The goal of screening is to recognize toxicity at an earlier stage than the development of a visible bull’s eye maculopathy, which is a late change. Our Heidelberg Spectralis® HRA and OCT is one of the most sophisticated OCT instruments to do this.

We can provide these improved screening tools and newest knowledge about the prevalence of this toxicity question for your patients.

I would be happy to discuss this with you personally, if you have questions.

Sincerely,
Norman D. Radtke, M.D., F.A.C.S.
Vitreoretinal Surgery

Page

FDA Approves Telescope Implant for Age Related Macular Degeneration

Purpose

To magnify images in eyes central blind spot that are blocked by disciform scars from wet age related macular degeneration or geographic atrophy caused by dry age related macular degeneration.

Eligibility

  • Patient must be 75 years old or older.
  • Severe vision impairment in both eyes secondary to the end stage of age related macular degeneration.
  • Can not have had cataract surgery.

Cost

$15,000.00
Medicare does not cover this.

Additional Aspects

Patients must receive post-surgical rehabilitation with low-vision specialist. Meeting with the patients requires more time and patience than many physicians are accustomed to spending.

Page

Acknowledgement of Our Research on Retinal Transplantation

Paul S. Baker, M.D., and Gary C. Brown from the Retina Service, Wills Eye Institute, Jefferson Medical College, in Philadelphia, Pennsylvania, wrote an article “Stem-cell therapy in retinal disease” for Current Opinion in Ophthalmology 2009; 20:175-181. They stated on page 178 of the article:

Although some studies were unable to demonstrate any positive effect on vision, other patients transplanted with fetal retinal sheets showed improved visual acuity over time (up to 6 years) [57**, 58].

The unprecedented double starring of our article in the reference meant “of outstanding interest.”

Page

References and Recommended Reading

Papers of particular interest, published within the annual period of review, have been highlighted as:
*of special interest
**of outstanding interest

Additional references related to this topic can also be found in the Current World Literature section in this issue (p. 226).

Radtke ND, Aramant RB, Petry HM, et al. Vision improvement in retinal degeneration patients by implantation of retina together with retinal pigment epithelium. Am J Ophthalmol 2008; 146:172-182.

This study demonstrates the safety and clinical benefit of retina RPE grafts in human subjects with retinal degeneration. Visual improvement was observed in seven of ten patients (three retinitis pigmentosa and four AMD).

Radtke ND, Aramant RB, Seiler MJ, et al. Vision change after sheet transplant of fetal retina with retinal pigment epithelium to a patient with retinitis pigmentosa. Arch Ophthalmol 2004; 122:1159-1165.

We were honored that our work received such recognition from these esteemed professors.

Page

Hyperbaric Oxygen Treatment

Treatment for patients with central retinal artery occlusions or branch retinal artery occlusions with Hyperbaric Oxygen is successful if patient is treated within 48 hours.

This treatment is available at Norton Audubon Hospital. Roberto Penne-Casanova, M.D. has been trained in the U.S. Air Force and appointments can be made by calling 502-636-8380. At this time the facility is only staffed Mondays, 8am-12pm, Tuesdays, 8am-12pm and Thursdays, 7:30am-4pm.

Page

CATT Trial

After a one year delay the CATT Trial will begin recruiting patients in January 2008. It will have two primary purposes:

  • Compare the safety and efficiency of Lucentis and Avastin
  • Determine whether or not as-needed dosing can produce a visual result that is as robust as what has previously been demonstrated with fixed dosing

The study chairman is David F. Martin, M. D., at Emory University.

Page