New Retina Medicines for 2013

written by Dr Kenneth Fong Choong Sian on 16 January 2013

Happy new year! I hope you have had a good break over the Christmas and New Year holidays and are ready to face 2013. I am quite excited as there will be a couple of new medicines for retinal diseases that will soon be available in Malaysia for my patients. Both drugs have to be injected into the eyeball as an intravitreal injection.

 
Eyelea (Aflibercept) blocks VEGF
Eyelea is a new type of Anti-VEGF drug that binds to VEGF molecules in the eye. VEGF is one of the factors involved in common eyes diseases like AMD, diabetic retinopathy, and retinal vein occlusion. Drugs that can reduce VEGF in the eye like Avastin and Lucentis are now widely used to treat these retinal diseases. The main problem is that we have to inject the current drugs into the eyeball every month as current medicines only last about one month in the eye and the disease recurs. Eyelea is unique in that it can stay in the eye for more than two months. This means that patients will need less frequent injections. I am looking forward to Eyelea being approved in Malaysia as I have many patients that require monthly injections and it becomes a big burden for them to come to clinic every month for their injection.  So, rather then needing an injection every month for your retina disease, you will probably only need an injection every 2 months if you choose to have Eyelea.
 
Jetrea (Ocriplasmin) is an enzyme that helps the vitreous to detach from the retina
 
In our eyes, the vitreous jelly is attached to the retina inside the eye. Sometimes if the vitreous is too tightly attached to the macula, this can lead to conditions like macula hole which is normally treated with vitrectomy surgery. During vitrectomy surgery, retina surgeons aim to release the vitreous from the retina and this can be sometimes very difficult. Studies have shown that Jetrea can help release the vitreous from the retina if injected before vitrectomy surgery. In some cases, the macula hole was actually closed with the injection of Jetrea alone and the patient did not require surgery! This is very exciting. This new drug may also be used for cases of diabetic retinopathy requiring vitrectomy surgery as detaching the vitreous from the retina is often required for such cases. Children with retina diseases like retinopathy of prematurity (ROP) or retina detachment, may also benefit from having an injection of Jetrea prior to vitrectomy surgery.  In children, the vitreous jelly is very stuck to the retina and it is extremely difficult to separate the vitreous from the retina with surgery. This new drug is a breakthrough and earned a publication in the prestigious New England Journal of Medicine for the discovery.
 
Have a happy and healthy year ahead!
 
Dr Kenneth Fong Choong Sian
Vitreoretinal Surgeon
Kuala Lumpur, Malaysia