How long after treatment should I see impr... - Macular Society

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How long after treatment should I see improvement?

Catseyes235 profile image
18 Replies

This may seem a strange question after 4 years of treatment but does anyone know how long after treatment one should see the drying effects of Eyelea? How long does it remain effective? Just curious I suppose as the deterioration in left eye was worse than at start of treatment.

I know it’s getting better but how many days after treatment is Eyelea effectively working?

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Catseyes235 profile image
Catseyes235
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18 Replies
Becky_MacularSociety profile image
Becky_MacularSocietyPartner

Good Morning Catseye235,

Although the injections are aimed towards maintaining as opposed to improving vision, sometimes individuals report a slight improvement within the first 2-3 injections, however, this is variable. After the first few injections, it is unlikely that someone will have a noticeable improvement in their sight.

A lot of people need regular injections for the rest of their lives, this does not mean that the injections are not working. The injections aim to prevent further damage to the macular and therefore prevent further sight loss. As long as the injections are stabilising and holding the eye, then they are performing their function. and are working.

Sometimes the eye can becomes stable for a period of time and injections may be stopped during these periods. However, it is possible that the wet AMD may become active again, in which case further injections would be needed.

All the best,

Becky

Macular Society

Advice and Information

0300 3030 111

help@macularsociety.org

Catseyes235 profile image
Catseyes235 in reply toBecky_MacularSociety

No this was about the actual length of time the Eyelea is active after each treatment?

Becky_MacularSociety profile image
Becky_MacularSocietyPartner in reply toCatseyes235

Oh sorry Catseye, I misunderstood your query!

The recommended treatment doses for wet AMD is one treatment every month for 3 months, then once every 2 months after that – as long as the vision is stable. This tends to be the normal. It is however not uncommon to need a treatment every 4-6 weeks instead. If the gaps between your injections are more than 4 weeks and you notice your vision getting worse before you next injection, this is worth discussing with your consultant as you might need more frequent injections,

All the best,

Becky :)

Catseyes235 profile image
Catseyes235 in reply toBecky_MacularSociety

Sorry you still not understood but maybe it’s me! I know about overall treatment, loading doses etc.

How long is Eyelea actually active as a drug for after treatment - days? A week? Does it go on acting for longer.

Retired130 profile image
Retired130 in reply toCatseyes235

You are asking a question with no possible answer. An Eylea injection is given to stop the fluid leak/bleed in the macula. So, in non-technical terms, the Eylea is injected into the eye & proceeds to allow the fluid leak/bleed to stop. The first 3 injections, each one month apart, are given as a load dose to get the "hole" or "holes" to begin to close up. If you are allowed to see your scan pictures as I am, you will see the "hole" or "empty area" begin to get smaller with each injection until after several injections, depending on the person, the "hole" or "hollow area" is filled in & the bleed stops. Then, depending on the individual, an injection of Eylea will be needed every 4 or 5 or 6 or more weeks to keep the hole or hollow area from reappearing & the bleed starting up again. The time between injections depends on the individual. For example, I cannot go more than 8 weeks between injections or the bleed starts again. My specialists wants an injection every 6 to 7 weeks, but in a situation where I can't get there, I can go 8 weeks rarely if I need the extra time due to scheduling. I have read extremes from where a person must have an injection every 4 weeks to people who eventually were able to go 4, 5, & even 6 months between injections.

So, your question of how long is the Eylea "Active" in the eye is mute. The real question should be, "How long does the Eylea keep the bleed from restarting. To try to give an alternate comparison, if a person gets a cortisone shot in the knee, the question is NOT "How long is the cortisone "active" or "present" in the knee?" The question is "How long does the cortisone relieve the pain in the knee?" So too, the Eylea may dissipate from the eye in a day, or so, but it is the results that matter, not how long the Eylea remains in the eye as an "Active present" medication. The Eylea will dissipate out of the eye, but its effect will last anywhere from 4 weeks to 6 months depending on the individual case.

Catseyes235 profile image
Catseyes235 in reply toRetired130

Sorry but you haven’t understood the question. I do know all about outcomes etc. I eventually ploughed through the Eyelea site and found that the drug remains active in one’s system for around two weeks and longer than other treatments.

Prior to a stroke in May I was reacting really well having 10 weeks between treatments and so had to wait 17 weeks in which time the right eye remained stable but the left deteriorated significantly .

Becky_MacularSociety profile image
Becky_MacularSocietyPartner in reply toCatseyes235

Hi Catseyes,

So I double checked with our research manager, she has come back with a research paper however, Eyelea will be active for around 8 weeks however the activity fades over time. The median half-life of free aflibercept was 11 days in the eye. In plasma, the concentrations of free aflibercept were low and transient, reaching undetectable levels during the first week after injection, and undetectable in all patients at time points beyond 7 days.

Here is the research paper

pubmed.ncbi.nlm.nih.gov/311...

Hope this helps,

Becky :)

Catseyes235 profile image
Catseyes235 in reply toBecky_MacularSociety

Fantastic ...so I won’t despair that there’s no great improvement after 2 days! I’ll now attempt to read the paper .....

Catseyes235 profile image
Catseyes235 in reply toBecky_MacularSociety

That article was painless..good to keep on file in case someone asks the same... thenkyou

Becky_MacularSociety profile image
Becky_MacularSocietyPartner in reply toCatseyes235

You're welcome :)

Hi, in eylea official info at eylea.us it says (I'm paraphrasing) there's no free drug in plasma 2weeks after dosing. It doesn’t mention as far as i can see how long the portion of drug that's bound in the eye is detected. As the min gap between inj is 4 weeks I'd guess it therefore is working for a period somewhere between the two?

Catseyes235 profile image
Catseyes235 in reply to

Thanks very much for understanding my question!! I too looked at the Eylea website and it seems you are correct and the drug is active for around two weeks or more and is active longer than other treatments. I ask because the fluid build up is worse than I had at the beginning of treatment nearly 4 years ago when I experienced bendy lines.

This is because I had a gap in treatment due to a mini stroke in May so had 17 weeks between treatments. The right eye remained remarkably fine while the left was a bit like looking through the bottom of a glass and so much more noticeable. As there will now be 8 weeks until my next treatment (left eye has had 3 loading doses) I just want to know how long it could be before I know the drug has stopped working and perhaps will need an extra injection.

Thank you again!

Patjo profile image
Patjo in reply toCatseyes235

Like you Catseye, my eyesight is worse than when I started injections 3 years ago. At my last checkup I couldnt read the eye chart at all with my wet md eye.In spite of this I was declare d stable because there was no current bleed. How muchworse could it get if its not treated , if I already cant read the chart !!!The only reason I continue with treatment is to catch problems with my good eye early.

Catseyes235 profile image
Catseyes235 in reply toPatjo

Sorry to hear that. I suppose if scan doesn’t show any further bleed that is stable to them. It’s a bit of a joke this using the eye chart to judge your improvement as where the fluid is is much more important - and what and how you see!

Shimano profile image
Shimano in reply toCatseyes235

Like patjo, I cannot read the eye chart At all with my bad left eye. It has deteriorated rapidly since my last injection in May. Appts constantly deferred though I have contacted them several times because consultant says eye is holding after looking at private scans my optician referred urgently to him. Like patio, I wonder how it could get worse and what would be the point of further injections which I find very painful. I am really confused. There is clearly something I am missing here.

in reply toCatseyes235

Hi, i don't know what you have but with my brvo/ mac oedema I had lots of spikes over 6 yrs, some taking my vision worse than when I was first diagnosed. I was lucky that the inj/implants usually brought me back though didn't stop the fluid returning.

I always used the amsler weekly to spot any deterioration quickly (marked prev in pencil so can tell difference) And used other things like familiar road signs and how well eye could see to read to decide when I would ring up and ask to be seen earlier.

Unfortunately they can't tell easily if fluid at any one time is new or left over from previous ie not fully cleared by inj. They told me they can only extend the time between inj, to when it's no longer active so any new fluid is seen as an increase rather than a stubborn but stable level.

I would say ring them after 4 weeks if you feel things are worse.

Best wishes going forwards x

Catseyes235 profile image
Catseyes235 in reply to

Yes I intend to. Just I’m being impatient after 2 days - not having had such a wobble, literally, in my left eye. The fluid has definitely decreased though but not enough for my liking. I was doing so well before. Amsler grid is just a blur. Sounds like you’re still driving?

My brother in Scotland has AMD and is having his 2nd cataract op today! My other brother, who died 2 years ago , was registered blind had AMD before the injections were fully developed so I know the frustrations he suffered and I suppose that is playing on my mind. ...plus COVID that sprinkles it’s own magic on everything! Onwards and upwards.

iAdnanShah profile image
iAdnanShah

Depending on the leakage and swelling, some needs 2-3 injections some needs more.

You yourself can see the improve in OCT test, if swelling has reduced than before.

Get well soon.

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