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Edge Care

and Retinal Surgery

     Specializing in Diabetic Eye Disease and Macular Degeneration

Retina News //

Now Available: Port Delivery Phase 2 LADDER AMD Study Results

September 1, 2019

Anti-VEGF therapy for exudative macular degeneration places a significant treatment burden both upon patients who must return frequently for intravitreal injections, and upon providers who need to provide a high volume of injections each day.  Additionally, it has been shown that due to a reduced frequency of injections over time, the mean visual gain initially achieved with treatment of this condition gradually erodes.  In an effort to address these issues, Genentech Inc. (South San Francisco, CA) has developed a revolutionary port delivery system to provide continuous treatment with ranibizumab. 

The core of the system is a refillable reservoir which is surgically implanted into the pars plana.  This reservoir can then be refilled with ranibizumab in the office every few months.  The system was designed to both reduce the treatment burden and to provide continuous release of anti-VEGF in the eye. 


In the LADDER study, patients were randomized to receive either monthly injections of 0.5 mg ranibizumab, or a formulation of 10, 40, or 100 mg/ml ranibizumab via the port delivery system.  The Phase 2 results have just been released and are extremely promising, showing noninferiority to monthly 0.5 mg ranibizumab injections.  As expected, the durability is longest at the highest 100 mg/ml dose.  When approved, this will be the first long-term therapy available for macular degeneration.  We will keep you up to date on the approval and availability of this innovative new system.

7-year results from MUST

November 11, 2017

The MUST trial compared the effectiveness of systemic therapy vs. fluocinolone acetonide implant for severe uveitis.  Intermediate, posterior and panuveitis patients were included.  In a nonprespecified 7-year observational follow-up of 215 participants from the randomized clinical trial, patients who had systemic therapy had significantly better visual acuity compared with those who received the fluocinolone acetonide implant, by a mean of 7 letters.  Previously, the trial had shown no difference at 2 years.  Findings are limited by a 30% loss to follow up, with possible selection bias.


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World Class Retina Care


Dr. Bharadwaj is Marin County's leading full-time retina specialist, with outstanding training and experience in the management of retinal problems.  He is pleased to apply his knowledge and skills toward the care of your eyes. 

At the same time we know you will find our practice environment to be efficient, effective, and caring.

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Diagnostic Imaging


Because ophthalmology and retina in particular are visual in nature, you will likely have at least one form of imaging at the office during your visit.  This may involve fundus photos, OCT testing, or angiography.  


The purpose of this testing will be to provide more in-depth information about your condition than possible at your general ophthalmologist's office.


Your eyes will be dilated for the examination and testing, and you should bring someone to drive you home after the visit.


Retinal Procedures


- Vitrectomy surgery


- Scleral buckling


- Pneumatic retinopexy


- Intravitreal injections


- Laser surgery


retina specialist east bay
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