Treatment

Developing novel treatments to cure diseases of the Vitreous, Macula, and Retina.

The VMR Institute is known for innovative therapeutic technologies.

The VMR Institute offers all standard therapies as well as a variety of novel treatments to cure diseases of the Vitreous, Macula, and Retina. Our in-office cryotherapy unit and solid state laser are available on-site to treat diabetic retinopathy, retinal vein occlusions, retinal breaks, and retinal detachment. Dr. Sebag has aided the American Academy of Ophthalmology to teach laser eye surgery.

In-Office Repair of Retinal Detachments

Dr. Sebag has vast expertise in treating retinal detachments in the office, without the need for hospitalization. Their excellent results have been presented at national and international meetings and the results have been published in the professional literature.

Related Publications

Sebag J, Tang M: Pneumatic retinopexy using only air. Retina 13:8-12, 1993.

Yee KM, Sebag J: Long-term results of office-based pneumatic retinopexy using pure air. Brit J Ophthalmol 95(12):1728-30, 2011

Drug Therapy

Injections are available on-site at the VMR Institute in Huntington Beach, Orange County for macular degeneration, diabetic retinopathy, and retinal vein occlusions. The VMR Institute previously participated in four separate national, multi-center clinical trials in these conditions, and our experience exceeds that of anyone in the community.

JETREA is a concentrate for solution for injection. After dilution, it is injected into the eye. It contains the active substance ocriplasmin.

JETREA is used to treat adults with an eye disease called symptomatic Vitreomacular Adhesion (VMA). JETREA works by dissolving the adhesion between the vitreous and the macula, thereby treating the associated symptoms.

LUCENTIS is the first FDA-approved medicine to treat wet age-related macular degeneration (wet AMD), diabetic macular edema (DME), and the 2 forms of macular edema following retinal vein occlusion (RVO): branch RVO (BRVO) and central RVO (CRVO).

LUCENTIS was approved by the FDA in 2006. It was the first anti-VEGF to be approved to treat wet AMD, DME, and the 2 forms of macular edema following retinal vein occlusion (RVO): branch RVO (BRVO) and central RVO (CRVO).

EYLEA is a prescription medicine that has been approved by the FDA for the treatment of patients with wet AMD. EYLEA is the result of nearly a decade of scientific research and development. It has been designed to bind to VEGF.

In two well-controlled clinical studies of over 2400 patients with wet AMD this treatment frequency was shown to maintain* or improve vision over one year in more than 9 out of 10 patients.

*Defined as losing fewer than 15 letters based on best-corrected visual acuity on an ETDRS eye chart.

Cryotherapy

Non-invasive retinal cryotherapy is available on-site at the VMR Institute to treat retinal holes/tears and neovascular glaucoma.

Microsurgery

Sutureless microsurgery is an area of expertise at the VMR Institute for Vitreous Macular Retina.

This advanced form of therapy is superior to the older method (still practiced by many other doctors in the area) and decreases operating time while increasing the speed of vision recovery with less time off work.

In 2008 Dr. Sebag was selected to establish a state-of-the-art vitreo-retinal microsurgery service at the Newport Bay Surgery Center in Newport Beach, Orange County.

Drug Therapy Replaces Vitreous Surgery 

The surgical removal of vitreous is often necessary for complex diseases of the Vitreous, Macula, and Retina inside of the eye. However a new form of therapy, known as pharmacologic vitreolysis, is being developed to replace surgery. The VMR Institute has participated in six national and international clinical trials to improve this surgery using novel drug therapy. Dr. Sebag has published seminal articles on this topic.

Related Publications

Sebag J: Pharmacologic vitreolysis. Retina 18:1-3, 1998;

Sebag J: Is Pharmacologic Vitreolysis Brewing? Retina 22:1-3, 2002;

Sebag J: Molecular biology of pharmacologic vitreolysis. Trans Am Ophthalmol Soc 103:473-494, 2005;

Sebag J: Molecular biology of pharmacologic vitreolysis. Am J Ophthalm 141:792, 2006

Sebag J, Ansari RR, Suh KI: Pharmacologic vitreolysis with microplasmin increases vitreous diffusion coefficients. Graefes Arch Clin Exp Ophthalmol 245(4):576-80, 2007

Sebag J: Pharmacologic vitreolysis – premise and promise of the first decade. Retina 29:871-4, 2009

Sebag J: The emerging role of pharmacologic vitreolysis. Retinal Physician 7(2):52-56, 2010;

Costa Ede P, Rodrigues EB, Farah ME, Sebag J, Meyer CH: Novel vitreous modulators for pharmacologic vitreolysis in the treatment of diabetic retinopathy. Curr Pharm Biotechnol 12(3):410-22, 2011;

Tozer K, Fink W, Sadun AA, Sebag J: Prospective three-dimensional analysis of structure and function in macular hole treated by pharmacologic vitreolysis. Retinal Cases & Brief Reports 7: 57-61, 2013;

Sebag J, Tozer K: Vitreous Biochemistry and Pharmacologic Vitreolysis. In: Pediatric Retina 2^nd Edition (ME Hartnett, ed), Lippincott Williams & Wilkins, Phila, 2013;

Stalmans P, Duker JS, Kaiser PK, Heier JS, Dugel PU, Gandorfer A, Sebag J, Haller JA: OCT-based interpretation of the vitreomacular interface and indications for pharmacologic vitreolysis. Retina. 2013 Jul 22. [Epub ahead of print]