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Avastin and the like are all overated. You make a living off these drugs and as such you promote them.

Lowly optometrist,

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I give the drug away for pete's sake. (since it is only about $20 a dose its not quite such a big deal if we don't get reimbursed-- as it would be for Lucentis which is $1950 a dose) If you want to get into an argument about the costs of medicines, take it to the politics forum and I will be happy to bash big pharma along with you.

From wiki:

Treatment
Most of the treatments that are available now and and currently being studied are aimed at stopping the neovascular (or wet) form of AMD.
In June 2006, the drug ranibizumab (Lucentis) has been approved by the FDA for use in the treatment of AMD.[9] Ranibizumab has been shown to halt the progession of the disease in most patients receiving the treatment. Unlike previous treatments, a significant minority of patients (20-40%) receiving Lucentis had an improvement in vision. [10][11] Ranibizumab is given as an injection into the eye. The initial studies required an injection every 4 weeks for 2 years.
Bevacizumab (Avastin), a drug approved for use in colon cancer, has been used by ophthalmologists in the treatment of wet macular degeneration. The drug is very similar to ranibizumab and targets the same molecule as ranibizumab. Doubts about whether this drug can penetrate the layers of the retina led to the development of ranibizumab. Before Lucentis was available, Avastin was widely used by ophthalmologists who treat macular degeneration. Some of their experiences with large numbers of patients with relatively short follow-up times were recently published. No randomized controlled clinical trial with systematic safety data collection has been performed to validate its efficacy and safety with same certainty as ranibizumab. Bevacizumab, when administered at the usual cancer treatment doses (more than 100 times the dose used in the eye), has been shown to cause systemic adverse effects. The most common adverse effect was hypertension. There is a continued interest as the Avastin for use in the eye can be obtained for about 30-50 dollars per dose, compared to 2,000 dollars per dose for Lucentis. Following the recommended protocol for Lucentis costs about $50,000 per eye over two years. The National Eye Institute is planning a head-to-head Lucentis vs. Avastin, randomized, controlled clinical trial for treatment of macular degeneration. Currently more than 50% of retinal specialists use Avastin as the first line drug (ACRS Practice Patterns Survey).

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Renodoc,

I will do my best to be civil with you. There is no point in trashing one another. My point is that ODs are capable of being front line eye docs, and you feel otherwise. Let's leave it at that.I retract calling you an ahole when we have never even met so I apologize for that. It just rubbed me the wrong way when I felt I was doing a good job in answering OOT questions about generic eye problems and then got slammed about being incompetent.

I never hinted in anyway that OD's ,myself included, know more about the eyes than MDs and certainly not more about the retina than you do, so I don't see the point in you asking me about Lucentis,Avastin etc and how that would prove that OD's are not comeptent front line docs if I did not know the answer. It is like asking a general practioner to decide the best course of action between surgery vs chemotherapy vs radiation for a patient with stage 3 esophageal cancer and deeming him incompetentif he can't.My only knowledge of these drugs is from CE lectures and reading medical journals and my limited experience with patients whom I referred to have these treatments.My job is to detect eye disease and refer them off appropriately, and I feel that I along with most other ODs can do this as well as anyone. Having said all this, I'm sure it doesn't change your views of my profession......so like 7thonline says, we'll agree to disagree. But I do want to ask you a question about cnvm. What is the difference bw CNVM from histo,amd, progressive myopia or whatever? IS there a different protocol when using these newer drugs to treat each type of CNVM?