Your ophthalmologist should have extensive experience with all the treatment options for wet AMD. Ask if he or she regularly treats patients with the condition, and discuss treatments based on your diagnosis and what outcome you can expect with each. For example, laser surgery and photodynamic therapy may slow the progression of vision loss, but they have not been shown to improve vision.

If you and your doctor decide to start with Avastin, your doctor should screen you for medical conditions that could increase your risk for complications. Tell him or her if you have a recent history of heart attack or stroke, or if you're at increased risk for either.

Other safety precautions:

• If you need to have surgery for any reason, inform your surgeon and any other physicians, including dentists, that you are undergoing Avastin treatments. In some cases, your physician may want you to stop treatment for a time before and after your surgery. Also, if you're scheduling surgery, be sure to discuss it ahead of time with your ophthalmologist.
• Do not rub your eyes or swim for three days after each injection.
• Immediately contact your ophthalmologist if you develop any of the following signs of eye infection or other complications: pain, blurry or decreased vision, sensitivity to light, redness of the eye (compared with immediately after an injection), or discharge from the eye.
• Obtain emergency medical care if you have symptoms that could indicate a systemic complication. Those include:
• • abdominal pain with constipation and vomiting
  • abnormal bleeding
  • chest pain
  • severe headache
  • slurred speech
  • weakness or numbness on one side of the body
• Keep all post-injection appointments or scheduled phone calls to your doctor to check for complications.

Bottom line: Avastin is a commonly used drug to treat wet AMD, though it is not FDA-approved for this use. It is likely that a doctor will discuss using it with you if you need it. Our advice: Consider Avastin if cost is an issue and you've talked with your doctor about all available treatments.

This off-label drug use report is made possible through a collaboration between Consumer Reports Best Buy Drugs and the American Society of Health-System Pharmacists. This is the first in a series based on professional reports prepared by ASHP.

These materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).