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My father-in-law has wet macular degeneration and is opting out of the so-called preventative shots that his doctor would like him to take. Are there clinical outcome studies concerning the shots? What do they show? I would hate to see him pass up on treatments that might help him maintain or improve his vision? Can you provide some input concerning this issue and direct me to the study results, if there are available? Thanks! [ 04/17/10 ]
Treatment of wet macular degeneration via the injection of anti-angiogenic compounds to prevent the growth of new, leaky vessels in the eye is a promising method of treating macular degeneration. This has been shown in several independent studies, and presently the National Eye Institute is sponsoring a clinical trial called the “CATT” (Comparison of AMD Treatments Trials) to compare the effectiveness and relative safety of Lucentis and Avastin, two drugs currently used to treat advanced age-related macular degeneration. A summary of the results of a previous trial conducted on the efficacy of Lucentis injections for treatment of macular degeneration can be found at the following web address: http://www.lucentis.com/lucentis/hcp/efficacy-trials.html Should the house be kept as bright as the light outdoors on a sunny day, or I need to “exercise” the pupils to expand and contract them with varying lighting conditions throughout the house? Can you let me know which is better? [ 04/15/10 ]
There is no benefit to "exercising" your pupils by exposing yourself to varying lighting conditions throughout the house. There is also no strong evidence that normal light exposure causes age-related macular degeneration. However, ultraviolet light (UV) exposure has been linked to the development of cataract, and wearing glasses outside on a sunny day is recommended. My mom is 76 years old and has wet macular degeneration; however, she was told that she could not have the treatment that involves injections into the eye. Is she being given accurate information? [ 04/13/10 ]
Lucentis and Avastin are anti-VEGF injections that are used for the treatment of wet macular degeneration. The relative safety profiles of Avastin and Lucentis are still being studied in a current clinical trial called The Comparisons of Age-Related Macular Degeneration Treatments Trials (CATT). Avastin is also used as a chemotherapeutic agent for various types of cancers. Although the dose injected into the eye for macular degeneration is much lower than the systemic doses used for chemotherapy, ophthalmologists follow relative contraindications for the use of Avastin in the eye. Avastin (in chemotherapeutic doses) has been found to increase the risk of arterial thromboembolic events (blood clots) and therefore is used with great caution in patients with a history of stroke or heart attack. You should ask your mother's ophthalmologist why she is not a good candidate for Avastin or Lucentis. My husband, who is age 57, is suffering from wet macular degeneration. We have heard that stem cell treatments have been used in clinics within the United States since January 2010. Is this true? If so, what steps do we need take to find out if these treatments are suitable for my husband? Also, where do we go to participate in the program and obtain treatment? [ 04/11/10 ]
The efficacy of stem cell therapy for macular degeneration has not been established in clinical trials at this time, and is not considered standard of care for macular degeneration. It is possible that in the future, stem cell therapy may become an important therapeutic option for AMD patients, but at this time, the technique is still in development and is experimental. My mother has macular degeneration and we both are nearsighted. Is it guaranteed that I am destined to get this terrible disease? I am really worried about this because my grandma (my mom's mom) also had this eye condition. What can I do to lower my risk and what treatments are available for myopic macular degeneration? [ 04/09/10 ]
There is a strong genetic component to myopia. The risk of myopic macular degeneration is highly dependent on the severity of myopia, which is variable even within family members. Your ophthalmologist would be able to better tell you your personal risk of developing myopic macular degeneration. Anti-VEGF agents that are used for the treatment of wet age-related macular degeneration can also be used for myopic macular degeneration that has progressed to choroidal neovascularization* (CNV). However, there are no proven interventions that reduce the risk of development and progression of myopia to myopic CNV. I have used pile cream (Germoloids) for the bags under my eyes for several years and was recently diagnosed with macular degeneration. Could this cream have caused the damage? [ 04/02/10 ]
Germaloids cream contains lidocaine and zinc. The spray formulation of Germaloids contains hydrocortisone, a steroid. If you use this around your eye, it can contribute to the development of elevated eye pressure and lead to glaucoma. Steroids can also hasten the development of cataracts. Neither ingredient should contribute to the development of macular degeneration. I was diagnosed with macular degeneration in my left eye in October 1993 and had surgery for it one week later. The surgeon removed the gel in the eye and sutured the hole. Recovery took about 3 months. I sat with my head down 10 minutes of each hour and slept on a rolled up towel. The doctor filled the eye with a gas that dissolved in about 3 months. The center of my vision is not entirely clear; however, the visual acuity around that region is excellent. Do you know much about this surgery? I am so pleased with the result of my surgery that I wonder if others have been helped like me. [ 03/31/10 ]
From your description, it sounds like you did not have age-related macular degeneration, but rather a macular hole. Macular hole repair is surgical and can be very effective when treated early. However, this is not the same disease process as macular degeneration. I had dry macular degeneration in one eye and the wet form in the other. The dry eye has now changed into the wet form. My doctor advised me to discontinue taking the AREDS and vitamins with lutein that I had been taking for years. He recommended that I should now take a standard multi-vitamin. Does this make sense considering the facts presented? Is there any benefit to continue taking the AREDS formula and vitamins with lutein? [ 03/29/10 ]
Your doctor's advice is consistent with current medical evidence. The AREDS formulation has been proven to decrease the risk of progression of dry macular degeneration to advanced macular degeneration (wet AMD or central geographic atrophy). Once you have converted to wet macular degeneration, there is no proven benefit to continuing the AREDS formulation over a standard multivitamin. Moreover, the AREDS formulation is likely more expensive than a regular multivitamin. Search for a Question
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