I am 67 years old and I am being treated with azathioprine for Wegener’s granulomatosis. I was recently also diagnosed with wet macular degeneration and require Lucentis injections. I wonder if Wegeners could be the cause of the bleeding in the macular area. Can you comment on that? [ 03/17/12 ]
In wet age-related macular degeneration (ARMD), bleeding is caused by growth of new blood vessels, called chorodial neovascularization, or CNV. Wegener's granulomatosis is a disease where the body attacks its own small and medium blood vessels, causing inflammation. Typically, Wegener's granulomatosis affects the nose and kidneys, though it can cause various problems in the existing retinal blood vessels as well. Wegener's granulomatosis would not likely cause bleeding from the CNV secondary to ARMD.
Are steroids, such as prednisone, contraindicated if you have macular degeneration? [ 03/16/12 ]
Oral steroids such as prednisone are not prohibited if you have age-related macular degeneration; however, this class of medication has a long list of side effects, which your doctor should make you aware of.
Can tanning beds cause dry macular degeneration? [ 03/15/12 ]
Tanning beds have not been definitively linked to causing or exacerbating age-related macular degeneration (AMD). However, ultraviolet (UV) radiation is released by the sun or artificial sources such as sun lamps or tanning beds. UV light can cause severe damage to our eyes and skin, including an increased risk for AMD, cataracts, skin cancer, snow blindness, and premature aging of the skin. In some states, legislation has been passed to restrict youth access to tanning beds. It is recommended that overexposure to sunlight be prevented by wearing wide-brimmed hats and using high quality sunglasses that have a rating of 99- or 100-percent UV-A and UV-B protection, and preferentially wraparound sunglasses to block harmful rays entering from the side.
I have been diagnosed with Best disease. I would like to find more information regarding the progression of the disease, current research, and any effective treatments. Also, I would be interested to know if there are ways that I can compensate for my visual limitations. Thank you. [ 03/14/12 ]
The e-medicine review article below is freely accessible on the internet and offers a reasonable overview of Best disease. No treatments are currently available for this eye disorder; however, many ways exist to maximize remaining visual potential. A low vision specialist can help you determine ways to compensate for your visual limitations. Your retinal specialist can help you obtain a referral.
Do you know if there is any research being performed on how medications affect macular degeneration (such as metoprolol, verapamil, digoxin, simvastatin and Prilosec)? [ 02/12/12 ]
Yes, studies aimed at evaluating the effects of these and other compounds on age-related macular degeneration (AMD) are being performed. These include studies conducted using experimental models (cell culture and/or animal models of AMD) to look at the effect of drugs on specific factors or processes known to be associated with AMD development.
To put it simply, each of these studies* examined the effects of the drug in question on specific cell types or processes that are known to be critically involved in development and/or progression of AMD. And, based upon the findings of their respective studies, each group speculated some potential benefit of the drug in the treatment of AMD. Studies of this type lay the foundation for others aimed at determining whether these compounds can eventually be extrapolated to treatment of human patients with AMD. Additional studies based upon analysis of patient database information are also being performed (i.e., studies that attempt to correlate the number of patients who had or developed AMD while taking various medications may help determine whether there is an increased or decreased risk of development and/or progression of the disease, or if there no apparent relationship). This is particularly true regarding the potential use of statins like simvastin for AMD treatment. So the short answer to your question is yes; the research is being done. Some preliminary studies have been inconclusive whereas others have been promising, but we still likely have a ways to go before seeing any of these compounds incorporated into the daily care of AMD patients.
* In a recent study by Yoshida et al., (FASEB Journal (2010) volume 24, no. 6, pgs.1759-1767), it was reported that digoxin inhibits retinal ischemia-induced Hif-1alpha and ocular neovascularization.
Hoffman et al. (Graefe's Arch Clin Exp Ophthalmol. (2006) volume 244, pgs. 376-381) studied the effects of verapamil isomers on the proliferation of cultured choroidal endothelial cells.
A cross-sectional study conducted by Hall et al. (British Medical Journal (2001), volume 323, pgs. 375-376) evaluated the risk of macular degeneration in statin users and suggests a possible association between statin use and lower risk of AMD.
My daughter was diagnosed with retinal macular degeneration when she was 14 years old. The vision in her left eye is -15.50 and -3.50 in her right eye. I was told she had anisometropic amblyopia. Her last exam wasn't good; they saw some suspicious areas (blood vessels) and they are going to do an angiogram of the eye. If she does have macular degeneration, is she a good candidate for gene therapy? [ 02/11/12 ]
The prognosis for your daughter depends on her exact subtype of macular degeneration. Age-related macular degeneration (ARMD) is the most common type, and is not typically seen in people under the age of 55. It is unlikely she has ARMD because of her age. If she is very nearsighted (-15.5 in the left eye) she could have myopic degeneration. With this disease, she is more prone to the formation new blood vessels, called choroidal neovascularization (CNV). If diagnosed using fluorescein angiography and OCT imaging, these new blood vessels can be very effectively treated. Currently, CNV is not treated with gene therapy, but rather with injections of Avastin or Lucentis, and less commonly with a specific type of laser treatment, called photodynamic therapy (PDT).
My husband has wet macular degeneration in one eye and has received a second injection of Avastin. After the first injection of Avastin, upon examination, his visual acuity went down one level on the chart. He was also diagnosed with Fuchs’ dystrophy. Is it possible the Avastin is not as helpful for the macular degeneration due to the Fuchs’ dystrophy? [ 02/10/12 ]
You are exactly correct that Fuchs' dystrophy may limit your husband's vision. Even if he did not have age-related macular degeneration (ARMD), the Fuchs' dystrophy could cause slowly worsening vision. Please speak to your eye specialist about the severity of your husband's Fuchs' dystrophy so that you can estimate its impact on his vision compared to the ARMD. Imporantly, multiple treatments exist for Fuchs' dystrophy including drops and corneal transplant, from which your husband may benefit. Reduction or gain of one line of vision may be due to chance rather than the effect of Avastin or worsening of ARMD. Different eye charts, lighting conditions, etc. can result in a minimal fluctuation in vision, such as a difference of one line.
The Macular Degeneration Research program is admirable, but what is missing is research into the effect of common drugs on macular degeneration. I'm sure you are aware that many drugs warn that they should be avoided if you have glaucoma. I can find no such warnings for macular degeneration. Please correct me if I am wrong. [ 02/09/12 ]
At this juncture, most drugs have not definitively been associated with age-related macular degeneration (ARMD) progression, which is why such warnings are not commonplace. Smoking has been definitively proven to worsen ARMD progression in multiple studies and this is a main risk factor that can be changed.