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Ask an Expert about Macular Degeneration

Latest Questions and Answers
Is there a surgery for dry macular degeneration that can prevent the progression to the wet form of the disease? [ 03/29/11 ]

No surgery exists to prevent the conversion of dry age-related macular degeneration (ARMD) to the wet subtype. However, smoking cessation and nutritional supplementation can definitely slow the conversion. Ask your retina specialist if you are a candidate for ARMD nutritional supplements. It is important to note that these supplements are only beneficial for a subgroup of patients with dry ARMD.


I am 51 years old and was recently diagnosed with macular degeneration. Is there any way to predict how quickly the disease will progress, and is there anything that I can do other than take PreserVision? Is there a difference between macular degeneration and age-related macular degeneration? I feel as though I should be doing something! Any advice would be appreciated. [ 03/28/11 ]

You are correct in thinking that certain factors can slow the progression of the dry subtype of age-related macular degeneration (ARMD) in certain patients. PreserVision has been shown in a large clinical trial to definitively slow the progression of disease in certain patients with dry ARMD. Smoking cessation has also been shown to slow progression. Other behavioral changes like a healthy diet, exercise, and omega-3 fatty acid supplementation may be beneficial. ARMD is a subtype of macular degeneration, and frequently referred to as “macular degeneration,” though this general term includes many other diseases.

Read more about risk factors and prevention of age-related macular degeneration.


My sister, who is 71 years old, has macular degeneration and is receiving Avastin injections. In February, she was awakened by a pain behind her eyes. When she opened her eyes, a watery liquid "poured out." What would cause this to happen? [ 03/27/11 ]

Pain after Avastin injection is not uncommon. The eye can respond to a noxious stimulus, such as recent injection, antiseptic drops, or antibiotics by secreting tears and mucous as a self protective mechanism. This may have been one possible cause. Please understand that fluid associated with redness, pain, or decreased vision is a reason to contact your doctor.


I have wet macular degeneration and an iodine solution is used to disinfect my eye after the Avastin injections. Unfortunately, I am allergic to iodine. Is there some other antiseptic that can be used to avoid the potential allergic reaction? [ 03/26/11 ]

The antiseptic agent used prior to Avastin injection is povidone-iodine, and allergy to this is very rare. Have your doctor perform a patch test to confirm this allergy. A history of systemic iodine allergy is usually not a contraindication for topical povidone-iodine. In the rare case of a true povidone-iodone allergy, one could consider using aggressive topical antibiotics, but this would be an inferior antiseptic method and would select for resistant bacteria over time.


Does Coumadin affect macular degeneration? [ 03/25/11 ]

This is complicated question and depends on exactly what you mean by “affect.” First, the AREDS supplement prescribed for people with a certain subtype of age-related macular degeneration (ARMD) contains high levels of vitamin E which can affect warfarin (Coumadin) levels. Also, a recent study has proposed that patients with the wet form of ARMD can have increased rates of bleeding inside the eye compared to patients with wet ARMD who do not take Coumadin. Please do not stop taking Coumadin without consulting the physician(s) who prescribed it to you.


Can x-ray therapy treat wet macular degeneration? Is this treatment available now? [ 03/25/11 ]

Oraya Therapeutics is presently testing a device called the IRay system to treat wet macular degeneration.  This device may be used alone or in combination with certain anti-VEGF therapies to promote anti-inflammatory, anti-neovascular and anti-fibrotic effects.    Preliminary testing of the efficacy of the IRay in animal models seems promising.  As such, patients are now being recruited for Phase I clinical trials.  More information regarding the clinical trial, entitled “Safety & Efficacy Study of the IRay System in Patients with Choroidal Neovascularization (CNV) Secondary to Age-Related Macular Degeneration (AMD),” can be found on the ClinicalTrials.gov website.


Please provide some information about Dr. Nicholas Bazan’s research concerning neuroprotectin D1. How does this compound affect toxins that build up in the retina? [ 03/24/11 ]

Dr. Bazan's research group has done extensive work regarding the role of neuroprotectin D1 (NPD1) in the central nervous system, which includes the retina. Overall, they report that NPD1 promotes “cell-protective, anti-inflammatory, pro-survival repair signaling,” specifically in retinal pigment epithelial cells, which play a critical role in the development of macular degeneration.

Currently, Dr. Bazan and colleagues are testing whether NPD1 can preserve vision in mice with age-related macular degeneration (AMD). So far, they've taken photos and specific measurements of the back of the eyes (retinas) of the mice and created the treatment delivery system. Next year, they will treat the AMD mice and compare those results with this year's measurements to determine whether NPD1 can protect vision. If this treatment works in mice, the next step will be to take it into human clinical studies.

Below are the references for two comprehensive scientific review articles that summarize some of the work he has done on NPD1.

  • Bazan NG. (2009) Neuroprotectin D1-mediated anti-inflammatory and survival signaling in strok, retinal degenerations, and Alzheimer's disease. J Lipid Research, Supplement 50, pages S400-5.
  • Bazan NG. (2007) Omega-3 fatty acids, pro-inflammatory signaling and neuroprotection. Current Opin Clin Nutr Metab Care, volume 10, issue 2, pages 136-41.

I have had dry age-related macular degeneration for at least 25 years, and it has remained stable. Approximately 5 months ago, I started using Restasis for dry eyes. About 1month ago, however, my right eye started to show signs of wet macular degeneration, and I am now getting a series of Avastin shots to stop the bleeding. Is there any relationship between using Restasis and the development of wet macular degeneration? [ 03/23/11 ]

According to the product information provided by Allergan, the makers of Restasis, the most common side effects of using the medication are: temporary burning, eye redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging and blurred vision. I found no published reports, either from Allergan or other sources, suggesting any possible relationship between the use of Restasis and development or progression to wet macular degeneration. You may wish to discuss this further with your ophthalmologist.


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Disclaimer: The information provided here is a public service of the BrightFocus Foundation and should not in any way substitute for the advice of a qualified healthcare professional; it is not intended to constitute medical advice. Please consult your physician for personalized medical advice. BrightFocus Foundation does not endorse any medical product or therapy. All medications and supplements should only be taken under medical supervision. Also, although we make every effort to keep the medical information on our website updated, we cannot guarantee that the posted information reflects the most up-to-date research.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

Last Review: 04/29/13


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