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Ask an Expert about Macular Degeneration

Latest Questions and Answers
I am a 44-year-old Hispanic male under a great deal of stress with a Type A personality. I was recently diagnosed with wet age-related macular degeneration and was wondering if there is research showing a connection between stress or personality type and the development of this eye disorder? [ 11/11/10 ]

At present, there does not appear to be any scientific evidence linking Type A personality or increased emotional/physical stress with increased risk for developing macular degeneration. The known risk factors for the disease include:  genetics (family history of the disease), smoking, obesity, gender (women appear to be at greater risk than men) and race.  Most pamphlets or published information for patients regarding risk factors for age-related macular degeneration usually state with respect to race that Caucasians appear to be at greater risk for developing the disease than are African Americans, and may not mention specifically other ethnic groups.  However, data obtained from the Los Angeles Latino Eye Study (LALES), one of the largest studies of visual impairment in Hispanics conducted in the U.S., shows the risk for Hispanics to be comparable to the rate seen in Caucasians.   It is important to remember also that certain lifestyle practices such as eating a healthy diet, maintaining a healthy blood pressure, not smoking, exercising regularly, etc. may help lower one's risk of developing this eye disease; therefore, it would be prudent to development adaptive strategies for coping with life's stressors.

I am being treated for wet macular degeneration with Avastin shots in my left eye every 6 weeks. This treatment has been going on for almost 2 years. Progressive ultrasonic scans have shown a significant decrease in the pooling as well as a significant reduction in the size of the capillaries. If fact, the last scan showed little, if any, pooling. With such significant results, is it possible that the shots may no longer be required or is it just a matter of time before the pooling resumes? [ 10/25/10 ]

Repeated Avastin injections are a very common treatment for wet macular degeneration. Fluid in the retina usually signifies active disease in wet macular degeneration, and requires more injections. OCT scans (optical coherence tomography) are typically used to monitor retinal fluid as it resolves during treatment. If the most recent scan has shown that the fluid is decreasing, then the Avastin injections are having a good effect in treating the disease. If the fluid disappears completely, you may be able to stop injections. For some patients however, the fluid returns if they are not treated for an extended duration. Others patients can stop treatment permanently. Your retina specialist will help make a treatment plan customized for your eye, and how your eye responds to treatment.

I am 32 years old and was told that I have Hallermann-Streiff Syndrome. In the 90s, I had a ‘membrane’ and I lost the central vision of one eye. This year, a new membrane appeared and I have had 5 eye injections thus far. I do take antioxidants, but I am curious about other options that I might have. [ 10/22/10 ]

Hallerman-Streiff syndrome is associated with two common eye problems: very small eyes and clouding of the lenses requiring cataract surgery. Membranes can refer to several eye diseases such as epiretinal membranes, choroidal neovascularization, or a membrane across the pupil. Without knowing the exact kind of membrane, I cannot answer more accurately. I suspect you might have an epiretinal membrane causing swelling in the retina that is being treating with steroid injections. Antioxidants are neither helpful nor harmful for epiretinal membranes. Another option might be surgical membrane removal from the retina. However, any surgery in an eye that is very small is at a higher risk for complications.

Our company provides care to a man with macular degeneration and hearing impairment. What activities can our caregiver engage in with this man to keep him from becoming bored with his routine? Any suggestions will be helpful. Thank you. [ 10/21/10 ]

Macular degeneration and hearing impairment are a very debilitating combination of ailments. I would suggest that the patient first consult with his eye specialist to see if a low vision evaluation would be appropriate. Low vision specialists can provide access to devices and special training to maximize the remaining visual abilities. This may allow for more engagement in the daily routine and subsequently less boredom.

You may get some ideas from the "Living With Low Vision" section of our website, which focuses on strategies for everyday life with macular degeneration.

I was previously told that I had age-related macular degeneration. However, after a recent dye test, I was told that it was ‘macular pattern.’ What is it and what is the difference between ‘macular pattern’ and macular degeneration? I was told that macular pattern is not as serious, and that the treatment is the same as for macular degeneration. Can you please provide me with advice? [ 10/20/10 ]

The term “macular pattern” is not commonly used, but your doctor may have meant a pattern dystrophy. A pattern dystrophy is a class of diseases that can mimic age-related macular degeneration but carries a better prognosis. The vast majority of people with pattern dystrophy maintain reading ability in at least one eye. In contrast, age-related macular degeneration affects 30% of people older than 75 years of age, and is thought to cause severe vision loss in at least 10% of this group.

How long can a person receive Lucentis shots? How frequently should they be administered? [ 10/13/10 ]

Many people have been receiving Lucentis shots monthly for very prolonged durations. Two large clinical trials have demonstrated the safety of once monthly Lucentis for two years (24 injections total per eye). It is not currently known for sure whether shots of Lucentis can be given less frequently than monthly and still obtain the best visual results. Several clinical trials worldwide are trying to figure out the least number of injections that can be given while still obtaining the best visual results. Many retina specialists give Lucentis every 4 – 6 weeks currently, but this may change in 2011 as these clinical trials conclude and provide more definitive data.

I was diagnosed with birdshot retinopathy and wet macular degeneration in both eyes. Is macular degeneration caused by the birdshot retinopathy or are they two separate diseases? [ 10/12/10 ]

Birdshot retinopathy and wet macular degeneration are two different diseases. Birdshot retinopathy is a rare, likely inflammatory disease, occurring in the back part of the eye. Birdshot retinopathy does not cause age-related macular degeneration or vice versa. Age-related macular degeneration is far more common with around 30% of adults over the age of 70 demonstrating some signs of this disease. Around 90% of vision loss is caused by the wet subtype of macular degeneration.

A couple of months ago, I was diagnosed with a vitreous detachment in my right eye, which also has degeneration of the macula. Is it safe to take 5 milligrams of Cialis, or would that put me at risk for a retinal tear or retinal detachment? I did take this drug prior to being diagnosed with macular degeneration and had no vision problem or any side effects; however, I have not taken it since being diagnosed. Thank you for your input! [ 10/11/10 ]

Cilias or tadalafil belongs to the class of drugs called phosophodiesterase inhibitors. These drugs cause increased blood flow to the eye, and most commonly cause a blue tinge to vision and increased sensitivity to light. The phosophodiesterase inhibitors have not been linked to retinal tears, but very rarely have been reported to cause loss of blood flow to the optic nerve (the connection between the eye and the brain) and vision loss from that loss of blood flow. However, most eye doctors consider tadalafil as very unlikely to cause any eye problems including retinal tears or retinal tears leading to detachment.

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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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