My paternal grandmother, father, half-sister, and her son appear to have Best disease with juvenile-onset. I have no symptoms of it, and have been told that since it is caused by an autosomal dominant gene, I can't "pass it on" as my half-sister did; however, I want to be sure before I have children. Is there strong data to suggest that if I don't appear to have the disease, then I don't have the gene to pass it on? Should I have genetic testing? I am 37 years old, and want to know for sure before trying to get pregnant. [ 07/05/11 ]
You are correct in thinking that Best disease is typically autosomal dominant. That means that anyone carrying the disease gene exhibits symptoms or signs that can be detected on an eye exam. If you have no symptoms and a normal eye exam, you likely do not have autosomal dominant Best disease. Approximately half of offspring of a person with autosomal dominant Best disease will develop the disease. Very rarely someone will have a variant of Best disease that can be autosomal recessive, which is not detectable without specific genetic testing. Approximately one quarter of offspring of two people both having autosomal recessive Best disease will develop the condition. Please ask your retina specialist if genetic testing would be beneficial for you in terms of family planning.
My son is 11 years old and has been experiencing intermittent vision loss. He had an ultrasound of the eye and it showed that he had drusen in both eyes. The right eye had really large "stones," and the left eye had a larger number of smaller “stones.” I don’t really understand this at all. Are these signs of macular degeneration, and will it lead to his complete vision loss? If so, how long does it normally take to lose all vision? I know you can’t give me specifics, but just having a vague understanding would assist me in getting my head around this diagnosis. [ 07/04/11 ]
Age-related macular degeneration (ARMD) does not typically occur in patients younger than 55. You are correct in thinking that drusen are a finding in ARMD, however drusen can also appear in other diseases. Your son may have “optic nerve head drusen,” which can cause visual loss in rare cases by compressing the optic nerve or by influencing the growth of new blood vessels in the macular region. The good news is that vision loss from optic nerve head drusen in not common. Your son may also have a different kind of macular degeneration causing drusen, but these diseases are very rare. Please discuss this with your eye doctor; he or she can determine the exact type and location of drusen in your son's eyes, as well as the prognosis for these drusen.
Is it true that a mild electric current into the eye will clear up macular degeneration? [ 07/03/11 ]
A handful of physicians presented this idea several years ago; however, no definite proof currently exists to support electric current as a valid treatment for age-related macular degeneration (ARMD).
Approximately five years ago, my sister was diagnosed with dry macular degeneration. She must be in the intermediate stage now. Is it true that after a certain number of years, the dry form will never turn into the wet form? Also, since there is no treatment for dry macular degeneration, I wonder if it is really necessary for my sister to have tomography, angiography, and the other standard tests anymore. Thank you for your opinion. [ 07/02/11 ]
You are correct in that only a certain subgroup of patients with dry age-related macular degeneration (ARMD) convert to the wet subtype. However, as dry ARMD becomes more advanced, the chance of developing wet ARMD increases. If you sister has been diagnosed with intermediate ARMD, her chance of conversion to wet ARMD is approximately 27% over the next five years. If she develops wet ARMD, prompt treatment can stop and sometimes improve vision loss. If treatment is delayed, vision loss can be permanent. It is important that she fully understand the need for tests such as optical coherence tomography and angiography in following her ARMD, so please suggest that she discuss the role of these tests with her retina specialist.
I was diagnosed with macular degeneration six months ago, which has recently changed to the wet form. I had a Botox shot in my forehead recently, and was curious if this could have caused the changes in my macula? Also, can viewing a computer monitor all day cause harm to the eyes if someone has macular degeneration? [ 07/01/11 ]
No relationship has been established between Botox injections and age-related macular degeneration. Computer viewing can cause worsening of eye dryness, and this can lead to a reduction in vision independent to vision loss caused by age-related macular degeneration. You can try artificial tears to counteract this dryness. Computer viewing has not been linked to the development or progression of age-related macular degeneration.
My husband has wet macular degeneration in one eye. He has been treated with Avastin injections, which seemed to help for a while. He also has rheumatoid arthritis, for which he takes methotrexate, and his doctor thinks that the thinning of the cornea and recent deterioration of his eyesight might be related to this joint disease. Does this make sense to you, and is it possible that methotrexatecause could have caused the macular degeneration? [ 06/30/11 ]
Rheumatoid arthritis can cause a variety of eye manifestations such as dry eye, inflammation of the white part of the eye (sclera), and uveitis (a form of inflammation inside the eye). Inflammation can lead to thinning of the eye wall and swelling of the retina, which can cause a decrease in vision. Dry eye can also have an impact on vision. Methotrexate does not cause age-related macular degeneration (ARMD) and, in fact, has been recently proposed as a treatment for this disease. It is thought that ARMD is partly an immune-mediated disease and can be treated with immunosuppressive drugs, such as methotrexate.
My grandmother turned 101 years old in September of 2010, and her only ailment is her macular degeneration. This eye disease causes her much distress due to the visual impairment. Lately, her symptoms have become worse and I feel that her doctors are just telling her to cope with the problem due to her advanced age. Are there are any macular degeneration treatments that would be safe for a woman of her age? [ 06/29/11 ]
The treatment options for your grandmother depend on the exact type of age-related macular degeneration (ARMD) that she has. ARMD is divided into two subtypes, wet and dry. Currently there are multiple FDA approved treatments for the wet subtype, but none for the dry subtype. Certain patients can slow the progression of dry ARMD by taking a special vitamin formulation. If your grandmother is not being offered any treatments, it is possible she does not have a currently treatable form of the disease. Your grandmother, however, may still benefit from referral to a low vision specialist. Such a specialist can help optimize your grandmother's vision using training and assistive devices for activities that she likes to engage in, such as reading, using a computer, etc. Your retina specialist can help you with the referral.
Can a botched cataract operation cause macular degeneration? [ 06/05/11 ]
There is no evidence that strongly supports a relationship between cataract surgery and increased rates of age-related macular degeneration (ARMD). A complicated cataract surgery can cause visual decline for a variety of reasons; however, an increased rate of ARMD is not thought to be one of them.