In 2001, I had carotid surgery and was prescribed 325 milligrams of aspirin once each day. In 2009, I had aortic valve replacement and was prescribed 85 milligrams of aspirin once daily. Six months later, I was diagnosed with wet age-related macular degeneration (AMD). Did high aspirin doses contribute to the development of AMD? I have been treated for wet AMD with Avastin injections for three years and soon I will have knee replacement surgery. Is there information that my knee surgeon should know about my AMD treatments? [ 06/17/13 ]
The exactly link between aspirin and worsening of age related macular degeneration (ARMD) is not well understood. For example, three well designed studies have reported a possible association between aspirin usage and worsening of ARMD. Likewise, three other well designed studies did not find an association between aspirin usage and worsening of ARMD. Eye injections for wet ARMD have no known interaction with knee replacement surgery or healing after such a surgery. You can mention to your orthopedic surgeon that you are getting Avastin injections for wet ARMD, as it is important for all your medical providers to know your complete medical history.
My mother is 87 years old; her right eye retina is atrophied, and she is blind in her left eye. She also has glaucoma, but is not using eye drops at this time. Is she in the last stage of macular degeneration, called geographic atrophy? How will her field of vision change in the future? [ 06/17/13 ]
Without performing a complete eye examination it is not possible to define what stage of age-related macular degeneration (ARMD) your mother is in. The end stages of ARMD are divided into multiple different subtypes based on physical findings including central geographic atrophy, fibrotic scar tissue, bleeding, fluid in the retina, or a combination of all of these. Wet ARMD typically causes central vision loss only, and glaucoma causes slow peripheral vision loss first and then finally central vision loss. Please discuss the prognosis for your mother’s visual field tests with her managing glaucoma specialist.
My son was recently diagnosed with myopic degeneration, and is receiving injections of Avastin (bevacizumab) in his eyes. Will these injections help, or is there anything else that can be done to correct this condition. His right eye is fine, but I am worried that he will get the disease in the other eye. He also has severe nearsightedness. Would surgery in his right eye prevent myopic degeneration? [ 06/17/13 ]
Avastin is not a treatment for myopic degeneration, but it is used to treat new blood vessels that can sometimes grow secondary to myopic degeneration. This new blood vessel growth is called choroidal neovascularization. These Avastin injections are very effective in preventing vision loss from the abnormal blood vessel growth and can sometime improve vision, but only if the vision has been lost due to the new blood vessel growth. Eye injections like Avastin are usually the best available treatment from new blood vessel growth.
Myopic degeneration can cause vision loss for a variety of reasons in addition to new blood vessel growth, and surgery will not prevent progression of myopic degeneration. Sometimes surgery can be used to treat complications of myopic degeneration, such as retinal detachment, however. Myopic degeneration is typically present in both eyes, though it may certainly be worse in one eye compared to the other. If your son is nearsighted in the right eye, he probably has myopic degeneration in that eye also.
My 88-year-old mother was receiving Lucentis injections for a couple of years in her one good eye (the other eye is scarred from wet macular degeneration). One year ago, her doctor switched to using Eylea. She recently complained of worsening vision, and it was revealed that there were "dry changes" to the eye. I am sending a link which talks about Anti-VEGF drugs causing "dry" macular degeneration, which is what my mother now seems to have acquired. In other words, the Eylea injections are now seemingly causing "dry" macular degeneration in her good eye. Your thoughts and comments would be most welcome. Thank you. http://www.sciencedaily.com/releases/2009/11/091102121506.htm [ 06/17/13 ]
It is not known whether eye injections such as Lucentis and Eylea for wet age-related macular degeneration (ARMD) can speed up progression of dry ARMD. The potential to speed up dry ARMD progression has been proposed for both Lucentis and Eylea. Please remember that although dry ARMD typically can cause visual decline slowly, wet ARMD almost always causes significant visual decline more quickly, and the eye injections such as Lucentis and Eylea have been shown in multiple clinical trials to prevent vision loss in 90 percent of patients with the wet form of the disease. Studies are ongoing to determine whether long term anti-VEGF drugs can cause more rapid progression of dry ARMD. The study you referenced is a study performed in a mouse model, and studies done in mice do not always translate to similar clinical findings in humans.
I am 70 years old and I was diagnosed with wet macular degeneration and glaucoma a few years ago. I have been using Travatan drops and get new glasses once each year. I asked my doctor why this past year I was able to see in color on my 32 inch television from a distance of two feet, but at three feet, I can only see black and white; and everything is blurred even with glasses. Now she says that glasses would not help. At this rate, how long will it take for me to go blind? Can doctors halt the disease progression? What can I do? [ 06/17/13 ]
You have two separate diseases: glaucoma and wet age-related macular degeneration (ARMD). The glaucoma causes slow progressive loss of your peripheral vision and then eventual loss of central vision also. The wet ARMD can cause progressive central vision loss as well as loss of color vision. The vision loss from either glaucoma or wet ARMD cannot be corrected by glasses. Doctors can slow and halt the disease progression for both glaucoma and ARMD with a variety of therapies. The most common treatment for wet ARMD is injection of special medicines directly into the eye. These medicines can prevent vision loss from ARMD in 90% of patients. Please discuss with your retina specialist if you are an appropriate candidate to receive the medicines. You can also ask your eye doctors about the progression of the glaucoma and wet ARMD based on your past history, and they can also give you a prognosis for potential future visual loss.
My 86-year-old mother has wet age-related macular degeneration and has been receiving monthly injections of Lucentis for 18 months. Her vision has not improved but has remained stable. A few weeks ago, her retina specialist switched her to Eylea to reduce the frequency of the injections. Then, after one week, her vision became blurry and her acuity changed from 20/80 to 20/200! Her doctor took retinal pictures and did several other tests but could not find any reason for the changes. Do you think her blurred vision is permanent and do you think she should go back to Lucentis? Thanks for your time. [ 09/24/12 ]
Though research is ongoing, no one knows the definitive effects of switching patients with wet age-related macular degeneration (ARMD) from one therapy, such as Lucentis, to another therapy, such as Eylea. The trials performed with Eylea were performed on patients who had never been treated with any medicine for wet ARMD. Though these large clinical trials have demonstrated that overall, both Eylea and Lucentis perform similarly for large groups of untreated patients with wet ARMD, it may be that particular individuals respond better to one medication than the other. However, many patients have been switched between drugs without adverse events in practices across the country. Please ask your retina specialist about the possible reasons for the visual decline, as well as if switching back to Lucentis may be beneficial.
Is there any reason to be concerned that regular use of eReaders could exacerbate mild macular degeneration? [ 09/24/12 ]
There is no evidence that use of computers, tablets, or eReaders is harmful to people with dry or wet age-related macular degeneration (ARMD). In fact, patients with ARMD often benefit from the abilities of these electronic devices to provide increased contrast or enlargement of text. Low vision specialists often recommend such assistive devices when reading for patient with various eye diseases.
I am 49 years old and was diagnosed two months ago with myopic degeneration with choroidal neovascularization in my left (non-dominant) eye. I received one injection of Avastin, which thus far has stabilized the vision in my left eye. I am wondering how likely it is that my right eye, which is also highly myopic will be affected by choroidal neovascularization? Also, would scleral buckling reduce my chance of getting choroidal neovascularization in my right eye or slow the progression in my left eye? [ 07/23/12 ]
People with high myopia have a higher risk of developing choroidal neovascularization (CNV). In people who have developed CNV in one eye, the risk of developing this condition in the other eye is around 35 percent. Scleral buckling is a treatment for certain types of retinal detachment and would not typically be helpful in the treatment of CNV or myopic degeneration. People with high myopia are also at higher risk for retinal detachment, so it is important to discuss the warning signs with your retina specialist so that you know what symptoms to watch for.