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Slow degradation of my vision. Seeing a retina specialist

Eye Conditions | Last Active: Jan 19 10:38am | Replies (154)

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@darby01

It’s most interesting to me that you had laser treatment for floaters and, although it seems somewhat later, developed retinal bleeding. I had laser treatments in both eyes for a film that formed over my eyes that interfered with my vision. The right eye was treated first and I noted that the treatment in that eye was longer and more intense than the treatment applied to the left eye. Shortly after the right-eye treatment, I was examined by my ophthalmologist and sent for consultation with a retinal specialist who detected retinal bleeding and scheduled an angiogram and subsequent eye injections(which I have undergone approximately every 6 weeks for the last 2 1/2 yrs). The condition was diagnosed as age-related wet macular degeneration; however, I did not have any retinal problems in either eye prior to the laser treatment. Although the possible causal connection between the laser treatment and the diagnosis probably cannot be proven, I find it relevant that you seem to have experienced something quite similar. The injections, although unpleasant, apparently have stabilized my condition and seem to be preventing further deterioration.

I’m sorry that you have had this problem as it is a serious condition. Fortunately there is treatment. I wish you all the best.

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Replies to "It’s most interesting to me that you had laser treatment for floaters and, although it seems..."

Darby, I'm very interested in your schedule of injections - something I've consulted three retinologists about. Also done lots of research about (reviewing many clinical trials comparing the effectiveness of frequency of injections and with what injection chemicals).

I've been told by all three, that yes (wonderfully), current research demonstrates that the injections are indubitably helpful in halting loss of vision and possibly even somewhat improving acuity. (That's by drying up and preventing the further growth of abnormal capillaries whose leakage causes the death of retinal cells by irreversible scarring).

They also agree, however, if the leakage is not ongoing, there is no utility in continuing injections. If it resumes (becomes "wet" again, to any degree), then yes, it's useful - indeed vital - to return to injections until the capillaries dry up again.

Do I understand you continued to receive eye injections (of the anti-VEGF chemicals) to prevent regrowth of the abnormal capillaries, even while they were not ACTIVELY leaking the combination of blood and toxic fluids?

Where did you receive your injections and have you ever asked your physician the basis of his/her injection protocol? Is it their intention to continue injections indefinitely and if so, at what intervals? Have they been using the same anti-VEGF chemical the whole time, and if so, which? (If not, what combination of chemicals?)

I'd really like to know about this as I've done a huge amount of study and had consults about precisely this question.

I've received three injections of Lucentis at one month intervals (right eye only) which discontinued the leakage and stabilized . Since then, I've received no more injections, nor does he intend to resume any unless leakage becomes active again. (I'm to carefully check my vision - daily - for any changes by using a diagram called an AMSLER grid. If there's any deterioration, I'm to see him immediately for him to evaluate my eyes for a possible return of the toxic fluids into - and/or beneath - my retina.)

That WOULD call for repeat injections . That is, "wet" macular degeneration. (The wet or most advanced stage of macular degeneration, is the only kind amenable to successful injection treatment.)

A top retinologist in PA , one at John Hopkin's and another highly respected retinologist-researcher at a teaching hospital (I found her from intensive online research), all agreed about this approach.

Otherwise stated, they say, there is NO utility in injecting eyes prophylactically (one or both, as affected). If the "wet" condition remains stable (dry) - if there's no repeat leaking/fluid beneath the retina - no injections. They call this the "treat and extend" approach, the goal being to avoid unnecessary injections which among other drawbacks, runs the risk of causing infection capable of permanently destroying vision in that whole eye.

Please compare your doctor's approach and if possible, who and where they practice? (In a PM if preferred, for privacy)

Thank you!

PS I'd also much appreciate input about the same question from any of you receiving anti-VEGF injections for wet macular degeneration.