Wet Myopic Degeneration

[CookinCO]

I am almost 50 and have pretty severe myopia...-11 and -9 contacts.    Recently, I started to see distortion (wavy lines) in my left eye. I went to the optometrist today and they found blood pooling in a level lower than my macula.   I am freaking out.  I am to see a Retinal Specialist on Friday but am so worried that I am going to go blind.    

The optometrist mentioned the possibility of a a shot in my eye for treatment.    I have no central vision issues just the distortion.  

Help!  

[CookinCO]

Curious Dr. Hagan on what future treatments are in the works for those of us with MMD?   I guess Lucentis and Aventis were big breakthroughs for which we should be so thankful for.  

[ValveJob]

What really scares me is that the last time I saw the specialist, I asked him what the probability is of its happening in the other eye.  He said that the statistics they have are on AMD (not the myopic type) and the risk is 40%!!  Even though neither you nor I have AMD, I still find that pretty scary.

The only person I know who seems to have this is the husband of a friend of mine who lives in Texas.

[John C Hagan III, MD, FACS, FAAO]

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[CookinCO]

I'm with you...very scared about it happening in my right eye too.  I was only diagnosed last week and had the one shot of Avastin.  I am 49 with a 6 year old child and am so afraid of not being able to "see" him grow up.   I feel fortunate that we have Avastin to give us some hope......can u imagine what people did 15 years ago without any kind of treatment?  My RS did mention that I may still have some distortion and I can live with that as I am sure you could do too.   It's the loss of central vision in both eyes that has me terrified.  Good point about the Areds...the double whammy would be awful.   I pray for both of us that our right eyes will be healthy forever with no visual distortion or loss.   I know nobody else with this sort of issue and it is very frightening for sure.    

[ValveJob]

I also have wet macular degeneration in my left eye due to pathological myopia.  To make a long story short, I had to wait two weeks (this January) to see my retinal specialist (I live in Montreal, and I have heard that there are only 13 retinal specialists in the whole province).  I had to wait two weeks for the appointment.  In any case, there was the pooling of blood and there was edema.  He gave me the injection of Avastin, I came back in a month, the swelling was down, but there was still a bit of blood, so he gave me another injection.  I went back in March and the Avastin had done what it was supposed to do.  However, my vision (although slightly improved) is still distorted.  This is because when the retina goes back into place, it is rarely nice and flat and pristine as it was before.  So, I am very bummed out and very scared about its happening in my right eye.

I will be seeing the specialist again towards the end of this month.  I am going to ask him what I should do if something happens and I cannot get an appointment immediately.  Should I go to the ER?

As far as AREDs, I was told that for myopic degeneration, they will do nothing to help the situation since it is caused by mechanical rather than biochemical causes.  However, I started taking them anyway because since I am 66 years old, I don't want to also get AMD which would be a double wammy!!

[CookinCO]

Thank you.  It looked to me that everyone with my condition these days was getting avastin so I was happy that is what my doctor injected.   Mantpy posts I've found are old where it seemed that they used photodynamic treatment plus visudyne or something.   I just don't know if places like Mayo, Jules Stein, johns Hopkins are doing even newer better things....

[CookinCO]

Also forgot to ask my doctor if those Areds are indicated for what I have?

[John C Hagan III, MD, FACS, FAAO]

Before the development of VEGF inhibitors (avastin, lucentis and the newly released eyelea) an eye like yours ended up almost always legally blind with good peripheral vision but very bad central vision. I would suggest you consider this:

1. Use the search feature and archives and read the many informative posts on myopic wet macular degeneration.
2. Get an Amsler grid from your Eye MD ophthalmologist and test both eyes daily.
3. When you see the Eye MD ophthal mologist next time you need to ask "if I have a sudden change in the vision in my good eye or a big change in my bad eye can you or your associates see me the same day, on weekends and holidays" if the answer is "no" then consider finding a new group.

We have two retina MDs in our group and use a second group for back up. We can always see eye emergencies same day or within 24 hrs. If we find a possible wet mac degen and its sudden onset (totally different if its been there 3-4 weeks) our retina MDs or the other group will see same day or within 24 hrs.

Also for all your routine care, glasses-glaucoma check I would transfer to a comprehensive Eye MD ophthalmologist rather than a non-MD, non-physician, limited skill optometrist. You can find one near you at www.geteyesmart.org

If you are still concerned then go ahead and get a second opinion from a different group of retina Eye MDs.

[CookinCO]

So I was seen For my appointment by the RS and received the diagnosis of the neovascular myopic degeneration in my left eye.  Right eye still fine for now.   I received an injection of Avastin.  Is that the standard treatment?   Hard to know if I should be going around the country to top eye clinics for other opinions....if this was your eye what would you do?   Shot by the way no biggie...though stinging in eye all evening after was not fun but well worth it if it will save or delay vision loss.  

[John C Hagan III, MD, FACS, FAAO]

I cannot offer any diagnosis or reassurance since I can't see into your eye. I still would try and get in tomorrow rather than Friday.
JCH MD

[CookinCO]

Thank you Dr. Hagan.  What the optometrist showed me from the test she gave me was some pooling of blood in a layer below the macula.   She never used the term "wet myopic degeneration" but I figured that is what it is called because of the presence of blood.  Am I correct with that assumption?   I noticed the wavy lines about 3 weeks ago and finally thought I should have it checked out.   That bleeding was probably there for a while....Will 2 extra days really make a huge difference?  

Does someone with that bleeding have a very bleak future?   I am in a total panic over here that I won't be able to see my son grow up......Can you offer me any reassurance at all?  I need something to take for my anxiety.   I have been shaking since I left the Optometrists office early today...thanks

[John C Hagan III, MD, FACS, FAAO]

First this should be treated as an emergency and you should be seen TOMORROW.  I would call and tell them you were told you might have "wet macular degeneration".  All retina referral offices are set up to deal with same day emergencies. TELL THEM IT's an EMERGENCY and you need to be seen Wednesday not Friday.

All of our recent onset possible wet ARMD are see same day to next day.  

JCH MD