Wet AMD Caught Early

By ddaronian

1 min read

I am a retired ophthalmologist so when I first noticed metamorphopsia (visual distortion of straight lines), I quickly contacted my retinologist.

Wet AMD

He confirmed that there was wet AMD just beginning. An anti-VEGF drug(Lucentis) was administered and the symptom disappeared within 24 hours! With every 3 month maintenance, it has not returned after one year.

Stay alert

My message: Be alert for visual changes and don't delay seeking treatment. Once edema, scarring, and hemorrhage set in, treatment is much less effective if at all, from my experience.

We are lucky to live at a time that these wonder drugs are available. In time, better treatment with easier means of delivery will happen.

In the meantime, healthcare experts usually recommend eating plenty of leafy greens, nuts, and salmon, and quit smoking. It’s important to talk to your healthcare provider on ways you can improve your treatment.

Dianne Aronian, MD

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Brown Eyed Girl Moderator
<inline-mention username="ddaronian" user-id="6758649"/> welcome to our community and thanks for your positive and useful comment. You certainly had a good response to the Lucentis. Your advice to be vigilant and catch it early is very valuable. May I ask, when you say 3 month maintenance, do you have another shot each 3 months, or simply a check-up with presumably an OCT? Wendy, Patient Leader.
ddaronian Member
I have received an injection of Lucentis every 3 months for a year now. Since the first injection it resolved in 24-48 hours and has not returned. I have been followed with OCT at each visit. As I understand it, Lucentis is actually an antibody against VEG F (vascular endothelial growth factor) a protein naturally made by platelets in the blood. It serves in development of the fetus and also in wound healing. It is made in response to damaged blood vessels. Unfortunately it is a double edged sword because it also helps to provide blood vessels for growing tumors. It occurs in wet ARMD because of damage that occurred to delicate blood vessels supplying the very metabolically active photoreceptors. In the case of wet macular degeneration,the new blood vessels it makes are defective and leaky. The Lucentis actively binds up the VEG F and makes it ineffective. Think about the spike protein in covid and how the antibody attaches to it disable it (until the virus reinfects you). Unfortunately, the process of damage to the macular vessels is ongoing and the antibody needs to be refreshed in most cases, every 3 months. If it stops working, there are other anti veg f agents being developed and hopefully in the future, different ways of delivering it. I know that the injections are not a cure but a stop gap for the ongoing damage from living. I also know that I must protect my vision by wearing sunglasses and a visor in sunny situations, eating green leafy veggies containing plenty of lutein and vitamins ACE and red meat for zinc and sea food and seeds for copper. Of course smoking is forbidden. Prevention is the key but early detection is the lion tamer. 
1. Brown Eyed Girl Moderator
 <inline-mention username="ddaronian" user-id="6758649"/> thank you for your reply and for explaining how the anti-VEGF medication works. It is very interesting to read in more detail about this. Your reminders about protection from the sun and appropriate diet are also appreciated. Best wishes, Wendy, Patient Leader.
ddaronian Member
You are very welcome. As a retired ophthalmologist and patient with ARMD I am in a position to advocate for prevention and early detection. Dianne Aronian MD
1. Brown Eyed Girl Moderator
 <inline-mention username="ddaronian" user-id="6758649"/> I was wondering if you would share the steps your doctor took when giving you the injection as far as the anaesthetic is concerned. Our Community members seem to receive drops, gel or a shot, or a combination of the above. Some experience pain and others don't. Wendy, Patient Leader.
ddaronian Member
Topical drops are the accepted anesthetic together with an antibiotic. The same numbing is used for cataract surgery although some IV sedation may be used also because the surgery takes some time. The intravitrial injection takes a second or two and is no worse than a pinch. Post injection discomfort may last for a few hours due to the drying effect on the cornea and light sensitivity from dilation of the pupil. Often one can see the injected bubble of medicine floating around for a day. One can count on half a day of mild discomfort but if blurring of vision or pain occurs for longer than a day,call your physician .
1. Brown Eyed Girl Moderator
 <inline-mention username="ddaronian" user-id="6758649"/> thanks again for your comprehensive answer. Best wishes, Wendy, Patient Leader.

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