Tag: Yoshihiro Yonekawa

  • Hope For Age-Related Macular Degeneration

    Hope For Age-Related Macular Degeneration

    Age-related macular degeneration (AMD) is a common eye condition that impacts millions in the United States alone. In our previous article, we explored the different levels and types, as well as major risk factors.

    Thankfully, treatment is an effective option now.

    Even just fifteen or so years ago, having the advanced form of AMD almost guaranteed that your vision would become severely impaired. 

     

    Treatment for Wet AMD

    Treatment for wet AMD is one of the biggest advances – in all of medicine – within the past two decades. 

    Currently, the standard treatments for wet AMD are delivered by injections into your eye. 

    A needle to the eye sounds scary, and everyone is nervous the first time.  But rest assured, it’s not as bad as it sounds. 

    Every single one of my patients after their first injection has commented along the lines of, “That’s it?”, “That wasn’t bad at all!” or “You’re done already?”.  We numb the eye well, and you might feel some pressure, but it shouldn’t be painful.

    Your eyes may feel irritated for the rest of the day after the numbing medication wears off though, and this is caused by the anti-septic that we all use to prevent infections. 

     

    Stay Alert After Your AMD Treatment

    The main precaution is to contact your retina specialist if you have any vision loss or pain a few days after an injection, which are potential signs of an infection, and that needs to be treated aggressively.  Infections are very rare but that’s one thing to look out for as a patient receiving injections.

    One of the joys of being a retina specialist is that we get to know our patients with wet AMD and their families really well. 

    In fact, you’ll probably see us more than any one of your other physicians. The injections, for the time being, are required relatively frequently, especially in the beginning.

     

    New Advances in Treatments for AMD

    There are many promising new treatments in the pipeline for wet AMD also, that hopefully will work even better with longer durability, so that we can decrease the treatment burden and further improve outcomes.

    Tremendous efforts are being made in numerous laboratories and clinical trials to advance what we can offer patients with wet AMD. 

    Right now, is one of the most exciting times for developments in the management of wet AMD, and hopefully, similar strides can be made for dry AMD as well.

    Some exciting clinical trials and research for geographic atrophy (GA) include agents to block specific pathways are also underway. 

    There is a lot of hype and hope surrounding stem cells in all of medicine, but one word of caution regarding stem cell therapies: please talk to your retina specialist before enrolling in stem cell trials. 

    There are very few legitimate active stem cell trials, but there have been reports of fraudulent and financially driven “stem cell clinics” that have blinded vulnerable patients looking for hope.

     

    Hope for the Future

    You are definitely not alone. 

    In addition to the millions of other people living with AMD, your retina specialists and thousands of vision researchers are working hard to make new discoveries.

    February is National AMD Awareness Month – please spend a moment to talk to your friends and family to discuss what it means to live with AMD, the progress that we have made, and the promising hope we have for the future.

     

  • What is Age-Related Macular Degeneration (AMD)?

    What is Age-Related Macular Degeneration (AMD)?

    You’re not alone if you were recently diagnosed with age-related macular degeneration (AMD).

    Age-related macular degeneration (AMD) is a common eye condition that impacts millions in the United States alone. In our previous article, What is AMD?, we explored the different levels and types, as well as major risk factors.

    It’s one of the most common causes of visual impairment in older adults, affecting millions in the United States alone. Chances are, the nice woman sitting next to you in a clinic’s waiting room has AMD also, and undergoing treatment.

    AMD is caused by deterioration of the cells in the macula, which is the part of the retina that is responsible for your central vision. Why this occurs is complex and multifactorial.

    Risk Factors for AMD

    The biggest risk factors for AMD that are not under your control include older age, a strong family history of AMD, being Caucasian, and female.

    A modifiable risk factor that everyone should avoid is cigarette smoking.  Many studies have looked at other various factors, but optimizing your cardiovascular status and being healthy overall is beneficial.

     

    Types of AMD

    There are three levels of age-related macular degeneration: mild, intermediate, and advanced.

    Mild AMD

    Most patients have mild AMD, characterized by small yellow deposits in the macula called drusen, which are accumulations of metabolic byproducts.

    Intermediate AMD

    Intermediate AMD is when the drusen become larger and more numerous.

    Thankfully, vision is usually not affected at these levels of AMD, but it’s important for you to know of the diagnosis because it changes how your eye is examined.

    Intermediate AMD is when your doctor will likely recommend taking AMD vitamins, which have been shown in large clinical trials to slow the progression to advanced AMD.

    There are many brands of AMD vitamins, but make sure to look for the “AREDS-2” formulation.  AREDS stands for “age-related eye disease study,” which is the name of the National Eye Institute clinical trial studying these vitamin combinations.

    Advanced AMD

    Advanced AMD is when vision loss is noticeable.

    There are two types of advanced AMD: geographic atrophy (GA), and “wet” AMD.

    GA is a continuation of the dry macular degeneration, where there is a loss of retinal cells, resulting in blind spots.  These blind spots usually develop just outside the center of your vision but may progress to involve the center of your vision over time.

    We, unfortunately, do not have interventions to reverse this process, but it is one of the “hottest” areas of research in medicine, and there are numerous treatments in the pipelines.

    What about the other form of advanced AMD, the “wet” type?  Abnormal blood vessels develop underneath the retina and cause bleeding and swelling of the macula.  This happened in approximately 10% of all cases of AMD. Common symptoms include blurriness and waviness or loss of central vision.

    Please contact your retina specialist immediately if you experience such changes, as we have good treatments now, that can improve or stabilize the vision in the majority of patients.

     

    Up Next

    In a follow up article, we’ll explore available treatments for AMD, and why you should remain hopeful if you’ve been diagnosed with age-related macular degeneration.