Can wet ARMD improve without injections in elderly females?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I completely understand your mother’s fear and disappointment, wet age-related macular degeneration (wet AMD) can be overwhelming, especially for someone who loves reading and values their independence. The good news is that there are now treatments available that can significantly help preserve and, in some cases, even improve her vision.

Here is a breakdown of what this condition means and the treatment options available to her:

Probable causes:

Wet AMD is caused by age-related degeneration of the retina (macula). It involves abnormal blood vessel growth (choroidal neovascularization) under the macula. Family history or genetic factors may play a role, along with lifestyle factors such as smoking, high blood pressure, and possibly cardiovascular disease. While blood thinners do not cause AMD, they can increase the risk of bleeding if abnormal blood vessels are present.

Investigations to be done:

1. Optical Coherence Tomography (OCT): This test is used to monitor fluid or thickening in the retina.

2. Fundus Fluorescein Angiography (FFA): This helps visualize abnormal blood vessels under the retina.

3. Regular Visual Acuity Tests: Using an Amsler grid at home can help detect any subtle changes in her vision.

Differential diagnosis:

It is important to differentiate wet AMD from conditions such as dry AMD, diabetic retinopathy, central serous chorioretinopathy, and retinal vein occlusion.

Probable diagnosis:

Your mother likely has wet AMD, which leads to central vision distortion and fluid leakage under the macula.

Treatment plan:

Intravitreal Injections (Anti-VEGF Therapy): These are the primary treatments for wet AMD. Medications such as Aflibercept (Eylea), Ranibizumab (Lucentis), and Bevacizumab (Avastin) block the growth of abnormal blood vessels and reduce fluid leakage, helping to prevent further damage.

How often are injections needed?

Initially, injections are typically given monthly for the first three to four months. After that, they may be spaced out every six to 12 weeks, depending on her response. Some newer treatment regimens use a "treat and extend" approach, reducing the need for frequent visits.

Can Vision Improve?

Yes, in many cases, especially when treatment is started early. Patients often notice some improvement in the clarity of their central vision, but the primary goal of the treatment is to stop further vision deterioration.

Is the injection painful?

While it is natural to be scared, the eye is numbed with anesthetic drops, and the needle used for the injection is very fine. Most patients tolerate the procedure surprisingly well after the first injection.

Blood thinners like Aspirin or Warfarin can slightly increase the risk of minor bleeding (such as a visible red patch on the eye) after the injection. However, these medications do not typically increase the risk of serious complications. Your mother needs to inform her eye doctor, but injections are generally safe for patients on blood thinners.

Follow-up care:

Initially, your mother will need monthly injections and monitoring.

Once her condition stabilizes, she will likely only need follow-up visits every two to three months.

Any sudden blurring, distortion, or dark spots in her vision should be reported immediately.

Preventive measures:

Keep up with regular follow-up appointments as advised.

If applicable, quit smoking.

Maintain good blood pressure and cholesterol control.

Use the Amsler grid daily to track changes in her vision.

Consider taking AREDS-2 supplements (which contain lutein, zeaxanthin, zinc, and vitamins C and E), as they may help the other eye or slow the progression of the disease.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.