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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have been diagnosed with a retinal wrinkle which seems to

Customer Question

I have been diagnosed with a retinal wrinkle which seems to be worsening. What is the official name of this condition? Apparently, there is a new drug for this condition? What are side effects after injection?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I am a retina specialist and treat this issue very frequently. A "retinal wrinkle" usually refers to an epiretinal membrane, also called macular pucker.

Dr. Rick :

Was the doctor who told you that you have this condition an ophthalmologist (eye MD)?

Dr. Rick :

Do you have any medical problems or take any medication?

Dr. Rick :

Good Afternoon. Welcome to chat

Customer:

I do not have any other medical problems, per se. I take 0.1 mg of thyroid medication and 30 mg of cymbalta.

Dr. Rick :

Ok.

Customer:

Yes, the doctor is an opthalmologist, apparently a retinal specialist

Customer:

He's talking about injection of a new drug and has ordered it for me

Customer:

I would like to know more about this and cannot remember the name of it.

Dr. Rick :

Afibercept is the new drug out there ( it is in the same class as lucentis and avastin) but these medications are not used for retinal wrinkles.....and a retina specialist like myself would have this drug on hand in the office....

Dr. Rick :

do you think your condition might be called choroidal neovascular membrane or age related macular degeneration and not retinal wrinkling?

Dr. Rick :

Are you still there?

Customer:

He does not refer to it as ARMD, and the original diagnosis was retinal wrinkle. It is the fluid behind the retina that has dried and formed a membrane, causing distortion of my vision. I am now seeing double and triple objects and having a harder time reading what used to be no problem

Dr. Rick :

Ok. Well, there is no injection or medication that can be used to treat this issue. T

Customer:

The medication is a brand new release and just started being used in January 2013. He is waiting for a special freezer from the manufacturer of the drug before he can actually receive the medication

Dr. Rick :

Treatment requires a vitrectomy and membrane peel......a fairly extensive eye surgery only done by retina specialists.

Customer:

Apparently this medication is a $4000, one-time per eye per lifetime, procedure

Dr. Rick :

Yes. I know about that drug and currently it is not, in my opinion, as good as the surgery.

Customer:

Would you then recommend that I seek a second opinion?

Customer:

What is the drug called?

Customer:

what is a choroidal neovascular membrane?

Dr. Rick :

That is a form of macular degeneration.

Customer:

He is actually seeing the membrane attached to the retina

Dr. Rick :

yes. It can be seen with a contact lens put on your eye, with a computer test called OCT and also with a fluorescein angiogram. It is pretty easy to see....

Customer:

I believe I had the test on the computer

Dr. Rick :

ok.

Customer:

What about a second opinion at this point

Customer:

he did mention another condition . .. guess I'd better find out what that might be

Dr. Rick :

It never hurts to get a second opinion. I do not recommend treatment of an epiretinal membrane until the patients vision is limited to the 20/40 level or worse, except in rare cases.

Customer:

My vision deteriorated significantly in the six weeks between appointments.

Dr. Rick :

Did he tell you the name of the new drug he wanted to use and why he feels you would do better with this then the standard surgery?

Dr. Rick :

That does not sound like an epiretinal membrane to me then.....it doesn't not change that fast usually.

Customer:

I believe it starts with a "j" - forgot to write it down.

Dr. Rick :

Are you sure this doc is an ophthalmologist? At the very least he doesn't sound like a retina specialist to me.

Customer:

I've been seeing him since last fall, and he's been waiting for this drug to become approved. Since it's success rate is only 25%, I would wonder.

Customer:

He is the retinal specialist in this eye group I see. I'm considering a second opinion with another local doctor or heading to Jules-Stein eye center at UCLA.

Dr. Rick :

You will get fantastic care at Jules Stine. For a Medical Center in California, there are not bad (Being from Harvard, I just had to throw that little dig in...sorry. I couldn't help myself :)

Customer:

Do you know any California retina specialists you would recommend. I live between Stanford and UCLA, but those are the only ones I know about.

Dr. Rick :

Either retina department with give you the best possible care

Customer:

Harvard . . . good place. Maybe you could do the surgery?

Dr. Rick :

It is just not clear to me what this doc is thinking about right now......

Dr. Rick :

Harvard is pretty good....but, by JA policy, I'm not allowed to recruit patients from this site. Never fear, you will be just fine at either Stanford or Jules Stine.

Dr. Rick :

And Boston is Terrible this time of year :)

Customer:

I'd better clarify that he just doesn't want to use me as a test

Dr. Rick :

that would be my thought.......first of all, your symptoms don't seem to match your diagnosis, especially with the rapid decrease in vision. Nor does waiting for some drug to come in make sense to me either. But, I'

Dr. Rick :

I've only be doing this for 21 years, so I'll admit I don't know everything....

Dr. Rick :

I'm glad you came online to learn more about what is going on....even if we have not been able to pin things down exactly at this point.

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

Dr. Rick :

I guess that you have stepped away from your computer.

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7906
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.
Hi Elizabeth,

I just finished doing a epiretinal membrane peel and my thoughts turned toward you.

Have you managed to talk to another retina specialist and figure out what is going on with your eye? I'd be very interested in knowing how you are doing.

Take care

Dr Rick MD FACS
Customer: replied 1 year ago.

I see another retina expert tomorrow...will let you know what he has to say. thanks for the follow up. I never expected that.

Expert:  Dr. Rick replied 1 year ago.
Elizabeth,

I look forward to your reply.

You know, it is OK for you to mash the excellent feedback button now if you so desire....I'll still be here :-)
Customer: replied 1 year ago.

this retina specialist said my membrane was too severe, and that he didn't think the injection was appropriate. recommended the surgery solution for my condition. I think I wail take his advice.


Thank you again for your responses.

Expert:  Dr. Rick replied 1 year ago.
That sounds like excellent advice.

Best of luck to you.
Customer: replied 1 year ago.

thank you again.

Expert:  Dr. Rick replied 1 year ago.
It has been my pleasure, Elizabeth.

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