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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8515
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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POHS for 10+years both eyes. Right eye active at present time.

Resolved Question:

POHS for 10+years both eyes. Right eye active at present time. Have used avastin, lucentis, kenalog over the years no help. I have had PDT 25+times with very good results until this year. It was not very effective with 2 treatments in the spring. Started on eylea 4 shots so far 4 weeks apart with minimal improvement. Should i try PDT again? Can eylea and PDT be used together?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today. I am retina specialist and care for a number of POHS patients in my practice.

To answer your question directly, Yes. eylea and PDT can be used in the same eye but you probably would not do the intraocular injection on the same day as the PDT infusion/treatment.....although I suppose you could do both at once.

Would this give you a better outcome? Unfortunately, this has not been studied in any controlled fashion, even with the older anti-VEGF drugs such as avastin and lucentis. I, personally, have not combined the two in my practice and would have to consult with my colleagues and think about it to see if I could justify adding PDT to eyelea in hopes of getting a better outcome then using either alone.

Does this make sense to you?

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. You may also receive an email survey after our chat, if you can please give me a “10” rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.

Since POHS has to do with antibodies gone wrong, kind of like lupus, do you think adding low dose steroids such as pred-forte and an aspirin regime would help the outcome.

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

No. I do not. Pred Forte will not obtain significant levels in your vitreous cavity (back of your eye) nor your vascular system and aspirin is not going to affect your immune response significantly.....

But those are good thoughts :)

I have treated a number of POHS patients like you over the past few decades and, I must admit, they have caused me to loose sleep -- much like I'm sure your retina doc is doing now :(

At this point, there is not a lot of data available to tell us what to do when facing refractory POHS like yours.....

Don't forget to mash the positive feedback button for me...the one labeled "excellent" is the most fun to push by far ;)

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8515
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick
Dr. Rick
Ophthalmologist & Retina Specialist
5459 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest