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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7924
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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I have AMD and am currently being treated by an injection of

Resolved Question:

I have AMD and am currently being treated by an injection of Avastin every 2-3 months. I find this to be extremely painful so I am wondering what, if any, is the alternative. Will I go blind if I discontinue treatment completely?
Neil Blackmore
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.
Hello from JA

I assume this is wet macular degeneration.

How long have you been on avastin.

What is your level of vision now?
Customer: replied 1 year ago.

Hi Doctor. I did reply to you earlier, but for some reason you do not appear to have received it. My responses:-


Yes, it is the wet variety in my left eye. I have slight AMD in my right eye but it is slight and od the dry variety. Not to worry about it says my doctor.


I have been on Avastin about a year, and it does seem to have at least slowed the retinal discharges.


I do not have data but my eyesight is currently pretty good. I do not have to wear glasses except for close work.


Hope you can now answer my questions. Thanks,


Neil Blackmore

Expert:  Dr. Thomas, MD replied 1 year ago.
OK
Can you give me more detail as to why you want to change the treatment?
Expert:  Dr. Rick, MD replied 1 year ago.
Neil,

Hi. I am a retina surgeon and deal with wet ARMD every single day in my office and have been doing so for over two decades.

First of all, just let me say that if you do have wet ARMD and, after a year of Avastin injections, you still have useful vision in your left eye, you are absolutely correct: It has done a very good job of slowing/stopping the progression of the choroidal neovascular membrane in your eye.

As to your question if would go blind in your left eye if you stopped having the avastin injections as recommended: You would loose your central vision and become legally blind (vision less than 20/200) but, even at it's worst, wet ARMD would not be expected to make you "lights out blind" in that eye -- you would still have your peripheral vision. That being said, you would not be able to read, watch TV, recognize faces or operate a car with this level of vision.

So. What other options are available? Before Avastin was available the "gold standard" treatment for wet ARMD was laser surgery. You could, of course, have this treatment. I still use it in my office for patients who do not respond to injections.

The down side to the laser surgery is that, the moment you step away from the laser, you will have a significant loss of vision as the goal of this form of treatment is to sacrifice some central vision in the hopes of ending up with a "smaller" blind spot in your central visual field then you would otherwise have due to the natural course of the disease.

So. What is the take home message?

Even though the injections are painful I recommend you continue with them as Avastin, and drugs in the same class, are the best way to preserve your useful vision in that eye.

Also, there are things your ophthalmologist can do to make the shots less painful. Ask her about them.....

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

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 don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Also, Neil, since two experts have responded to you on this thread please take care when rating that you are giving the rating to the expert you intend to receive it.

I wish you the best of luck.

Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7924
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
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