- 83 years old
- Caucasian male
- Referred for distortion and a black central spot in the right eye for the last 2 months
- OD: 20/100
- OS: 20/20
SIGNIFICANT EXAM FINDINGS
- OD: drusen, subretinal hemorrhage and atrophic changes in the macula
- OS: macular drusen
- Wet age-related macular degeneration, right eye
- Dry age-related macular degeneration, left eye
- Same-day treatment with intravitreal aflibercept (Eylea) OD followed by a series of 2 more monthly aflibercept injections. Complete exam after the third injection.
- Recommend healthy diet (Mediterranean), exercise, sun protection, no smoking and AREDS II vitamins
- Amsler grid
- 1 month for aflibercept injection #2 OD
- Vision went from 20/100 OD to 20/20 OD after 2 injections
- OCT shows improved retinal anatomy and resolution of the subretinal hyperreflective material.
OD before injection:
OD after 2 injections of aflibercept:
- Wet AMD only accounts for ~10% of all AMD but is responsible for 90% of AMD- associated vision loss.
- AMD is the number 1 cause of vision loss in patients over age 65 in the USA
- Biggest modifiable risk factor is smoking. I really push the patient to quit and will keep doing so every visit if they are a smoker. I also recruit family members to help them quit and recommend they ask their PCP for programs and/or medications to help.
- New conversions from dry to wet AMD should be seen urgently. The biggest fear is a large submacular hemorrhage like this one:
As always, feel free to contact me directly via phone or text with any questions. If I don’t answer I may be in surgery or with a patient. You can always reach my office manager, Betsy Roberts at (713) 791-9620 or my surgical coordinator Debbie Rider at (713) 791-1790 as well.