Is Macula-ped near the fovea relates to Ma... - Macular Society

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Is Macula-ped near the fovea relates to Macular degeneration ?

Dsrb profile image
Dsrb
12 Replies

My brother been diagnosed left eye Macula-ped near the fovea. Does this mean he has Macular degeneration. We are shocked to hear this message as he is in 38.

Ophthalmologist suggested Intravitreal injection ( L ) - Anti-vegf under gvp. Really we did not understand this terms. Can some one help us on this.

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Dsrb
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ironbrain profile image
ironbrain

I'm fairly new to all this myself, but anyway here goes.

Your brother's been diagnosed with pigment epithelial detachment in the macular region of the retina near the fovea. I'm not entirely clear when they use the various macular degeneration terms, but if he has RPE (retinal pigment epithelium) detachment in the macular area then, in plain English terms at least, he will have some form of macular degeneration. It can be caused by blood, serous exudate, druen, or a neovascular membrane [CNV]:

retinalphysician.com/issues...

You maybe need to find out which. To properly distinguish between serous and CNV, I think you really need an FA (fluorescein angiogram) and possibly an ICG (Indocyanine green) angiogram in addition to the OCT (optical coherence tomography). Treatment of serous retinopathy tends to use laser activation of anti-VEGF injected into the blood rather than intravitreal injection and there's also the drug eplerenone.

As I understand it, most of the problem with this sort of thing is the RPE. It's the layer that supports the retina and connects with it. I think in the stem cell treatment trials, it's more this than the retina itself that they try to regrow. It's maybe the case that the retina can regrow itself but the RPE cannot (so well).

In the case of CNV, the anti-VEGF stops the excess growth of blood vessels. It also has some effect in serous problems (as implied above) – especially if there's CNV with the serous problem, I guess!

Intravitreal injection ( L ) just means an injection in the white of the left eye. For GVP, try:

ifa-fiv.org/wp-content/uplo...

Dsrb profile image
Dsrb in reply to ironbrain

Note: Recently enclosed my brothers Ophthalmic report in my original post.

Thanks for your details it really helps lot to understand his problem. Though i got more details from you, still i have few questions please help me.

Based on report,

1. Could you please confirm "Is my brother having Macular degeneration or not ?"

2. As you mentioned "It can be caused by blood, serous exudate, druen, or a neovascular membrane [CNV]". What could be reason in my brother's case. Could you please tell me.

3. Is my brother have Wet or Dry Macular degeneration ?

4. Is this best treatment for his case Intravitreal Injection Anti-VEGF under gvp.

Thanks in advance.

ironbrain profile image
ironbrain in reply to Dsrb

1. As I understand it, it may be the condition that causes the macular degeneration and not the condition being a result of the macular degeneration. But I don't know, for instance, what the difference is between just wet MD and age-related MD. Is the latter the same as the former if you are over, say, 55?

2. "But patients with type 2 CNV were younger (patient age <50 years), had a normal fellow eye ..."

bit.ly/2tYjQnI

3. I think wet MD sometimes develops from dry MD and wet MD is the result of neovascularization.

4. As far as I've read, anti-VEGF is the best treatment for neovascularization.

Dsrb profile image
Dsrb in reply to ironbrain

Thanks for details, now i got more details about this. Will keep posted about treatment and progress in coming days.

There are two main types of PED. The first one is a quite common age-related occurrence, when the vitreous jel shrinks and draws away from the retina or macula. This type on its own usually causes no risk to eyesight, but a person may see a number of floaters. But your brother is still quite young.

The second form of PED is usually associated with wet MD or similar eye conditions which should be treated. I was diagnosed with PED and wet AMD plus other several other complications 18 months ago and have had treatment ever since, apart from a short break from injections.

I know it is always a shock when you are first diagnosed and all the medical terms don't make you feel any easier when you are trying to understand and make sense of it all. But tell your brother not to worry too much. Much can be done and researchers are constantly looking for better treatment.

Best wishes

Dsrb profile image
Dsrb in reply to

Thanks for details.

Rufuscat profile image
Rufuscat in reply to

Hi, can you tell me any more about the first type of PED? It sounds like the type I was told I have, although I only found out it was a PED when I saw the letter sent to my GP. I was told it was an age related mark.

in reply to Rufuscat

PED stands for Pigment Epithelial Detachment, not to be confused with retinal detachment. Strictly speaking there is only one type of PED, but the causes can vary. That is why I made the distinction. As we get older the vitreous gel, the contents of the eyeball, tends to shrink and draw away from the retina. PED on its own does not normally require treatment. It has little effect on your vision, except that you may see floaters. Injections would not work for it anyway. Of course, there may be other conditions going on in your eyes, which may or may not need treatment. Did it mention anything else in the letter to your GP?

Rufuscat profile image
Rufuscat in reply to

The diagnosis part said they thought it was a normal variant of my long sightedness. At the appointment they didn’t seem concerned and discharged me.

My only concern is that the distortion had gone but is now back again even though it is very mild.

in reply to Rufuscat

Please do not worry too much. If you have been discharged that is surely a good sign. Keep checking your eyes on the Amsler Grid which you can find on the net. Also, you might get an eye chart from the net to make sure your visual acuity does not deteriorate. It will put your mind at rest. The distance you are to read it from may be difficult to achieve indoors, but as long as use the same distance and the same lighting you'll get a fair indication. You may have to recalculate ratio. One more thing, if your eyes get watery, even if it very little, this can distort your vision and cataracts too can have this effect. Just keep an eye on things.

Rufuscat profile image
Rufuscat in reply to

Thank you. x

Rosalyn-helpline profile image
Rosalyn-helplinePartner

Dear Dsrb,

It is important that your brother contacts his ophthalmologist via their secretary and asks for an explanation of the terms used and poses a list of questions to them. These could include e.g.

1.Which condition have I been diagnosed with?

2.Why am I developing it at this age?

3.What is the prognosis?

4.Is there treatment available for it?

5.If there is treatment available, why haven’t I had it?

6.Is there anything that I can do to help protect my eyes?

7.What do I do if I notice any sudden changes in my eyes?

8.Are you going to continue to monitor my eyes at the hospital? If not, why not?

Just to make you aware, we are currently offering free 6 month membership. This is a good way to keep up with current developments:

macularsociety.org/6months

The Macular Society helpline is open 9am – 5pm Monday to Friday on 0300 3030 111.

Alternately, you can contact us via:

help@macularsociety.org

Kind regards,

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