Age-related Macula Degeneration (AMD)

[Choonpon]

Anyone has experience of AMD. Its an eye condition, mostly for older people.

[ThaiHerbs]

I am 67yo this year. Approx 20 years ago I began having difficulty reading and had to hold the book/newspaper further and further away. After a couple years I had to use reading glasses and still do.

About 15 years ago I began spending many hours every day on the computer/internet, I still do. The strain on my eyes began to get acute and I was experiencing quite a bit of eye pain. I experimented with various natural supplements from my local health food store with no improvement. My naturopathic dr gave me a bottle of "Vision Support by AOR" and told me I will notice improvement after about one week. HE WAS CORRECT. He said the reason I was not getting any good results from the products I tried is that they do not have sufficient quantities of "Lutein". As we age our levels of Lutein decline (my understanding), but since Lutein is also a very expensive item most brands of products put in as little as posslble.

http://www.aor.ca/products-page/aging/vision-support-ii/

I order from my Canadian Dr. periodically with no problems (3 btls per shipment) but I observe many here order items from iHerb.com (never tried them)

http://ca.iherb.com/search?kw=vision+support+aor&x=0&y=0#p=1

The product is quite expensive (but works). I cut back to one capsule a day when my eyes seem ok with no issues. I have no connection to the company.

Doug

[ProThaiExpat]

The only post so far describes an eye problem that is not ARMD (Age Related Macular Degeneration)

Speaking only from my own experience and internet research, ARMD occurs when the tiny blood vessels in the very center of the macula of the eye bleed thus causing central vision blindness. There are two types of ARMD Dry and Wet. The dry version may not involve bleeding.

In my case the first symptom of wet ARMD was when a large black ball obscured my vision in the center of my eye. I could see around the edges of the black ball and many untreated ARMD people learn to live with that limited vision. but I don't see how.

I sought medical treatment with a general ophthalmologist who quickly referred me to a macular specialist. The most advanced diagnostic machine available at Sripat Hospital in Chiang Mai is called an OCT and was made in Germany. It uses sound waves to map the bleed in the macula and displays pictures of the amount of bleed on its computer for the doctor to evaluate.

The only treatment for the wet form of ARMD is an injection of a drop of one of two medicines that originated in the treatment of bleeding in female reproductive organs. Avastin manufactured by Genentech costs about $75 worldwide while the other one costs $2000 per injection from the same drug company and is called Lucenta (sic). Tests last year found them to be nearly identical in chemical makeup and equally effective. Genentech justifies the higher cost of Lucenta as it is US FDA approved while Avastin is not an Genentech paid for the FDA approval and must recover their costs. Last year Medicare in the US paid out more that 2 billion dollars for Lucenta treatments from Ophthalmologists maintain it is a better treatment even at the higher cost. I need not get into the issue of drug companies incentive to doctors to use certain of their products.

With my first injection of Avastin, my vision cleared right up and I have not had any decrease in vision for over two years. However, I do need an injection at Sripat every ten weeks to alleviate the bleed that causes the blindness. I had one injection a month for three months until my condition was considered stabilized and I went on the one shot every ten weeks, the need for the injection is measured by the OCT machine.

ARMD is a fairly common condition and there is an abundance of ophthalmologists in most major cities around the world who regularly treat patients for the condition. There are three such ophthalmologists at Ram in Chiang Mai where I started my treatment regimen but migrated to Sripat as that is where the OCT machine is.

I have no knowledge if any or what the treatment for dry ARMD, which is the most prevalent form of ARMD. I did get the impression that treatment for Dry ARMD is less sucessfull than that for the wet variety.

OP you should seek evaluation of your ARMD if you have symptoms but you probably already have or you would not be able to ask the question contained in your OP correctly.

May you be as lucky as I have been in finding excellent results from treatment.

[Choonpon]

The only post so far describes an eye problem that is not ARMD (Age Related Macular Degeneration)

Speaking only from my own experience and internet research, ARMD occurs when the tiny blood vessels in the very center of the macula of the eye bleed thus causing central vision blindness. There are two types of ARMD Dry and Wet. The dry version may not involve bleeding.

In my case the first symptom of wet ARMD was when a large black ball obscured my vision in the center of my eye. I could see around the edges of the black ball and many untreated ARMD people learn to live with that limited vision. but I don't see how.

I sought medical treatment with a general ophthalmologist who quickly referred me to a macular specialist. The most advanced diagnostic machine available at Sripat Hospital in Chiang Mai is called an OCT and was made in Germany. It uses sound waves to map the bleed in the macula and displays pictures of the amount of bleed on its computer for the doctor to evaluate.

The only treatment for the wet form of ARMD is an injection of a drop of one of two medicines that originated in the treatment of bleeding in female reproductive organs. Avastin manufactured by Genentech costs about $75 worldwide while the other one costs $2000 per injection from the same drug company and is called Lucenta (sic). Tests last year found them to be nearly identical in chemical makeup and equally effective. Genentech justifies the higher cost of Lucenta as it is US FDA approved while Avastin is not an Genentech paid for the FDA approval and must recover their costs. Last year Medicare in the US paid out more that 2 billion dollars for Lucenta treatments from Ophthalmologists maintain it is a better treatment even at the higher cost. I need not get into the issue of drug companies incentive to doctors to use certain of their products.

With my first injection of Avastin, my vision cleared right up and I have not had any decrease in vision for over two years. However, I do need an injection at Sripat every ten weeks to alleviate the bleed that causes the blindness. I had one injection a month for three months until my condition was considered stabilized and I went on the one shot every ten weeks, the need for the injection is measured by the OCT machine.

ARMD is a fairly common condition and there is an abundance of ophthalmologists in most major cities around the world who regularly treat patients for the condition. There are three such ophthalmologists at Ram in Chiang Mai where I started my treatment regimen but migrated to Sripat as that is where the OCT machine is.

I have no knowledge if any or what the treatment for dry ARMD, which is the most prevalent form of ARMD. I did get the impression that treatment for Dry ARMD is less sucessfull than that for the wet variety.

OP you should seek evaluation of your ARMD if you have symptoms but you probably already have or you would not be able to ask the question contained in your OP correctly.

May you be as lucky as I have been in finding excellent results from treatment.

Dear ProThaiExpat,

I asked because my husband has gotten this problem recently. We went to see 2 ophthalmologists and went through quite a number of tests. Took the Lucentis jab and photodynamic therapy last week. Its really cruel to jab right into the eye. Was given the Lutein supp too. At the same time we are taking traditional chinese medicine to help the condition. Been a week now, my husband's eye sight has not improved. He's very demoralised and I'm very worried. If he has to go through another jab again, I don't think he will want to do so.

I can understand your pain mentally and physically as well. Tough on you.

Can you still drive with your eye condition? How did you cope with the changes in your daily activities?

[ProThaiExpat]

Choonpoon: Read my post more carefully. I am totally symptom free, perfect vision in the affected eye after the first shot of Avastin. Perhaps you could tell me more about where you are and who is managing your treatment. Does your husband have wet or dry ARMD. You can send me private message if you wish. If you are in Thailand, I am surprised you are receiving Lucenta injections as they must be very costly.

[Choonpon]

Choonpoon: Read my post more carefully. I am totally symptom free, perfect vision in the affected eye after the first shot of Avastin. Perhaps you could tell me more about where you are and who is managing your treatment. Does your husband have wet or dry ARMD. You can send me private message if you wish. If you are in Thailand, I am surprised you are receiving Lucenta injections as they must be very costly.

My husband has wet AMD. We went to Singapore National Eye Centre for treatment. Lucentis was advised by the doctor, he said it is safer with lesser side effects.

I'm glad you have maintained your perfect vision. But you still are taking the jab every 10 weeks?

[ProThaiExpat]

Yes, I get an eye injection every ten weeks. The OCT machine shows an accumulation of blood in my macula at about that interval and I do see visual acuity start to deteriorate about that time. I detect visual acuity loss by covering my other eye and look at a straight line, pole, edge of wall or pipe and if it starts to undulate or waiver in its straight line I know it is time to have an injection. We confirm the build up of blood with the OCT machine.

If you are in Singapore, I cannot give you much help as my experience has been in Thailand and Australia.

I would be surprised if your doctor didn't give you an option of Avastin as an alternative medication.

My doctor has patients who have had to have an injection monthly for two years before it stabilized. Your husband needs to get his mind around a shot every month until his vision returns. I certainly would explore Avastin since the cost of Lucenta medication is astronomical if shots are needed every month. If you have health insurance, the Doctor may have felt there was no economic motivation to use Avastin. You definitely need to go back to a macular specialist and show him no improvement from the Lucenta shot and be guided by his advice.

If your doctor did not do an OCT examination of your husband, he clearly is not using the latest diagnostic tools available. Your husband may have to wait two weeks to detect any improvement depending on how bad his vision was when he received the first shot. He may not see improvement before a few shots. You need to be talking to your doctor about what to do next.

[Choonpon]

Yes, I get an eye injection every ten weeks. The OCT machine shows an accumulation of blood in my macula at about that interval and I do see visual acuity start to deteriorate about that time. I detect visual acuity loss by covering my other eye and look at a straight line, pole, edge of wall or pipe and if it starts to undulate or waiver in its straight line I know it is time to have an injection. We confirm the build up of blood with the OCT machine.

If you are in Singapore, I cannot give you much help as my experience has been in Thailand and Australia.

I would be surprised if your doctor didn't give you an option of Avastin as an alternative medication.

My doctor has patients who have had to have an injection monthly for two years before it stabilized. Your husband needs to get his mind around a shot every month until his vision returns. I certainly would explore Avastin since the cost of Lucenta medication is astronomical if shots are needed every month. If you have health insurance, the Doctor may have felt there was no economic motivation to use Avastin. You definitely need to go back to a macular specialist and show him no improvement from the Lucenta shot and be guided by his advice.

If your doctor did not do an OCT examination of your husband, he clearly is not using the latest diagnostic tools available. Your husband may have to wait two weeks to detect any improvement depending on how bad his vision was when he received the first shot. He may not see improvement before a few shots. You need to be talking to your doctor about what to do next.

Thank you for sharing your experience with me. Really appreciate that.

Yes the doctor did OCT and he's a Vitreo Retinal specialist.

Since its been a week now after the first treatment, we will continue to hope for improvement in the affected eye.

I wish you all the best:)