The common problems and questions related to age-related macular degeneration are uniformly organized as follows for your patients’ reference.
First of all: What is macular?
In each of my clinics, I hear this complaint from patients: Dr. Yu, I can’t see clearly in my eyes, I saw them in our local area, and the doctor said I have macular!
There is a conceptual error here. Many patients think that macula is a yellow spot-like lesion that grows on the bottom of the eye, but in fact it is not like that. Macula is the medical name for a site. The macula is the “center” of the retina in the fundus.
Why does macular disease usually have a significant impact on vision?
The structure of the eye is very similar to a camera, our cornea, the lens is two lenses, the retina of the fundus is the negative. The macula is the center of this negative, which is the focal point of eye imaging! Therefore, if the macula is diseased, the impact on the quality of the eye’s visual image is very obvious.
What is age-related macular degeneration?
Age-related macular degeneration, also known as age-related macular degeneration. Age-related macular degeneration, also known as age-related macular degeneration, is a condition that occurs primarily in the elderly and is located in the macular region.
Age-related macular degeneration is divided into two general categories: dry and wet. The manifestations and treatment options are different for each type. Let’s use an analogy: the retinal cells in the macula need a normal nutrient metabolic environment. If we compare the retinal cells to a tree, they need normal rain to nourish them. However, if you have dry AMD, these trees will wither away because of the lack of water, just like growing in the desert. In the case of wet age-related macular degeneration, the macula produces pathological neovascularization, which will seep and bleed, causing these trees to soak in swamps or even water, and will drown, resulting in loss of central vision.
Dry age-related macular degeneration takes longer to experience and progresses more slowly from its initial onset to its advanced stage, but there is no effective medical treatment for it, and some specially formulated multivitamins and trace elements and zeaxanthin can be taken orally.
Wet age-related macular degeneration is relatively more serious and is characterized by stubborn and easily recurring lesions. Although there is no cure for this condition, fortunately, there have been important advances in recent years, namely intraocular anti-VEGF therapy (often referred to as “injections” by patients), which brings hope to patients. Anti-VEGF therapy is now internationally recognized as the most effective treatment for wet age-related macular degeneration. The principle of anti-VEGF therapy is to fight against neovascularization, reduce the fluid in the macula and stabilize the disease.
How effective is anti-VEGF therapy?
There is no complete cure for wet age-related macular degeneration. The most effective anti-VEGF treatment currently available is effective in stabilizing the disease and preventing further deterioration with repeated bleeding and exudation. A significant number of patients feel visual improvement after drug injection, but some do not respond to drug injection.
What is the course of anti-VEGF treatment?
Anti-VEGF is effective for many types of macular lesions, such as PCV, highly myopic CNV, idiopathic CNV (mid-bleed), etc. The treatment regimen varies slightly from disease to disease. For wet age-related macular degeneration, the internationally recommended regimen is to start with three consecutive months of injections, one injection per month. After that, regular review and additional injections can be given in case of recurrence of the disease.
How do I make an appointment for intraocular injection at Concordia Hospital?
1. First, you need to register to see a fundus doctor for a clear diagnosis and treatment plan to determine if intraocular injection is needed.
The doctor will prescribe an OCT examination, and in most cases, this will be combined with the results of a fluoroscopic angiogram. Based on the results, a treatment plan will be developed (a small number of patients may require laser alone or combined laser treatment, as well as possibly other treatment options).
2. Then, make an appointment at the service desk for the injection time and go to the operating room at the designated time for injection
The doctor will prescribe the main related fees. After paying the fees, please register at the nurse’s desk and make an appointment for medication injection.
The medication refill time for Concordia Eye is every Wednesday and Thursday morning.
3.Where do I go to get my medication? Who will fill my prescription? What do I need to bring?
The department has arranged for a special doctor to inject medication in a medical clean room to ensure sterility and safety, not simply an outpatient treatment room, so you need to make an appointment, register and prepare.
After registration at the nurse’s desk, patients will be given a sheet of notes and instructions detailing the items you need to prepare for documentation, arrival time and location.
Top patient concerns.
1. I’m scared to give an injection to my eye. Does intraocular injection hurt?
Intraocular injection is done through the white of the eye and injects the medication into the eye. Surface anesthesia (anesthetic eye drops) is sufficient, the injection process is a few seconds, the pain is not obvious, do not worry.
2. Are there any side effects of intraocular injection?
Generally speaking, intraocular injection is a local drug and has very little effect on the whole body. The intraocular side effects of the drug are also minimal. The drug injection itself may have bleeding and effects on the crystal and retina, but they are very unlikely to occur.
3.What do patients need to pay special attention to before and after drug injection?
Endophthalmitis is the most serious complication of concern. Although the incidence is at the level of 1 in 1,000, it is especially emphasized here because of the seriousness of the consequences if it occurs.
The quality of the drugs injected by the doctor is strictly tested, the operating rooms are medically clean and the operations are sterile and aseptic, all of which will not be a problem. However, you must pay attention: this does not mean that everything is foolproof! The doctor will prescribe you antibiotic eye drops before the surgery, and you will need to take them carefully to prevent infection, and you must explain to the doctor if you have had a lot of discharge from your eyes recently. After the surgery, you must also order the medication for more than three days as required (if there is discharge, you need to extend the time of ordering medication). Do not wipe your eyes with your hands, tissues or even towels, because these are medically germy! Bacteria can multiply along the injection wound into the eye and form endophthalmitis! The wound of the injection will usually heal on its own within three to five days, so it is best not to wash your eyes for a week after the injection to strictly avoid dirty water entering the eye. You need to wash your hair as much as possible to go to the barber store to wash the safest.
4.I feel that my eyesight is quite good, but the TV media said that the elderly are prone to age-related macular degeneration, is it necessary to go to the hospital for regular checkups?
Although age-related macular degeneration is relatively stubborn and tricky, its overall incidence is still very low, especially the wet age-related incidence is even lower, so there is no need to worry about it. If there are various causes of eye vision loss, you can visit an ophthalmologist to find out the cause and treat it properly. If a straight line becomes a curved line, it is most likely that there is something wrong with the macula and you need to see a doctor.
My advice to patients with age-related macular degeneration.
It is important to keep a good and right mindset!
1.Knowing enough
As the saying goes, contentment is the only way to be happy, and I would like to say that contentment has two meanings.
One, although suffering from wet age-related macular degeneration is not a happy thing, we are grateful that there are still some ways to treat it in medicine this year, which is much better than being anxious and helpless ten years ago.
Secondly, in China, especially in big cities, the medical standard is by no means inferior to that of developed countries. Compared to some poor African countries and even some remote and poor mountainous areas in China, where medical conditions are backward and there is no medicine available after the disease, the medical conditions for Chinese patients are also good.
2.Regulate and change the lifestyle, the world is equally beautiful
Eyes are the main way we receive information. You can try and get used to listening with your ears more after you have trouble seeing. Look less at the fluorescent screen of cell phones, computers and TVs, and wear sunglasses when you go out in strong sunlight are useful habits.
3, have confidence
And many researchers are actively exploring better treatment methods and drugs, I believe that in the near future can bring the gospel to the majority of patients.