Early Detection ‘Crucial’ in AMD Patient Management

Shown to occur in 18 percent of patients over a five year period, the development of choroidal neovascularization (CNV) has been determined the cause of vision loss in patients with age-related macular degeneration (AMD). Furthermore, it has been determined that since there are successful treatments available for CNV before there are visual changes, if it is detected early enough, vision loss due to AMD can be mitigated.

 

Source: Attila Barbas via iStock

Source: Attila Barbas via iStock

Since treating CNV once damage and vision loss have occurred is not a successful method of restoring vision or reversing damage to the macula in most people, early detection in AMD patients is crucial to maintaining functional vision. By the time changes in vision are noticed by patients, permanent damage has already occurred. Clinical evidence has sufficiently proven that treatments of small AMD lesions has been highly successful, so the earliest possible detection provides the best outcomes in AMD patient management.

 

Early detection of AMD requires sophisticated equipment and testing processes if sight preservation is to be successful, due to the rapid progression. According to an article published in Retina Today and written by Anat Loewenstein, M.D., early detection “…means a significant gain of vision for most patients.” Not only can this outcome preserve quality of life for the aging population, Loewenstein details that it can generate savings into the billions of dollars annually just in Medicare for people suffering significant vision loss.

 

With early detection being crucial in AMD patient management, incorporating Optos’ ultra-widefield (UWF) retinal imaging technology into your practice can significantly impact the number of patients with vision loss due to AMD. With a view of up to 82 percent of the retina, multiple modalities, non-invasive scan and sophisticated software that enables image tracking for comparison purposes, you will be able to see more, discover more and treat more effectively.

 

View our full line of UWF retinal imaging equipment and contact us to learn more about how we can help your practice provide better patient outcomes.

 

Don’t Forget About Your Kid’s Eyes During the Back to School Rush

Getting your children organized for the return to school is a taxing time filled with lists of things to do. Optos would like to remind you of the importance of vision in your child’s success at school and provide you with some information about children’s eye safety.

Source: BartekSzewczyk via iStock

Source: BartekSzewczyk via iStock

In order to reach their maximum potential in school, children need to have excellent vision. In fact, nearly 80 percent of what is taught to your child in school is done so visually, according to experts. Considering that fact, it is easy to understand why children who are at a disadvantage due to poor eyesight struggle with school and learning what they must to be successful.

 

Comprehensive Eye Exams

Although schools do some basic testing, they are not qualified to diagnose problems with your child’s eyesight. Scheduling your child for a comprehensive eye exam can not only ensure your child’s vision is appropriate or corrected, but also rule out diseases that can potentially lead to vision loss over time.

 

Avoid Digital Eye Strain

Children spend a lot of time in front of computers and other digital screens, which can lead to eye strain. Talk to your child about exercising their eye muscles frequently to relieve stress on the eye muscles. Also remind them to blink often while they are in front of such screens to keep their eyes from getting dry or irritated.

 

Sun Protection

Despite the return to school signifying the end of summer, the sun’s UV rays can still cause damage to your children’s eyes. A critical part of children’s eye safety is to ensure they have proper protection from the sun while participating in outdoor activities.

 

Optos would like to wish everyone a successful school year and reminds you to protect your children’s eye health with a comprehensive eye exam. Speak to your doctor about including optomap® as part of the exam since it is non-invasive for your child and takes only seconds to get a highly-detailed view of the retina, which is critical for early disease detection.

 

What Causes Ocular Hypertension?

Ocular hypertension is a condition where the interior pressure of your eye is higher than what is considered normal. While some people who suffer from the affliction show no outward signs and maintain their vision, some people develop glaucoma and risk losing their vision. Knowing and understanding the causes of ocular hypertension may help you preserve your vision.

 

Source: monkeybusinessimages via iStock

Source: monkeybusinessimages via iStock

 

Causes of Ocular Hypertension

There are several factors that cause high eye pressure or contribute to the condition and they are closely related to the causes of glaucoma. The main cause of ocular hypertension is an imbalance of the clear fluid (aqueous humor) that flows through your pupil to the front chamber of your eye, between the colored portion (iris) of your eye and the cornea. When too much aqueous humor is produced, or the fluid is not able to drain as it should, the result is ocular hypertension. Other factors that may contribute are:

 

  • – Steroid medications taken orally or by eye drops may increase your eye pressure. If you have to take steroid medications, speak to your doctor about having your intraocular pressure (IOP) tested. Although steroids are most common to affect eye pressure, ask your physician or pharmacist if a higher IOP has been reported with any new medications.
  • – Eye injury or trauma such as an infection can increase the production of fluid or impair the drainage for you eye. If you have suffered either, the ocular hypertension may not be found immediately; it can appear months and even years later. Be sure your ophthalmologist is aware of any injury or trauma to your eyes.
  • – Cataract surgery and other eye diseases may cause increased pressure in your eyes. It is vital to have regularly scheduled with your eye care professional to monitor any conditions you may have.

 

Because ocular hypertension can lead to glaucoma, Optos would like to stress the importance of regular, comprehensive eye exams including optomap® to maintain your vision. While treatment is not always necessary, if it is required, early detection will provide you with the best possible outcome for your sight. Learn more about optomap and protecting your vision.

 

Seniors Can Remain Independent Even While Experiencing Vision Loss

As we age, chronic conditions and physical changes may threaten our independence. Among these is vision loss or low vision. While at one time vision loss may have threatened independent living, there are many resources for senior independence and vision loss that make it possible to carry out the activities of daily living without requiring care.

 

Source: lisafx via iStock

Source: lisafx via iStock

 

According to the American Council for the Blind (ACB), more than seven million people over the age of 65 have experienced serious degrees of vision loss with most due to age-related conditions. As the baby boomer generation heads towards senior ages, this number is likely to double by the year 2030. The most common age-related conditions that are causing the serious vision loss are:

 

  • – Glaucoma
  • – Age-related Macular Degeneration
  • -Diabetic Retinopathy
  • -Cataracts

 

If you have not already experienced significant vision loss, or you have not been to see your eye care provider in some time, regular comprehensive eye exams including optomap® UWF™ digital imaging are critical to maintaining your vision. If you are experiencing vision loss, it is even more important to keep the monitoring schedule set by your doctor.

Senior Independence and Vision Loss

With many resources available, vision loss does not have to mean the loss of your independence. With the growing numbers of people having to adapt to losing their sight either wholly or partially, you are not alone. The ACB provides three key suggestions along with training and education that will help you maintain your independence:

 

  1. Learn to accept the reality of your situation. Seek help if you are struggling with the acceptance stage as this is the most crucial to your independence.
  2. Work on maintaining a positive attitude. Think in terms of “I can do this,” rather than assuming you can’t.
  3. Open your mind to new ways of doing things that will make living with your impairment easier.

 

Optos would like to stress the importance of regular comprehensive eye exams including optomap to help protect against vision loss or to help to preserve your remaining vision. Your eyesight may weaken as you age but there may be underlying conditions that will lead to blindness if not detected in their earliest stages.

 

UWF Case Study: Angiomatous Proliferation in ROP

History

A 15 year-old African American female with a history of bilateral threshold retinopathy of prematurity was seen for a routine annual visit. As an infant, she was treated with scatter laser photocoagulation two months after her birth. At this visit, she was asymptomatic with a visual acuity of 20/25 in the right eye and 20/15 in the left eye.

Color fundus photograph of the right eye showing a yellowish orange round lesion at 2 o’clock of the superonasal periphery.

Mid-phase fluorescein angiogram of the right eye with focal, round area of hyperfluorescence in the superonasal periphery, approximately one disk diameter in size.

Mid-phase fluorescein angiogram of the right eye with focal, round area of hyperfluorescence in the superonasal periphery, approximately one disk diameter in size.

Examination

optomap® color images were obtained and showed a reddish orange, slightly elevated lesion at 2 o’clock in the far periphery of the right eye, anterior to the equator. Images also confirmed areas of previous laser treatment in the temporal periphery. optomap fluorescein angiogram images were obtained and showed the lesion to be hyperfluorescent and that the lesion had feeding and draining retinal vessels. The left eye did not have similar lesions, but did have evidence of previous laser treatment in the temporal periphery.

 

Discussion

optomap color and fluorescein angiography were used to document the appearance and investigate the characteristics of the peripheral lesion. The lesion was determined to be reactive angiomatous proliferation – a rare vascular proliferation which has been reported to occur in various chronic retinal diseases, such as retinitis pigmentosa and Coats’ disease. Most recently, it has been reported to have occurred in a 14 year-old female with a remote history of retinopathy of prematurity, similar to our patient. She underwent cryotherapy to the lesion, and early involution of the lesion was present one month following treatment.

 

Conclusion

optomap color and fa widefield imaging successfully captured, documented, and allowed the investigation of this rare vasoproliferative condition.

 

To obtain a copy of this case study, written by Anna Gabrielian, MD and Mathew W. MacCumber, MD, PhD, contact us at Optos.