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77-year-old woman who I saw in the office on July 15, 2009. She saw you last in January. At that time her vision was 20/20 and then about a week ago within the last week she was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor. She saw you for an evaluation, you saw a problem with the macula and suggest that she come in here for an evaluation. You suggested she also start taking eye vitamins. She had cataract surgery done in the right eye in November of 2006. VISUAL ACUITY: OD 20/200, OS 20/30. IOP: OD 16, OS 17. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There are 2+ macular drusen. OCT SCAN: The OCT scan of the right eye shows pigment epithelium thickening with overlying subretinal fluid and macular edema. The left eye shows patchy macular drusen. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows a predominately classic subfoveal choroidal neovascular membrane, less than 4 disc areas in size in the right eye with leakage in the late frames. The left eye has staining drusen. IMPRESSION: 1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE 3. CYSTOID MACULAR EDEMA – RIGHT EYE DISCUSSION: I explained to the patient she does unfortunately have wet age-related macular degeneration in the right eye. At this moment there is a treatment for that, which has a 90% chance of improving the vision some and a 50% chance of improving the vision a lot. I explained the treatment to her, including that it is generally an ongoing treatment requiring multiple injections, sometimes over the course of a few years. I treated the right eye with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today. Folow -up 3 years of injections and patient has small scar right eye and 20/200 visual acuity.

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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS166 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS113 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS103 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS107 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS90 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS73 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS81 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS65 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS60 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS91 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS53 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS75 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS54 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS71 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS68 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS105 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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cnvm_baro17.png
Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS77 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
00000
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cnvm_baro18.png
Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS73 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS107 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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Wet AMD Right Eye with Vision Loss for 1 week - 20/200 OD, 20/30 OS117 views77-year-old woman about a week ago was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor.
VISUAL ACUITY: OD 20/200, OS 20/30.
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area.
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77-year-old woman who I saw in the office on July 15, 2009. She saw you last in January. At that time her vision was 20/20 and then about a week ago within the last week she was rubbing her eye while she was watching TV and at that time noticed the vision in the right eye was poor. She saw you for an evaluation, you saw a problem with the macula and suggest that she come in here for an evaluation. You suggested she also start taking eye vitamins. She had cataract surgery done in the right eye in November of 2006. VISUAL ACUITY: OD 20/200, OS 20/30. IOP: OD 16, OS 17. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is 2+ macular edema. There is pigment epithelium thickening predominately inferonasal to the fovea. There are also retinal hemorrhages in that area. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There are 2+ macular drusen. OCT SCAN: The OCT scan of the right eye shows pigment epithelium thickening with overlying subretinal fluid and macular edema. The left eye shows patchy macular drusen. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows a predominately classic subfoveal choroidal neovascular membrane, less than 4 disc areas in size in the right eye with leakage in the late frames. The left eye has staining drusen. IMPRESSION: 1. AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – RIGHT EYE 3. CYSTOID MACULAR EDEMA – RIGHT EYE DISCUSSION: I explained to the patient she does unfortunately have wet age-related macular degeneration in the right eye. At this moment there is a treatment for that, which has a 90% chance of improving the vision some and a 50% chance of improving the vision a lot. I explained the treatment to her, including that it is generally an ongoing treatment requiring multiple injections, sometimes over the course of a few years. I treated the right eye with intravitreal injection of Avastin (1.25 mg/0.05 ml) without any difficulty today. Folow -up 3 years of injections and patient has small scar right eye and 20/200 visual acuity.