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62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. He also notices distortion in both eyes still. VISUAL ACUITY: OD 20/40, OS 20/30. IOP: OD 17, OS 19. There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is thickened pigment epithelium just superonasal to the fovea. OS: Vertical C/D ratio is 0.1. There is thickened pigment epithelium inferior to the fovea. OCT SCAN: The OCT scan in the right eye show no intraretinal or subretinal fluid. There is some retinal thickening still just superonasal to the fovea. In the left eye there is a new area of macular edema inferior to the fovea with intraretinal and subretinal fluid as well as thickened epithelium. FLUORESCEIN ANGIOGRAM: FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – BOTH EYES 3. NEW ONSET VISION LOSS FROM THE NEW SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – LEFT EYE 4. MACULAR EDEMA – LEFT EYE DISCUSSION: I explained to the patient the right eye looks better but unfortunately the left eye now has wet age-related macular degeneration. The office visit included a 15-minute counseling session during which I reviewed the alternatives, risks, benefits, and limitations of various treatment options. I treated with intravitreal injection of Lucentis (0.5 mg/0.05 ml) without any difficulty today. I asked him to return for a check in one month. What I will do on future visits is scan both eyes and treat whichever one is leaking on that day. If both eyes are dry, I will probably treat the left eye at least one more time with Lucentis. In addition, I may add photodynamic laser to both eyes requiring treatment over the next few months to at least one eye. He will see you back regularly as well. He is going to stop smoking today.

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Wet AMD 62 year old male smoker 133 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 151 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 147 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 102 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 113 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 72 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 84 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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Wet AMD 62 year old male smoker 91 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry.
He is going to stop smoking today.
00000
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Wet AMD 62 year old male smoker 103 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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wetamdjoca_051908_28729.png
Wet AMD 62 year old male smoker 97 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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wetamdjoca_051908_28829.png
Wet AMD 62 year old male smoker 88 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry.
He is going to stop smoking today.
00000
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Wet AMD 62 year old male smoker 116 views62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. OD 20/40, OS 20/30. FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. He is going to stop smoking today. FU: VA 20/30 OU with 2 years of every 6 weeks bilateral avastin!00000
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62-year-old man has wet age-related macular degeneration in the right eye. He has been undergoing treatment with Lucentis for that. Then his left eye developed hazy vision a few weeks ago while he was overseas and now his vision is hazy in both eyes. He also notices distortion in both eyes still. VISUAL ACUITY: OD 20/40, OS 20/30. IOP: OD 17, OS 19. There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is thickened pigment epithelium just superonasal to the fovea. OS: Vertical C/D ratio is 0.1. There is thickened pigment epithelium inferior to the fovea. OCT SCAN: The OCT scan in the right eye show no intraretinal or subretinal fluid. There is some retinal thickening still just superonasal to the fovea. In the left eye there is a new area of macular edema inferior to the fovea with intraretinal and subretinal fluid as well as thickened epithelium. FLUORESCEIN ANGIOGRAM: FA shows a classic subfoveal choroidal neovascular membrane in the left eye, which is leaking and in the right eye, which is dry. IMPRESSION: 1. WET AGE-RELATED MACULAR DEGENERATION – BOTH EYES 2. SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – BOTH EYES 3. NEW ONSET VISION LOSS FROM THE NEW SUBFOVEAL CHOROIDAL NEOVASCULAR MEMBRANE – LEFT EYE 4. MACULAR EDEMA – LEFT EYE DISCUSSION: I explained to the patient the right eye looks better but unfortunately the left eye now has wet age-related macular degeneration. The office visit included a 15-minute counseling session during which I reviewed the alternatives, risks, benefits, and limitations of various treatment options. I treated with intravitreal injection of Lucentis (0.5 mg/0.05 ml) without any difficulty today. I asked him to return for a check in one month. What I will do on future visits is scan both eyes and treat whichever one is leaking on that day. If both eyes are dry, I will probably treat the left eye at least one more time with Lucentis. In addition, I may add photodynamic laser to both eyes requiring treatment over the next few months to at least one eye. He will see you back regularly as well. He is going to stop smoking today.