Macular Edema -- Injections for it vs. Laser

Jill-O · #1 (**permalink**) 10-02-2007, 03:44 AM

Hi --

I was diagnosed with Macular Edema and initially was treated w/ eye drops (which didn't work or didn't work much). Following trying the drops (Nevamac?), I was referred by my Opthimologist to a specialist.

This may be "old news" to a lot of you, but I know almost nothing about this stuff right now. The doctor took tons of pictures and showed me the area of concern. Instead of laser treatment, which I'd anticipated, he had me get a shot in my right eye (the worse one) yesterday, and I'll get a shot in my left eye on Monday.

I tried to include a URL about Bevacizuma, which is what I'm getting treated with (the injection), but that didn't work... You can probably google Macular Edema, Injection, Colon Cancer (that's what this is FDA approved to treat, the Macular Edema application is off lable apparently).

The shot didn't hurt at all. The only painful thing was the lights in the room seemed bright after dialating and they put something in to keep my eye open. It was uncomfortable and I was afraid of the shot, but turns out it didn't hurt (so I won't be worked up about next week!).

Just in case it could help some of you to see the article. I will get a follow up in about 6wks to see how I'm doing if I understood correctly. If I will need laser surgery after all, it should be less intense than if I had not gotten the shots.

Jill

Cinnabon · #2 (**permalink**) 10-02-2007, 04:47 AM

Hey Jill-O

Been there 1 too many times. My best shot ever was my faith and the Avastin shots. This is a lot alike Lucentis, they are both for cancer, but it works real good. I you have aby questuins, please eek free to ask me.

xMenace · #3 (**permalink**) 10-02-2007, 05:48 AM

Taking pictures like that is a sign of a professional!

Jill-O · #4 (**permalink**) 10-02-2007, 05:56 AM

Thanks, folks

I feel confident in this doctor. This is not an area I know much about, but like I said, they took tons of pictures, including many after injecting a florescent dye to see how much current leakage. He showed me the pictures and explained what we were looking at. I didn't have this tunnel vision I have in my right eye about 65% of the time when I wake up, but not sure if it just wasn't a tunnel vision morning, or if it is from the shot.

BriOnH · #5 (**permalink**) 10-02-2007, 11:10 PM

Thats rather atypical to get eye complications so early in diabetic life.

Did you go untreated for a long time?

Glad you have a good doctor. There are so many hacks out there it is scary!

Jill-O · #6 (**permalink**) 10-03-2007, 03:20 AM

Yes, I think now in hindsight, I had gone untreated for years. I have a history of repeated miscarriage and when I was in to my old doctors for what turned out to be the third, the nurse asked if I had had something sweet for breakfast (I'd eaten nothing) because there was sugar in my pee. I didn't really think hard about it because I was so focused on what was happening to the pregnancy. The next time I got pregnant (years later -- it was last December), I decided to try a new doctor who immediately realized I probably had diabetes. Then I went to who is now my general doctor, to an opthimologist, and then to this more specialized eye doctor.

On a happy note, I did have the 24 hour urine collection done in light of what's happened to my eyes, and my kidneys are fine. I was so scared about that I could hardly think straight.

xMenace · #7 (**permalink**) 10-03-2007, 05:14 AM

Quote:

Originally Posted by BriOnH

Thats rather atypical to get eye complications so early in diabetic life.

Did you go untreated for a long time?

Glad you have a good doctor. There are so many hacks out there it is scary!

I believe something like 7% of newly diagnosed type 2's have some form of retinopathy.

Jill-O · #8 (**permalink**) 11-08-2007, 07:17 AM

Just an update. I've had 2 shots now in my right eye, one in my left (get the 2nd one in my left next week). I can see a big difference in my vision. I'm reasing a lot better on the eye chart. They did another set of pictures yesterday before my second shot in the right eye. The doctor is very pleased and showed me the photos and pointed out how much improved it all is

Doesn't hurt, either

The only unconfortable part is the doctor puts something in to hold my eye open and the light of the office is a little painful but just such a short period of time. I've very happy with the results and the doctor

Gabby123 · #9 (**permalink**) 12-03-2007, 10:09 AM

I just got back from the Retina specialist. I had an Avastin shot that I didn't know I was getting.I have seen on some forums that they really hurt. I saw Jill's post and I did really well.I have in the past fainted from shots and especially in weird places like the eyeball. It really didn't hurt at all .I was shocked.I will get another in 6 weeks.

Jill-O · #10 (**permalink**) 12-03-2007, 11:03 AM

Gabby --

I'm happy the shots didn't hurt you, either

I've had 2 in each eye and go in about 2wks for a 3rd set of photos. The doctor then will decide what kind of (mild) laser surgery I should have

Good luck with the rest of your treatments. They've really helped me a lot (in how I see and also what I see in the eye photos).

Jill

Gabby123 · #11 (**permalink**) 12-06-2007, 07:16 AM

Just wondering if you had any improvement after the first shot.? I haven't yet. I get another Jan.7th.After the first shot I saw a big black blob at the bottom in my vision and I think that is where the injection went. It subsided 2 days later.

Jill-O · #12 (**permalink**) 12-06-2007, 07:29 AM

Yes, I had improvement, but I don't know that I realized it prior to reading the doctor's eye chart. I was reading 2-3 lines lower! I thought I could read the on screen tv guide on the tv better but was not totally sure.

Now, though, I feel I'm maybe not seeing as sharp. Not sure. I will be seeing my doctor again for pictures and evaluation as to the depth of laser surger, on 12/17.

Gabby123 · #13 (**permalink**) 12-06-2007, 10:42 AM

I heard they sometimes don't last very long and more injections are needed. I hope this is not true. My insurance doesn't pay for them and the Doctor charges 425.00 each shot. They do give a discount if your insurance does not cover it. They say most insurance does Not cover Avastin because it is not FDA approved for the eyes.Just glad I can afford them as some cannot.

Jill-O · #14 (**permalink**) 12-06-2007, 11:34 AM

From what my Doctor explained to me, he didn't think the shots would be enough to make me not need the laser surgery, but that they'd make the surgery be less involved.

My insurance is not covering the injections (everything else they are though). However, my doctor only charges $80/shot, so it is not a big deal.

Achilles · #15 (**permalink**) 08-15-2008, 05:42 PM

My apologies for bringing up an old thread, but a search and read found this to be the most likely place for me to post this.

I was diagnosed 4 months ago with an unknown A1c but fasting was 262 mg/dL. I felt horrible and was somewhat shocked to find out I had diabetes but at the same time I felt that there was an explanation for why I had been feeling so bad.

I have regular eye exams because I wear glasses. Last year I had a full exam by an opthamologist who dilated my eyes and didn't detect anything. An optomotrist earlier this year didn't detect anything either. Well, after my diabetes diagnosis I have been working hard on my A1c and my first one came back 6.3% last month.

I scheduled an appointment with the same opthamologist I saw last year and he diagnosed me with diabetic retinopathy. He referred me to a retina specialist who I saw today.

The retina specialist looked at my eyes and confirmed background non-proliferative retinopathy in both eyes. On a scale of 1 to 10 with 10 being the worst, he said right eye was a 2 and left eye was a 3. He also said I have macular edema in my left eye.

I was shocked about all of this of course. I asked if rapidly improving my blood glucose may have caused this and he referenced the DCCT report where 13% of patients may experience something called "early worsening." I felt guilty about this because I've worked so hard to improve my numbers and then this! He said to keep my A1c under 6.5% and I told him I was aiming for under 6.0% which he said was even better. I asked him about what was better dealing with the "early worsening" or slowly bringing down the BG numbers. He said that it was better to get in control as quickly as possible to avoid more complications. The "early worsening" usually stabilizes and may get better if I control my BG numbers under 6.5%.

I got the dye injection in my arm and numerous photos were taken of both eyes. The doctor came in and explained them to me and asked if I had any questions. I did have a few and he recommended laser treatment for the macular edema on the left eye. He said it could get better on its own but it was my choice. In his opinion he said I should get it done. So I did. It only lasted about 3 minutes and was not very painful at all. I can still see 20 / 20 in both eyes with my glasses and tonight I seem to be seeing fine too. I asked about vigorous exercise and he said no restrictions there.

This macular edema thing is kind of frightening though. I go back in 3 months for a follow up. I should have my updated A1c at that time too.