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Medical Forum / General / Vision / August 2005Pigment clumping
My optometrist recently told me I had pigment clumping on and around my macula in the left eye. I am 45 years old with a history of retinal problems. Over twenty years ago, I had a retinal detachment repaired with a buckle. This caused a cataract, which was removed 10 years ago. Shortly after that, I had cystoid macular edema. The surgeon inserted a steroid bag into my eye which was succesful in clearing my vision. I also have a macular pucker now which is not affecting my vision too badly. When I do a google seach for pigment clumping, the results I get are all for macular degeneration. I have an appointment with my retinal specialist in 6 weeks, but the waiting is driving me crazy. Is there anything else that could cause this clumping? I'm thinking maybe it's caused by all my past surgeries. Could that be a factor? Any answers would be appreciated, as I am a nervous wreck waiting for my appointment. Thank you. Pigment clumping is a fairly ambiguous term that may or may not be a significant factor for eventual macular degeneration. It could simply be an after effect of the CME. So relax and wait for the retinologist. w.stacy, o.d. > My optometrist recently told me I had pigment clumping on and around my > macula in the left eye. I am 45 years old with a history of retinal [quoted text clipped - 9 lines] > Could that be a factor? Any answers would be appreciated, as I am a nervous > wreck waiting for my appointment. Thank you. As Dr. Stacy mentioned, pigment clumping may be totally innocuous or it may be related to several things, e.g. onset of macular degeneration (rather early in your case), scarring of the retina (possibly related to the retinal problems you have had). In the end, there is nothing you can proactively do about it. Try not to worry. Your retinal specialist will things for you. If your vision is unaffected then it's of little concern. ============= > My optometrist recently told me I had pigment clumping on and around my > macula in the left eye. I am 45 years old with a history of retinal [quoted text clipped - 9 lines] > surgeries. Could that be a factor? Any answers would be appreciated, as I > am a nervous wreck waiting for my appointment. Thank you. Thank you for your quick replies. Your answers have helped to calm me down somewhat. It is nice to know it could be related to my earlier problems. I'm hoping my retinal specialist will be able to put my fears totally to rest. Thanks again. Retinal detachment, repaired with buckle (usually using cryopexy with that) can cause pigment clumping, particularly if it was a macula-off detachment. Even if not, pigment from the detachment healing process can migrate, and end up under/around the macula later on. Nothing to do about it. On 7/12/05 6:05 AM, in article OePAe.2246$oZ.366@newsread2.news.atl.earthlink.net, "auriganews" <auriga2@REMOVEmindspring.com> wrote: > My optometrist recently told me I had pigment clumping on and around my > macula in the left eye. I am 45 years old with a history of retinal [quoted text clipped - 9 lines] > Could that be a factor? Any answers would be appreciated, as I am a nervous > wreck waiting for my appointment. Thank you. Thank you so much for your reply, Dr. Robins. It has helped me tremendously. My detachment did not include the macula, although the doctor said it came very close to it. I have noticed some dimming of my vision, especially at night, but I'm sure just the clumping itself could cause that. Sounds like I might be stressing out unnecessarily. Thanks for helping me to calm down. I appreciate it very much. Well, I finally saw my retinal specialist, and he said that I do have macular degeneration in both eyes. He said it was mild in my left eye, and microscopic in my right. However, at this point, it is only drusen, and some pigment clumping. He noticed the drusen a year ago, but now it has become more numerous, I guess. I understand the rate of progression is slow, but given that mine progressed already in only a year, is this indicative of it's rate of progress? I have no idea when to expect severe vision problems. 10 years? 5 years? I also have normal tension glaucoma which attacks the peripheral vision, so I am concerned that I will be left with hardly any vision at all. Also, I have been reading that the pigment clumping could be a sign that it will turn to the wet MD. Is this true? I am only 45 years old. I am starting to think I will be blind before I turn 50. If anyone has any answers, I would appreciate it. > Well, I finally saw my retinal specialist, and he said that I do have > macular degeneration in both eyes. He said it was mild in my left eye, and > microscopic in my right. However, at this point, it is only drusen, and > some pigment clumping. He noticed the drusen a year ago, but now it has > become more numerous, I guess. The only missing detail is the quality of the drusen. Hard, discrete dots are less significant. Softer, confluent, larger drusen are a pretty big risk factor. So is pigment migration. I think you should get in the habit of checking your central fields with a printed page or quadrille pad, once a month or so. I also think you should have a "PHP" visual field, and a macular OCT every year or two. You'll need a baseline flourescein angiogram in the near future. ---------- Dr. Stuart Richer's lifestyle recommendations, adapted from yesterday's lecture: --------- Avoid smoking Avoid exposure to bright sunlight. Increase antioxidant nutrients, especially spinach or kale, cooked tomatoes, oranges & bananas, blueberries, moderate red wine Avoid or control hypertension and cardiovascular risk factors Avoid high iron intake, give blood 3x/year Lutein (60 mg) plus a daily multivitamin with zinc Omega-3 fatty acids: sardines, salmon, tuna, herring, nuts 1 cup soy milk/day, extra vitamin D -------- > I understand the rate of progression is slow, but given that mine > progressed already in only a year, is this indicative of it's rate of > progress? I have no idea when to expect severe vision problems. 90% of macular degeneration is "dry" or atrophic, with less severe effect on vision. 10% of macular degeneration is "wet" or exudative. With wet MD, on average it takes about 10 years to go from 20/40 to 20/200. The most promising treatment approaching FDA approval is Lucentis. -MT, OD The grid Mike is referring to is termed an "Amsler grid" and there are various sites this could be downloaded from. Basically the grid has high contrast and has a centered dot which is fixated upon while testing. One is to look for waviness in the lines (any one) and note if parts of the grid are "foggy". Good luck. Don W > Well, I finally saw my retinal specialist, and he said that I do have > macular degeneration in both eyes. He said it was mild in my left eye, and [quoted text clipped - 9 lines] > am only 45 years old. I am starting to think I will be blind before I turn > 50. If anyone has any answers, I would appreciate it. Thank you both for your suggestions. I already have an Amsler grid that I was given 20 years ago after my retinal detachment. The lines on that are somewhat wavy, due, I am told to an epirentinal membrane. I check it every so often to see if the waviness is getting worse. So far, so good. He did not tell me what kind of drusen I have. He only mentioned they were quite small. I am assuming they were the soft kind, but I really don't know. I don't know what a PHP visual field test is, but I did have a visual field test done on Friday. I get them yearly to check the glaucoma. Only slight peripheal loss so far. My pressure stays at between 10 and 12, so he said eye drops would be useless in this case. I also don't know what a macular OCT is, either. I have never heard of that. But, I do get a flourescein angiogram yearly, because of all my other retinal problems, I assume. Basically, my eyes are a mess. I'm thankful I see as well as I do. I have been reading up on the diet and nutrition advice for macular degneration, and I will paying closer attention to what I eat. And quitting smoking too. Hopefully. Thank you for your advice. I guess there is not much I can do, except wait and see what happens. This is so frustrating. > I also don't know what a macular OCT is, either. I have never heard of > that. But, I do get a flourescein angiogram yearly, because of all my > other retinal problems, I assume. Basically, my eyes are a mess. I'm > thankful I see as well as I do. The OCT is optical coherence tomography which give data as to the depth of the retina. Seems like if you are getting angiograms the OCT would be a complement to this test. Don W |
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