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Medical Forum / General / Vision / August 2006wavy lines in dry amd: causes other than neovascularization ?
A sudden onset of wavy lines in the lower/right quadrant of the Amsler grid led to an emergency visit to my retinal specialist, who found no bleeding. Other than neovascularization (progression to wet amd), what other explanations exist? The wavy lines began right after workup for cataract surgery. Can eyedrops cause wavy lines? ( grasping at straws, I know :) Thank you, H.K. >A sudden onset of wavy lines in the lower/right > quadrant of the Amsler grid led to an emergency [quoted text clipped - 7 lines] > Thank you, > H.K. Your doctor should have given you an OCT. This might have shown the presence of drusen that would modulate the RPE and would thusly cause the Amsler grid lines to wave. This would occur with dry amd. Good luck. Don W. >A sudden onset of wavy lines in the lower/right quadrant of the Amsler >grid led to an emergency visit to my retinal specialist, who found no >bleeding. Other than neovascularization (progression to >wet amd), what other explanations exist? Retinal edema, progressing non-exudative non-treatable AMD changes. >The wavy lines began right after workup for cataract surgery. Can >eyedrops cause wavy lines? Certain drops (e.g., epinephrine, prostaglandin analogs) can increase your risk for, say, cystoid macular edema, which could cause your complaints. But, no, your eye doctor did not cause your metamorphopsia as a result of the eye drops he used as part of your cataract workup. >>A sudden onset of wavy lines in the lower/right quadrant of the Amsler >>grid led to an emergency visit to my retinal specialist, who found no [quoted text clipped - 9 lines] > your risk for, say, cystoid macular edema, which could cause your > complaints. The edema (whatever variety) would also have shown up on an OCT, which should have been given. Truth? Don W. >>>A sudden onset of wavy lines in the lower/right quadrant of the Amsler >>>grid led to an emergency visit to my retinal specialist, who found no [quoted text clipped - 12 lines] >The edema (whatever variety) would also have shown up on an OCT, which >should have been given. Truth? It is extremely hard to argue against performing a non-invasive test like an OCT for recent/sudden onset of unexplained metamorphopsia in a patient with AMD. But perhaps we don't know the whole story here. It also hard to imagine a retinal specialist who does not own an OCT in 8/2006. Another cause of such complaint could be an epiretinal membrane, but the onset of such is typically more insidious. >>>>A sudden onset of wavy lines in the lower/right quadrant of the Amsler >>>>grid led to an emergency visit to my retinal specialist, who found no [quoted text clipped - 22 lines] > Another cause of such complaint could be an epiretinal membrane, but > the onset of such is typically more insidious. It would be nice for the patient to find out why he didn't get this test. All it would take would be a phone call to the doctor's office. Too important for this to be left as is. Either that or get a second opinion. Don W. > It would be nice for the patient to find out why he didn't get this test. > All it would take would be a phone call to the doctor's office. Too > important for this to be left as is. Either that or get a second opinion. > > Don W. The doctor performed an OCT in the afflicted eye. He's a highly regarded retinal specialist in the Bay Area. No dearth of technology here. What our doctors lack is time, to explain and discuss. One famous ophthalmologist in the area allegedly averages 28 cataracts on the days he operates. If a patient like me notices wavy lines the day before a surgery, how much time does that doc have to explain retinal test results and suggest life-style changes? My doc's office is full of sales literature for the various IOLs. Not one pamphlet in the office informs the patient about amd or ocular nutrition. I think more emphasis should be on the intractable problems rather than on the effectively solved problem of cataracts, but I can understand that it's more pleasant to fix an ocular problem than to discuss fish, spinach, possibilities, probabilities and low vision aids. H.K. >> It would be nice for the patient to find out why he didn't get this >> test. [quoted text clipped - 21 lines] > > H.K. So the OCT _was_ judged as normal? Don W. The conclusions were "not wet" (yet) and ok to proceed with cataract repair. Whether the OCT was "normal," I don't know. The retinal specialist and the ophthalmologist huddled privately. You're teaching me to ask intelligent questions. Thank you, H.K. > So the OCT _was_ judged as normal? > > Don W. The conclusions were "not wet" (yet) and ok to proceed with cataract repair. Whether the OCT was "normal," I don't know. The retinal specialist and the ophthalmologist huddled privately. You're teaching me to ask intelligent questions. Thank you, H.K. > So the OCT _was_ judged as normal? > > Don W. The conclusions were "not wet" (yet) and ok to proceed with cataract repair. Whether the OCT was "normal," I don't know. The retinal specialist and the ophthalmologist huddled privately. You're teaching me to ask intelligent questions. Thank you, H.K. > So the OCT _was_ judged as normal? > > Don W. |
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