Download FOI1808 Attachment 5 - Heart of England NHS Foundation Trust

Ophthalmology Department
Telephone: 0121 424 2000
Information for Patients
Wet Age-Related Macular Degeneration
You have been diagnosed with Wet age-related macular
degeneration
Age-related macular degeneration is a condition affecting the light
sensitive portion of the eye - the retina. The central portion of the
retina is called the macula. The macula or central portion of the retina
is responsible for close or fine vision. When you read, or look at
something, you use your macula to see.
Description
Wet age-related macular degeneration is a condition where abnormal
blood vessels behind the retina start to grow under the retina. These
abnormal blood vessels are called choroidal neovascularisation
(CNV). These blood vessels tend to be very fragile and often leak
blood and fluid.
The blood and fluid raise the macula
from its normal place. This can cause
permanent damage and scaring if left
untreated and stop the macular from
working properly. With Wet AMD loss
of central vision can occur quickly.
Symptoms include:
 Blurred vision.
 Central or fine vision is affected.
 One of the earliest symptoms is
wavy lines.
 Holes or gaps in the centre of
vision develop.
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Information for Patients
Diagnosis
The diagnosis is made by a comprehensive ocular examination. With
the pupils of both eyes dilated. This may be followed by a fluorescein
angiogram. A fluorescein angiogram consists of a dye injection into a
vein in the arm, followed by photographs of the eye. The procedure
takes approximately ten minutes. Other tests include ocular
coherence tomography (OCT), a type of ultrasound to assess the
amount and distribution of fluid in the retina.
Treatment
The treatment for wet age-related macular degeneration is by an
injection of a drug called Lucentis. This treatment is aimed at sealing
or stopping the leakage, getting rid of the choroidal neovascularisation
and preventing further retinal damage.
The earlier that treatment is performed, the greater the likelihood of
success. When the retinal damage has progressed to scar tissue
formation, treatment is unlikely to help.
Lucentis is an agent that blocks VEGF. It is given via an injection into
the white of eye. VEGF stands for Vascular Endothelial Growth
Factor.
VEGF blocking drugs stop the growth of choroidal neovascularisation.
Lucentis has been proven for patients being treated that their vision
can remain stable or improve.
I am going to have Lucentis, what does this mean?
Lucentis is of proven benefit in those who have choroidal
neovascularisation. It is given via an injection into white of the eye.
The injection is given every month for 3 months.
The injection is performed with the aid of local anaesthetic in the form
of eye drops. It is performed either in the treatment room of the out
patients department or in an operating theatre. The injection takes no
more than a few minutes.
After the injection, your vision will be blurred and your eye may be
slightly red and sore. These effects will soon disappear.
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Information for Patients
Lucentis being injected into the eye
What is the risk of Lucentis?
The administration involves an injection
into the eye. Minor problems such as
redness, mild soreness and blurred vision
are usually temporary.
High pressure may develop after the
injection. Any injection into the eye can be
complicated by infection.
If your eye becomes progressively red or sore after the injection, you
need to contact the eye clinic. In the long term, repeated ocular
injections may increase the development of cataracts.
What do I do after the Lucentis treatment?
You should not rub your eye. You should avoid immersing your eye
for 48 hours. You should avoid vigorous exercise for 48 hours. After
which you can resume your normal life.
Follow up
Following your 3rd injection, an appointment will be arranged 4 weeks
later where you will have a review in clinic. At this appointment your
vision will be tested and an OCT will be performed this is to determine
whether you have responded to the treatment.
A decision for a further injection treatment will depend on these results
and you will be informed either by a telephone call to arrange a further
injection or letter for a further clinic review appointment.
Lucentis treatment is required until the leakage ceases. Occasionally
the leakage can stop and some months later recur. This is the reason
that you require follow up for 24 months following your first treatment.
You can consider the initial three injections as an induction regime
and the remainder of the injections as maintenance treatment,
required when there is disease activity.
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Information for Patients
Why can’t I have treatment?
If your vision is below a certain level, treatment is unlikely to help. The
retina has no powers of recovery. If the retina is badly damaged by
bleeding or scarring, then treatment is not going to change the long
term outlook and is of no benefit. If your disease has been present for
some time, scarring may well have developed
Long Term Outlook
Wet age-related macular degeneration will progress in the absence of
treatment with serious loss of central vision. Peripheral or out and
around vision will be preserved (Eccentric Vision)
Will I be able to drive?
Some people with Wet age-related macular degeneration can drive.
However there are some people who cannot continue to drive, as
vision is too poor and below the legal limit.
Can I have some new glasses?
During initial injection treatments we do not advise you have new
glasses, as your vision may alter month by month. The
Ophthalmology department have opticians who are trained in
dispensing glasses and low vision aids such as magnifying glasses
once it is advised by medical staff to change your glasses
The department also has an Eye Clinic Liaison Officer based at the
Solihull site who can refer you to the appropriate support services to
assist in maintaining your independent living or Focus Birmingham
based at Birmingham heartlands hospital who can provide
rehabilitation services to enable people to regain confidence and lead
their lives as independently as possible
Contact Us:
Emergency number: 0121 424 2000
ask for Bleep no 2489 (Macula Nurse)
Eye clinic Solihull
Eye clinic Heartlands
Eye clinic Good Hope
0121 424 4094
0121 424 0543
0121 424 9608
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Information for Patients
Eye Casualty after 5pm and weekends 0121 507 6780
Our commitment to confidentiality
We keep personal and clinical information about you to ensure you
receive appropriate care and treatment. Everyone working in the NHS
has a legal duty to keep information about you confidential.
We will always ask you for your consent if we need to use information
that identifies you. We will share information with other parts of the
NHS to support your healthcare needs, and we will inform your GP of
your progress unless you ask us not to. You can help us by pointing
out any information in your records which is wrong or needs updating.
Additional Sources of Information:
You may want to visit our Health Information Centres located at the
Main Entrance at Birmingham Heartlands Hospital, Tel: 0121 424
2280, or at the Treatment Centre at Good Hope Hospital Tel: 0121
424 9946 or Email: [email protected]
NHS Direct
Telephone 0845 4647 or visit them on the Internet at
http://www.nhsdirect.nhs.uk
Please use the space below to write down any questions you
may want to ask
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