The Retina Centers of Washington

  Contact : (301) 279-9123 , Fax: (301) 279-6828

Macular Degeneration Update

Age Related Macular Degeneration (AMD) & latest Treatment with Intraviteal injections of LUCENTIS & AVASTIN (anti VEGF). Exudative age related macular degeneration (wet ARMD) continues to be a common blinding retinal disorder. Laser treatment for wet ARMD often is not possible or worsens the patient’s vision. Unfortunately, the majority of leakages are occult or poorly defined choroidal neovascular membranes (CNVM) which are located under the center of the macula. These lesions respond the poorest to traditional laser therapy. The new treatments of anti-VEGF for exemple LUCENTIS or AVASTIN, might have a great benefit to patients with leakage located directly under the macula. So far, Dr. T.S. Melki has performed over 500 of these injections (2007).

Limited Retinal Translocation can move the retina inferiorly so that small classic (well defined) submacular CNVM can be moved “out” of the central macula prior to laser. Retinal surgeons now have the technical capability to perform translocation surgery. The CNVM can then be treated post-operatively while hopefully preserving the central macula. Limited retinal translocation is a reasonable procedure to consider for small classic submacular CNVM in a attempt to prevent further vision loss. Significant complications can occur following retinal translocation surgery.

Photodynamic Therapy (PDT) will allow for the treatment of subfoveal CNVM with less damage to the overlying retina. Hopefully, patients will experience less vision loss following PDT treatment. PDT requires the injection of a photosensitive dye prior to laser therapy. The preliminary results for PDT are encouraging when the majority of the leakage is classic (well defined). Unfortunately, in the same clinical trial, PDT was not proven visually beneficial in patients when the majority of the lesion was occult (poorly defined). Dr. T.S. Melki currently (2007) rarely offers this therapy option.

Transpupillary Thermotherapy (TTT) is an alternative therapy for patients with occult (poorly defined) subfoveal leakage. TTT utilizes the diode laser with an enlarged spot size and extended treatment time to treat subfoveal CNVM with less overlying retinal damage. TTT avoids the use and expense of the dye used in PDT. The preliminary results for TTT indicate the ability to stabilize vision loss in the majority of patients treated. TTT is already FDA approved. A large clinical trial of TTT is currently being organized. We are currently utilizing TTT in our offices for patients with otherwise untreatable subfoveal occult leakage.

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Retina Centers of Washington COVID-19 Safety Protocol

Dear Valued Patients and Friends,

We are truly grateful for the love and support you’ve provided us over the past few months as we navigated through the pandemic. With your continued support, we have been able to stay open, through this entire pandemic, to treat our patients' essential eye care needs. 

The safety of our patients, and our staff members, is our top priority; therefore, we have implemented safety protocols set forth by the Centers for Disease Control and Prevention (CDC) and by the American Academy of Ophthalmology (AAO).

Here are some of our new safety procedures that are currently in place for when you visit our office(s).

Prior to Your Appointment:

·  You will be pre-screened over the phone when scheduling your appointment.

·  If you have symptoms such as fever, cough, or shortness of breath, we ask that you call and reschedule your appointment.

·  If you have been exposed to anyone with the virus, we ask that you call and reschedule your appointment. 

·  We will minimize the number of people in the practice (please come alone unless there is a true need for someone to accompany you).

·  We request that anyone accompanying you to wait safely in their car, unless it is truly necessary for them to come into your appointment with you. We truly appreciate your cooperation on this.

Once You arrive:

·  We are requiring all patients to arrive wearing a mask (we will provide one if needed), and that it is properly worn through the entire visit. 

·  We will check your temperature upon your arrival.

·  We request that patients use hand sanitizer upon arrival and departure of our office.

·  We have reduced the number of chairs in the waiting area to respect physical distance protocol.

·  All magazines and brochures have been removed.

Staff and Strict Cleaning Protocols:

·  We complete daily prescreening for COVID symptoms for Staff, and Doctors. 

·  All Staff members will be using PPE and wearing masks at all times, including our providers. A face shield and gloves will be worn as needed.

·  Our staff regularly performs surface cleaning of frequently touched areas throughout the day.

·  Our waiting room, exam rooms, testing equipment, and other common areas are cleaned and sterilized after every patient appointment.

We thank you for your patience with all these changes, and for your cooperation as we continue to safely navigate through the pandemic. If you have any questions, please contact our office at 301-279-9124 and we will be glad to help you!