Case 2 of Disappearing Drusen
Gary Kirman, OD
Dr. Gary Kirman describes his second historic case of disappearing drusen in a patient with AMD.
I’d like to share with you a special case of my best friend’s mother.
The case wraps its way around having early AMD, dry AMD, in May of 2013. I counseled the patient on starting with AREDS2 vitamin therapy, monitoring blood vessel health, and monitoring herself regularly with Amsler grid screen.
Right eye: Wet AMD
Fast forward to December 2013 where patient called into the office, reported metamorphopsia in the right eye with the Amsler grid. Subsequently, she came in the same day and, as you can see by the photos, she had a sub macular hemorrhage. The photos show change from dry macular degeneration in May to a conversion to wet macular degeneration in December of 2013. I referred her immediately to a retinal surgeon who initiated Anti-VEGF treatment the very next day. Subsequently, four years later she is hemorrhage free, has not received an Anti-VEGF treatment in over eight months and, as you can see, her retina is completely recovered, except for some mild pigment drop out temple to the macular area.
Left eye: Dry AMD
The other significant point in this case is that the left eye, which you can see was developing intermediate AMD, after four years of AREDS2 formula vitamins her drusen are resolving. To a point where you could indicate just risk of AMD, at most early AMD. And her vision in that eye also is maintaining at 20/30. This is also significant in that her rod intercept time has improved in the left eye from abnormal back into the normal range.
Early intervention and treatment of AMD matters
This patient without a doubt ten years ago would be clinically blind in both eyes. It’s a case that is just wonderful; it is the ideal reaction or response to therapy that you could hope for. And what is remarkable is the disappearing drusen and, again, it’s a finding that I never knew could happen. I think throughout the country and the world, no doctor realized that drusen could actually disappear with appropriate treatment.