About Age-Related Macular Degeneration

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Retina Associates
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Retina Associates provides specialized care for retinal abnormalities to patients in Tucson, Arizona. Through Retina Associates, Dr. Cameron Javid and his fellow physicians treat numerous individuals with macular degeneration.

Age-related macular degeneration, or AMD, is the most common cause of vision loss in the United States today. It stems from the deterioration of an area known as the macula, which lies in the center of the retina at the back of the eye. In a healthy human eye, the macula is responsible for receiving and processing information from the patient’s central field of vision.

Because the retina is responsible for translating light into signals that the brain can read as vision, its degeneration can be devastating to a patient. Macular cells that no longer function can in turn no longer correctly tell the brain what the individual is seeing. This manifests as blurriness, image distortion, or even darkening in the affected visual field.

In most cases, this process occurs because the macula begins to gradually thin with age. At first, this does not cause noticeable symptoms but instead prompts the development of small deposits under the retina, which an ophthalmologist may notice on examination. Vision loss then slowly begins and worsens as damage increases.

Dry macular degeneration may progress into the disease’s wet form, which occurs as a result of abnormal blood vessel growth under the retina. These vessels are structurally unsound and leak into the retina, which in turn can cause rapid and severe vision loss. Wet macular degeneration requires timely medical treatment, so that a retina specialist can treat the condition with injections of medicine into the eye or cold laser.

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Treatment Options for Ocular Melanoma

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Retina Associates
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Retina Associates of Tucson, Arizona, offers one of the largest ocular oncology programs in the southwestern United States. At Retina Associates, Dr. Cameron Javid provides treatment for ocular melanomas and similar conditions.

Treatment of an ocular melanoma depends largely on the stage of the tumor. The smallest ones, for example, may simply require observation to assess whether they will grow and cause problems. If diagnosis of the tumor indicates that treatment is needed, the patient may undergo radiation or surgery.

For less sizable tumors, the attending physician is likely to recommend radiotherapy. For ocular melanomas, this most often takes the form of brachytherapy, which involves placing a tiny radioactive plaque which looks like a small disc right next to the tumor. Other patents may receive procedures such as proton beam radiotherapy, which treats the tumor with a focused stream of proton particles.

Patients with larger tumors may undergo enucleation, which involves the full removal of the eye itself. In addition, each tumor undergoes a biopsy for genetic testing and gives very valuable Information regarding prognosis. This information gives the percentage of metastatic spread during the first five years and helps with the frequency and need for ongoing blood tests and CT scans to monitor the body for the potential of tumor spread.

Treatments for Ocular Melanoma

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Retina Associates
Image: retinatucson.com

Retina Associates, located in Tucson, Arizona, is nationally known for its ocular oncology program. With one the largest eye cancer program in the southwest United States, Dr. Cameron Javid and associates frequently diagnose and treat eye cancers and were invited to participate in the Collaborative Ocular Melanoma Study. Current studies are available for ocular melanoma with metastatic spread.

Ocular melanoma is a very rare and aggressive form of cancer that affects about 2,000 Americans each year. This slowly developing cancer involves portions of the uveal tract in the eye. Though melanoma of the skin is often caused by exposure to ultraviolet rays, the exact cause of ocular melanoma is unknown.

The Collaborative Ocular Melanoma Study has widely influenced the treatment of ocular cancer. Common approaches involve diligent monitoring, radiation, and surgery.

If a tumor is small, ophthalmologists can opt to monitor the tumor’s growth. If growth is detected or symptoms increase, treatment may be utilized at that time. Biopsy of the tumor is performed for gene expression profiling which gives accurate information regarding the chance of metastatic spread in the future and provides a guideline on how frequent monitoring should occur for the liver and lung.

Radiation can also be used to treat ocular melanoma. The most common type of radiation is brachytherapy, or plaque therapy. The treatment involves attaching a small disk, or plaque, on the surface of the eye. The plaque contains I-125 radiation and is worn for several days.
Proton beam radiation may be an option as well.

Surgical treatments may be necessary. These treatments may removal of the eye in advanced cases with large tumors.

An Introduction to Diabetic Retinopathy

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Diabetic Retinopathy
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Since 1974, Retina Associates has provided specialized care for patients in Tucson and southern Arizona. Dr. Cameron Javid and the team at Retina Associates have welcomed numerous individuals with diabetic retinopathy, one of the most common conditions that the practice treats.

Diabetic retinopathy occurs when an excess of sugar in the blood causes damage to the blood vessels in the retina. In the early stage of the disease, known as background or nonproliferative diabetic retinopathy (NPDR), these damaged blood vessels may begin to leak into the retinal tissue.

NPDR is often mild and typically asymptomatic, though it may lead to the closing of capillaries in the retina and a subsequent blurring of vision. Patients may also experience a swelling of the macula, a small region at the center of the retina that is responsible for central and precise vision. Swelling in this region stands out as the most frequent cause of vision loss in patients with diabetes.

Some patients with diabetic retinopathy develop the proliferative form of the disease, which manifests with retinal blood vessels closing and impeding blood flow. Although the retina does then respond by creating new blood vessels, these vessels are structurally abnormal and do not allow for sufficient blood flow.

Proliferative diabetic retinopathy (PDR) can lead to more severe loss of vision as compared to NPDR. Patients can develop a retinal detachment or a neovascular glaucoma, the latter of which occurs when new blood vessels grow in the iris and block the flow of fluid from the eye. As a result, pressure builds up in the eye and leads to damage of the optic nerve.

Patients with PDR are also at risk of vitreous hemorrhage, or the leaking of blood into the vitreous gel located in the central portion of the eye. This leakage blocks light rays from reaching the retina and causes varying degrees of vision loss. Vision often returns when the leakage clears, though the loss may be permanent if macular damage is present. Therefore, it’s extremely important for all diabetics to obtain regular exams of their retina.