DEAR DR. DONOHUE: You have discussed mostly dry macular degeneration. I was diagnosed with wet macular degeneration and was given intraocular injections of Lucentis. My vision has been restored to 20/20. Not everyone will achieve the same results, but please advise your readers about the wet kind of macular degeneration and that help for it is available. — Anon.

ANSWER: Of the two varieties of macular degeneration, the more common one is dry, accounting for about 90 percent of cases. Wet macular degeneration comes about from the sprouting of fragile blood vessels beneath the macula and the retina. Those blood vessels leak fluid and blood. That’s the reason for the “wet” part of its name. The macula is a small circle of the retina that provides clear, central vision — the kind needed for reading, driving and recognizing faces. Wet macular degeneration can progress much more rapidly than the dry variety, so there is urgency for prompt treatment in order to obtain good results.

One favorable aspect of wet macular degeneration is the number of effective treatments for it. Your treatment with Lucentis is a good example. That drug stops the sprouting of those fragile blood vessels. Another drug with the same mode of action is Avastin. Both work well. They’re both given as injections into the eye, a thought that turns most people’s stomachs. The procedure is painless, and a very thin needle is used. It’s not a traumatic experience.

Another treatment for wet macular degeneration involves injecting a dye into a vein. The dye eventually makes its way into the eye’s blood vessels. The doctor directs a laser into the eye, and the laser beam activates the dye, which destroys the troublesome blood vessels. The name of this procedure is photodynamic therapy.

There are other treatments.

Thanks for telling us about the good results you achieved with Lucentis.

DEAR DR. DONOHUE: I have a great-grandchild, 5 years old. He complains about tingling in his legs. The doctors say they cannot find anything wrong. Our concern is that there is a history of multiple sclerosis in his mother’s family, and I have a daughter who developed MS when she was 40.

This child has the most wonderful parents in the world. They are very loving and attentive. The boy eats well and is normal in every way. Would there be any connection between his tingling and MS? — V.M.

ANSWER: I can see why the specter of multiple sclerosis came into your thoughts. A strike against the diagnosis of MS is the fact that it usually appears between the ages of 20 and 40. MS in young children is quite rare. Another fact that makes the diagnosis less likely is that your great-grandchild has had no new symptoms and no change in symptoms. For the diagnosis of MS, a person has to have had two or more separate episodes of symptoms and signs reflecting involvement of two different brain areas.

If no relative has multiple sclerosis, the chances of developing it are 1 in 1,000. If a first-degree relative has it, the chances are 1 in 25 to 1 in 50. A first-degree relative is a parent, a brother, a sister or a child. If I understand your letter correctly, the child has no first-degree relative with the illness.

I believe it’s safe to assume this child does not have MS.

DEAR DR. DONOHUE: A friend of mine has inflammatory vessel disease. She feels like her skin is on fire. It started on her feet and moved up her legs and onto her torso. She is on prednisone, but the symptoms persist. What can you tell me about this disease? — K.S.

ANSWER: Inflamed blood vessels are called vasculitis. There are 14 different kinds of vasculitis, each with a unique set of signs and symptoms, and often requiring slightly different treatments. Prednisone, one of the cortisone drugs, is a medicine often used for vasculitis treatment and may be combined with other drugs. Your friend might not have been on this drug long enough to experience complete relief.

If you find out which of the vasculitis illnesses she has, write back. I’ll take it from there.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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