Macular Degeneration

Macular Degeneration

Affecting nearly 2 million Americans, macular degeneration, often called age-related macular degeneration (AMD), is the leading cause of vision loss and blindness in older people. As the name suggests, the macula (the center part of the retina that provides sharp, central vision) degenerates. In most cases, macular degeneration is a slow, painless loss of vision.

While older people are usually the ones who develop macular degeneration, the progressive disorder appears to affect whites and females particularly. Many forms may be linked to the normal deterioration of eye tissue associated with older people, but there is also evidence of a genetic link to the disease. Routine eye exams of older patients can often detect signs of macular degeneration before actual symptoms are noticed.

In addition to aging, other risk factors associated with macular degeneration include smoking, heredity, high blood pressure, obesity and inactivity, side effects of certain drugs, and possible nutritional deficiencies.

While there is no known cure for macular degeneration, some treatments are known to delay its progress and even offer some vision improvement.

Macular degeneration is diagnosed as one of two forms: 1) dry, which is more common, or 2) wet, which is a more serious and potentially damaging form of the disease.

Dry AMD

Dry AMD is an early stage of the disease. Of those patients diagnosed with macular degeneration, about 85 to 90 percent are diagnosed with the dry form. Dry AMD is detected as yellow spots, called drusen, which accumulate from the debris of deteriorating tissue around the macula. This accumulation of tissue eventually creates a dark spot in the center of the image the eyes see.

While there is no FDA-approved treatment for dry AMD, research seems to indicate that certain nutrients (vitamins A, C, and E and zinc) may help prevent macular degeneration or slow its rate of progress. Because these vitamins are usually taken in higher doses, you should seek the advice of your ophthalmologist.

Wet AMD

Wet AMD is the more advanced and damaging form of the disease. In this form of AMD, new, abnormal blood vessels grow beneath the retina and leak fluid and blood, causing permanent damage to retinal cells.

Wet AMD is further classified as one of two general forms – classic or occult. Classic wet AMD is characterized by well-delineated outlines created by blood vessel growth and scarring. This form usually results in more severe vision loss. In the occult form, blood vessel growth and leakage beneath the retina are less pronounced.

Treatment

Presently, there is no cure for macular degeneration; however, several mitigation strategies can slow the disease’s progress and can often improve vision.

Treatments can include Lucentis®, Avastin®, Visudyne® Photodynamic Therapy and Thermal laser.

As mentioned elsewhere, certain risk factors (smoking, high blood pressure, obesity, and inactivity) can be minimized by the patient. Nutritional supplements may also be advised.

Because vision loss due to macular degeneration can be permanent, low vision devices such as magnifying lenses and bright lights provide some improvement. In addition, special low vision devices are available, and with training an AMD patient can learn to adjust.