Age-related Macular Degeneration (AMD) is a disease, which causes visual loss in patients over the age of 50. The vision loss is painless, usually gradual and not severe, but can be variable among patients. Macular degeneration is named for the macula, the part of the retina responsible for central vision. Peripheral vision is usually not affected by macular degeneration and often, this illness will go unnoticed until a patient engages in a task such as driving or reading, in which central vision is crucial. As the term “degeneration” implies, the illness becomes more noticeable over time and tends to get worse with or without treatment. Macular degeneration typically affects adults over 65 and the main risk factors for the disease are increasing age and genetics (family history of macular degeneration). Smoking, high cholesterol and hypertension are also risk factors. This disease does not cause total blindness and most macular degeneration patients can see well enough to care for themselves.
Because macular degeneration usually occurs in one eye before the other, a patient may only notice the symptoms upon covering one of their eyes. To test for Macular degeneration, your eye care provider may use an Amsler grid macular degeneration test (a test that can also be done at home by the patient to monitor symptoms).
Little is known about the causes of macular degeneration, except that it pertains to aging in specific retinal layers. Macular degeneration occurs in two forms: exudative (“wet”) and atrophic (“dry”). Most cases, 90% in fact, are dry– the less severe form. However, dry macular degeneration occasionally evolves into the more severe wet macular degeneration. Wet macular degeneration causes a faster and more severe form of visual loss.
As the population’s life expectancy grows, macular degeneration is becoming a greater health concern and more medical researchers are devoting more energy to treating this illness. Unfortunately, macular degeneration has few treatment options. However, the Age-Related Eye Disease Study (AREDS 2) shows that anti-oxidants and caratenoids such as Vitamins C, Vitamin E, Zeaxanthin, Lutein and minerals such as copper and zinc, help slow the disease’s progression when it reaches the intermediate phase (AREDS 2 eye vitamin).
For wet Macular degeneration, laser photocoagulation or photodynamic therapy (PDT) may be an option. In this particular treatment, an intense light is used to focus on and close areas of leakage that are linked to wet macular degeneration. Most patients are not a candidate for laser or PDT unless the leakage is outside the center of the macula or the leakage is unresponsive to the standard medicine injections (discussed momentarily). In cases where the leakage is within the center of vision, patients may consider another treatment. One approach may be the new class of drugs known as anti-VEGF (anti vascular endothelial growth factor) that are injected into the vitreous cavity. These drugs include:
Injecting these medicines into the center of the eye helps reduce the prominence of actively growing blood vessels in the outer retina. This in turn can reduce the risk of further vision loss and in some patients, actually improve their vision. All forms of wet macular degeneration treatment are most effective when applied early on in the disease process. The leakage is easiest to target when localized, as in the early stages of macular degeneration. Therefore early diagnosis is key to managing and preventing the progression of this disease.
If you feel you have taken the Amsler grid test and are concerned about your results, or have other reasons to suspect you are suffering from macular degeneration contact Retina Associates of Orange County today. Our qualified retinal specialists can help restore your sight.