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Macular Degeneration

Macular DegenerationMacular degeneration, sometimes called ARMD or age-related macular degeneration or simply AMD, is an eye disorder that damages the center of the retina, which is called the macula. This makes it difficult to see fine details. Other than heredity, scientists aren’t sure what causes AMD, but the disease is most common in people over the age of 60.  Other factors that seem to increase risk include Caucasian, females, high-fat diet, obesity and cigarette smoking.

The macula is the part of the retina that sharpens our vision and gives it more detail. When the area around the blood vessels that supply the macula is damaged, the macula is in turn also damaged.  There are two phases of AMD:  termed dry and wet. Most AMD starts with dry macular degeneration; only about 10% progresses to the wet stage. Essentially, when the blood vessels under the macula become thin and brittle, small yellow deposits called drusen form. Eventually the drusen, as they increase in number and size, start to cloud the central vision of the eye.  If the wet version occurs, it is caused by the blood vessels leaking blood and fluid into this portion of the eye and causing vision loss at a much higher rate.

Symptoms

Although at first you may not have any symptoms from macular degeneration, as the disease progresses, your central vision may be affected. The most common symptom in dry AMD is blurred vision, limited to the center of the field of vision. During this stage, objects in the central vision start to appear distorted and dim with faded coloration. A patient can see well enough to perform without trouble, but may find reading print or seeing other details troublesome.

Eventually, you may find you need more light to read or perform everyday tasks. The blurred vision in the center gradually grows and darkens. Finally, you may not be even be able to recognize faces without being very close up. Interestingly enough, AMD does not affect peripheral vision, so you will never completely lose your vision.

If you are over age 60 and you’ve had changes in vision, your eye care provider will do an examination. During the exam, the doctor will use drops to enlarge (dilate) your pupils, and a special lens to view your retina and optic nerve. He will look for changes in blood vessels and the drusen that is associated with dry macular degeneration.

Tests that may also be performed include viewing the Amsler grid, Fluorescein angiogram and Optical Coherence Tomography (OCT).

Treatment

Although no treatment exists for dry macular degeneration, there is a combination of vitamins, antioxidants and zinc which may slow the progression of the disease. This combination of vitamins is often called the AREDS” formula. The recommended supplements contain: 500 milligrams of vitamin C, 400 International Units of beta-carotene, 80 milligrams of zinc, and 2 milligrams of copper.

Treatment for wet macular degeneration may include:

  • Laser surgery (laser photocoagulation): A small beam of light destroys the abnormal blood vessels,
  • Photodynamic therapy: A light activates a drug that is injected into your body to destroy leaking blood vessels and
  • Special medications that slow the formation of new blood vessels in the eye (anti-angiogenesis, anti-VEGF therapy): Drugs such as bevacizumab (Avastin) and ranibizumab (Lucentis) are injected into the eye to stabilize or improve vision.
  • Low-vision aids (such as special lenses) and therapy:  Can help you use the vision that you have more effectively, and improve your quality of life.

There is no prevention of macular degeneration, but the following lifestyle factors can reduce your risk of developing the condition:

  1. Don’t smoke.
  2. Eat a healthy diet that is high in fruits and vegetables and low in animal fat.
  3. Exercise regularly.
  4. Maintain a healthy weight.

Finally, see your eye care professional regularly for dilated eye exams.

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