Macular Degeneration

Overview

Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss, affecting  5% of Americans 65 or older according to the National Health Interview Survey. It destroys a person’s sharp, central vision, which is needed to see objects clearly and to do things like reading and driving.

Warning Signs & Symptoms

There are two kinds of AMD: dry or wet. For dry AMD, the most common of the two, the most common early sign is blurred vision. As fewer cells in the macula are able to function, people will see details, like words in a book, less clearly in front of them. Often this blurred vision will go away in brighter light. People may also see a small but growing blind spot in their field of vision. The vision changes for dry AMD tend to develop slowly. If only one eye is affected, the other may compensate.

For wet AMD, the classic early symptom is that straight lines appear crooked. This results when fluid from the leaking blood vessels gathers and lifts the macula, distorting vision. A small blind spot may also appear in wet AMD, resulting in the loss of one’s central vision.

Diagnosis

If you notice any of these symptoms, check with your eye doctor. A comprehensive eye exam includes tests to detect macular degeneration. If your doctor sees any signs of AMD, he or she will likely take special photographs of your eyes with fluorescein angiography and optical coherence tomography (OCT) to aid in diagnosis and treatment. Early detection of AMD is key to slowing vision loss.

Treatment/Procedures

While there is no cure today for AMD, there are several treatment options for wet AMD that slow the disease progression. For wet AMD, treatment most frequently begins with injections of drugs that reduce blood vessel growth (Avastin, Lucentis, Eylea).  Photodynamic therapy and thermal laser frequently supplements these injections. Very few treatments exist to treat dry AMD, however there are new drugs in clinical trials.

Prevention

Recent studies indicate about half of AMD cases seems to be genetically related. Aging also increases the risk, with the risk particularly high among whites and females. Certain nutrients, including zinc, leutein, and vitamins A, C, and E seem to lower the risk of AMD and slow down it’s progression.

Smoking greatly increases your risk of developing AMD. If you have a family history of macular degeneration, stop smoking and get a comprehensive eye examination from an ophthalmologist (M.D.).