Macular Degeneration

As we age our risk of macular degeneration (ARMD) increases. There are two main types…wet and dry. Wet is when blood vessels in the retina start to leak and fluid builds up in the retina causing swelling and vision loss. Dry is a gradual deterioration of the cells in the retina which slowly die off.

When I qualified several decades ago any patient presenting with “wet” ARMD was considered untreatable and was simply told, “nothing can be done, but don’t worry, you will never go completely blind. You will have your peripheral vision to help you get around”.

Patients presenting with “dry” ARMD were told their vision would gradually deteriorate but would probably take many years to deteriorate significantly. In both cases there was no treatment that could be offered.

In the 80s researchers found that diet had a beneficial effect on the rate of change in dry ARMD. In the 90s multivitamin supplements were developed which dramatically slowed the rate of deterioration in dry ARMD and in the early noughties drugs used to treat bowel cancer by stopping blood vessels leaking were found to help patients with wet ARMD. These two modalities – multivitamin supplements and anti-VEGF injections have remained the mainstay of treatment for many years. Neither offers a cure but can slow down and in some cases stop any further loss of vision.

The latest research is extremely exciting. Researchers are now trying to use stem cells to replace the damaged cells in wet ARMD and using gene therapy to treat dry ARMD. Both treatments seem to offer a hope of reversing the loss of vision caused by ARMD.

Until then we cannot halt the aging process but we can all eat healthier diets rich in anti-oxidants (fruits and vegetables) and cut out smoking and excessive alcohol consumption.