MACULAR DEGENERATION

Age-related macular degeneration (AMD) is a chronic disease of the macula, the central area of the retina, and is the leading cause of irreversible vision loss in the developed world.

AMD is classified into “dry” and “wet” forms. Dry AMD ranges from the presence of deposits under the retina known as drusen, to severe geographic atrophy. Vision loss could range from being clinically insignificant to very severe. Wet or neovascular AMD is characterized by growth of abnormal blood vessels from the retina or more commonly the underlying choroid into the subretinal space, leading to fluid leakage or subretinal hemorrhage. Wet AMD develops in only 10%-15% of eyes with AMD, but it is responsible for most of the vision loss from macular degeneration.

The prevalence of AMD increases with age. There are a number of additional risk factors for the development of AMD development and its progression. The greatest modifiable risk factor is smoking, which is linked to both incidence and progression of AMD. Smoking cessation should be strongly encouraged in all patients. Other modifiable risk factors include eating a diet high in saturated fat and being overweight. Non-modifiable risk factors include being over 5o years of age, having a family history of macular degeneration, and being Caucasian.

Dry macular degeneration symptoms usually develop gradually and without pain. Symptoms may include visual distortions, where straight lines may seem wavy. There may also be reduced central vision, or the need for brighter light when reading or doing close work. People may also notice decreased brightness of colors and difficulty recognizing faces.

Many symptoms of wet macular degeneration are similar to that of dry macular degeneration. Wet macular degeneration may have developed if there is a sudden onset or rapid worsening of symptoms, a new blind spot in your vision, or a general increase in blurriness.

It’s important to have routine eye exams to identify early signs of dry and wet macular degeneration. Currently there is no treatment for dry macular degeneration but you can take steps to slow the progression. The following measures may help reduce progression of macular degeneration. If you have conditions affecting your heart or blood vessels it is important to take your medication and follow your doctor’s instructions for controlling the condition. If you do smoke it is important to discontinue smoking. Maintain a healthy weight and exercise regularly. Eat a healthy diet, consisting of fruits, leafy greens, and nuts and fish high in omega-3 fatty acids. Also, certain vitamins and antioxidants have been shown to decrease the progression of macular degeneration.

Wet macular degeneration can be treated with medications that stop the growth and leakage of the abnormal vessels that grow under the retina. These medications, which are the first line treatment for wet macular degeneration, include avastin, Lucentis and Eylea.

It is important to monitor your vision daily. If you notice any changes in your vision it is important to notify your doctor. Your doctor may give you a grid called an Amsler grid, where you can see if there are changes in the straight lines like increased distortion or blurring.