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Macular degeneration is also known as age-related macular degeneration, AMD, or ARMD. It occurs when the central portion of your retina, the macula, wears down, resulting in vision loss.
Your macula is responsible for focusing central vision in the eye. It controls your ability to read, drive, recognize faces and colors, and see objects in refined detail.
When the cells of your macula deteriorate, you begin to lose central vision, but retain peripheral vision. The prevalence and severity of AMD increases with age.
Macular degeneration is one of the leading causes of vision loss. It affects over 10 million Americans. It is most present in Caucasians.
There are two types of macular degeneration: dry (non-exudative) and wet (exudative). The majority of cases, 80 to 90 percent, of all AMD are the dry form.
People who have dry AMD will develop yellow deposits, called drusen, in their macula. At first, a few small drusen may not affect your vision. However, as they increase in size and number, they may cause visual distortion or dimness, especially while reading.
As the eye disease progresses, the light-sensitive cells in your macula wear away and eventually die. This can cause blind spots in the center of your vision and may ultimately result in the loss of central vision.
In wet AMD, the blood vessels underneath your macula begin to leak blood and other fluids into the back of the eye. This distorts your vision and causes straight lines to appear wavy.
Eventually, these abnormal blood vessels and their fluids will form scars, resulting in a permanent central vision loss. Wet AMD often results in more severe vision loss than dry cases.
In rare cases, approximately 1 in 20,000, AMD will develop in children or teenagers. This is known as Stargardt disease. While Stargardt disease is similar to AMD, it is thought to be caused entirely by genetics.
There are three stages of macular degeneration:
Most people do not experience vision loss in the early stage. An eye doctor can diagnose early AMD during an eye exam by spotting medium-sized drusen (yellow deposits) in the macula.
In this stage, there is usually some vision change or loss. However, not everyone will experience vision problems yet. Optometrists will perform an eye examination to look for larger drusen or pigment changes in the retina.
During late AMD, vision loss has become noticeable. There may be permanent thinning or scarring of cells.
In the early stages of AMD, you may not recognize any symptoms. They often go unnoticed until both eyes are affected, or your eyesight deteriorates significantly.
Signs of AMD include:
If you experience any of these symptoms, you should schedule an eye exam immediately. You should also undergo an annual eye examination, especially after the age of 50, to maintain proper eye health care.
AMD is a little-understood disease. The exact cause of macular degeneration is still unknown. Researchers believe there are genetic components as well as environmental factors that may affect your susceptibility to AMD.
AMD is diagnosed during a complete eye examination. If you are at risk for AMD, they may perform one or more tests to check for signs of macular degeneration:
Your optometrist may ask you to look at an Amsler grid. This will test for deficiencies in your central vision. If some of the straight lines in the grid appear wavy, broken, or faded, this may be a sign of macular degeneration.
Your eye doctor may dilate your eyes by administering eye drops. They will then use a special instrument to examine the back of your eye. They will be looking for drusen, the yellow deposits that form under the retina. These are a sign of macular degeneration.
This involves your doctor injecting a colored dye into your arm. The dye travels to the blood vessels in your eye. A camera will take several pictures as the dye highlights the blood vessels. The images will reveal if you have abnormal blood vessels or changes in your retina.
This is a non-invasive imaging procedure that will take detailed cross-sectional images of your retina. It will identify areas of retinal thinning, thickening, or swelling.
While doctors are not one hundred percent certain of AMD's causes, there are certain preventative measures you can take to decrease the risk of developing severe macular degeneration in the future, including:
There is no known cure for macular degeneration. For dry AMD, there are no FDA approved treatment methods. However, there are many treatment options depending on the type and severity of your condition.
The Age-Related Eye Disease Study (AREDS) by the National Eye Institute, has found that, in clinical trials, nutritional supplements have benefited people with intermediate or late AMD.
The original AREDS formula contains:
Nutrient | Amount |
---|---|
Vitamin C | 400 mg |
Vitamin E | 400 IU |
Beta-carotene | 15 mg |
Copper (cupric oxide) | 2 mg |
Zinc | 80 mg |
The AREDS2 formula was modified to remove beta-carotene, which increased smokers’ chances of lung cancer:
Nutrient | Amount |
---|---|
Vitamin C | 400 mg |
Vitamin E | 400 IU |
Copper (cupric oxide) | 2 mg |
Lutein | 10 mg |
Zeaxanthin | 2 mg |
Zinc | 80 mg |
The vitamins C and E, beta-carotene, zinc, copper, lutein, zeaxanthin, and omega-3 fatty acids have all been linked to reducing the risk of vision loss.
Your doctor may prescribe you nutritional supplements containing antioxidant vitamins to combat the progression of AMD.
Laser therapy can reduce the progression of wet AMD. In this treatment, an ophthalmologist injects a dye to guide the laser to the affected areas. The procedure seals off leaking blood vessels and leaves healthy ones alone.
However, laser therapy has not proven successful long-term, and this procedure will likely need to be repeated.
Anti-VEGF drugs are currently the most common and effective treatment for AMD. VEGF stands for vascular endothelial growth factor. This drug is injected into the eye and stimulates the growth of new blood vessels.
This procedure takes approximately fifteen minutes and has shown great potential in slowing down and even preventing macular degeneration progression.
Low-vision devices improve vision for people who suffer from poor vision. They can be optical, non-optical, or electronic. There are a wide variety of instruments and techniques available.
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