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Macular Degeneration

Overview

Age-Related Macular Degeneration (ARMD) is an age-related degeneration or deterioration of the retina. It’s medical condition which occurs when part of the retina, called the macula, is damaged. The macula is responsible for central, high resolution vision. When this is impaired, you are unable to decipher fine details, but your peripheral (side) vision is normal. For instance, imagine you are looking at a clock with hands. With ARMD, you might see the clock’s numbers but not the hands. ARMD is the leading cause of vision loss in people 50 years of age and older.

There are two types of ARMD: 

  1. ‍Dry ARMD: This form is quite common with 90% of ARMD patients having this type. Dry ARMD is when parts of the macula get thinner with age. There is also cellular debris called drusen that accumulate between the macula and choroid of the eye. 
  2. Wet ARMD: Although only 10% of all people with ARMD have this type, it accounts for 90% of all people with severe visions loss from ARMD. Wet ARMD is when new, abnormal blood vessels grow under the retina. These vessels may leak blood or other fluids, causing scarring of the macula. You lose vision faster with wet ARMD than with dry ARMD.

Symptoms

Many people don’t realize they have ARMD until their vision is very blurry. It’s important to have regular visits to an ophthalmologist who can look for early signs of ARMD before you have any vision problems.

Causes

You are more likely to develop AMD if you:

  • Eat a diet high in saturated fat (found in foods like meat, butter, and cheese)
  • Are overweight
  • Smoke cigarettes
  • Are over 50 years old
  • Have a family history of AMD
  • Are Caucasian (white)

Having heart disease is another risk factor for AMD, as is having high cholesterol levels.

Diagnosis

During an eye exam, one of our retina specialists may ask you to look at an Amsler grid. This grid helps you notice any blurry or blank spots in your field of vision. Your retina specialist will also put drops in your eyes to dilate (widen) your pupils and look through a special lens to see if there are changes in your retina and macula.  Y

Your physician may do fluorescein angiography to see what is happening with your retina. Yellow dye (called fluorescein) is injected into a vein, usually in your arm. The dye travels through your blood vessels. A special camera takes photos for the retina as the dye travels throughout its blood vessels. This shows if abnormal new blood vessels are under the retina.

Optical Coherence Tomography (OCT) is another way to look closely at the retina. A machine scans the retina and provides very detailed images of the retina and macula.

Treatment

Dry ARMD: Right now there is no way to treat the dry form of ARMD. However, people with a high accumulation of drusen or serious vision loss might benefit from nutritional supplements. Your retina specialist can tell you if vitamins and minerals are recommended for your dry ARMD. A large study found those people may slow their dry ARMD by taking these vitamins and minerals daily: 

  • Vitamin C (500 mg)
  • Vitamin E (400 IU)
  • Lutein (10 mg)
  • Zeaxanthin (2 mg)
  • Zinc (80 mg)
  • Copper (2 mg)

Wet ARMD: To help treat wet ARMD, there are medications called anti VEGF drugs. Anti-VEGF treatment helps reduce the number of abnormal blood vessels in your retina. It also slows any leaking from blood vessels. This medication is given through injections (shots) in your eye.  Laser surgery may also be used to treat some types of wet ARMD. Your eye surgeon shines a laser light beam on the abnormal blood vessels. This reduces their number and slows their leaking. Talk with your retina specialist about ways to treat your ARMD.

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