Causes of Age Related Macular Degeneration (AMD)
Age Related Macular Degeneration (AMD) is a degenerative condition of the Macula related to age, genetics and diet. This results in a slow but progressive loss of function. The visual effects of Macular Degeneration can be relatively minimal with a mild “dimming” or “distortion” of your central vision, or very profound resulting in a complete loss of your central vision. However, while AMD can cause legal blindness, it DOES NOT result in total blindness. Its effects are limited to central vision and does not cause any loss of your peripheral vision.
Types of Age Related Macular Degeneration (AMD)
There are two main types of Age-Related Macular Degeneration (AMD): “Dry Macular Degeneration” and “Wet Macular Degeneration”.
Dry Macular Degeneration
Dry Macular Degeneration, also called Atrophic Age-Related Macular Degeneration, is the most common type of Age Related Macular Degeneration, making up some 85-90% of cases. Dry AMD results in a slow, gradual progressive “dimming” of your central vision. If you have Dry Macular Degeneration, during your eye exam the doctor will see small, yellow colored deposits between the retinal layers, which are called drusen. Many people 50 years of age or older begin to display some drusen; they are not a direct problem for your vision unless they are large or confluent. If you have drusen, your doctor may ask you to schedule eye exams more frequently or order additional testing such as Optical Coherence Tomography (OCT) or Intravenous Fluorescein Angiography (IVF) in order to evaluate and monitor them.
Wet Macular Degeneration
Wet Macular Degeneration is far more likely to cause serious vision loss than Dry Macular Degeneration but fortunately only accounts for about 10-15% of cases. Wet Macular Degeneration is characterized by a growth of abnormal blood vessels under the retina called “neovascularization”. These blood vessels are fragile and prone to be leaky and can easily break and bleed. If leakage occurs, the Macula may actually begin to swell. If the new blood vessels break and bleeding occurs, it can result in scarring. Scarring of the Macula can cause a sudden, rapid and severe loss of central vision, which is irreversible.
Macular Degeneration is a complex eye disease. Early Diagnosis and treatment may help preserve your vision.
Diagnosis and Treatment of Age Related Macular Degeneration
Early diagnosis and treatment is the key to preventing vision loss from Age Related Macular Degeneration (AMD). If you are over the age of 40-45 and especially if anyone in your family has been told that they have macular degeneration, it is a good idea to have a complete eye exam each year. Make certain that you tell the eye doctors and staff at Center for Sight if you have a family history of Macular Degeneration. During your eye examination, eye drops will be put in your eyes to dilate your pupils to carefully examine the macula and retina using various types of instruments and sources of high magnification.
Additional tests that your doctor may perform to further evaluate the macula during your eye exam can include checking your color vision and an Amsler Grid Test, which helps identify distortion of your central vision. Distortion may be an indication of swelling or fluid in the macula. Your doctor may recommend that you take an Amsler Grid home and use it each day to check for changes in your vision. If necessary, your doctor will supply you with an Amsler Grid and instructions on how to use it.
If your doctor detects any signs of macular degeneration or if they believe that you may be at risk, you will be scheduled to see Center for Sight’s Medical Retinal Specialist, Robert Kelly, M.D. Dr. Kelly may find it necessary for you to have some specialized color pictures taken of the macula and retina, an Intravenous Fluorescein Angiogram (IVF) and/or Optical Coherence Tomography (OCT) test.
These tests give Dr. Kelly a considerable amount of information regarding whether certain types of treatments such as Intravitreal Vascular Endothelial Growth Factor (VEGF) Inhibitor Injections might help stabilize your vision and prevent vision loss. Today, thanks to the advances in treating Wet Macular Degeneration, it may be possible to avoid significant vision loss.
Treatment of Age Related Macular Degeneration
If you have evidence of “neovascularization”, or growth of new blood vessels, and thus Wet Macular Degeneration, it is possible to inject anti-VEGF medications into your eye to block or inhibit a specific protein called “Vascular Endothelial Growth Factor” (VEGF) that causes the “neovascularization” to occur in the eye. Most anti-VEGF medications have been developed and FDA approved with specific indications to treat Wet Macular Degeneration. Each of these drugs works by inhibiting Vascular Endothelial Growth Factor (VEGF) so that there is little or no stimulus to grow new blood vessels in the Retina.
Usually, they need to be repeated every four to eight weeks. Clinical studies of these anti-VEGF Injections indicate that when given monthly to patients who have evidence of new blood vessel formation, over 90% of patients will maintain their vision.
The anti-VEGF Injections are performed by prescription only and injected only by Center for Sight’s Medical Retinal Specialist, Robert Kelly, M.D. If anti-VEGF Injections are an option for you, Dr. Kelly will spend the time necessary to thoroughly review the risks, benefits and side effects with you before you decide to proceed.
Age Related Macular Degeneration & Diet
There are several clinical studies that have strongly suggested that nutrition may play a role in the likelihood of developing Macular Degeneration. Simply stated, it appears that people who have a diet that is rich in fruits and vegetables—particularly green leafy vegetables—have a considerably lower incidence of Macular Degeneration. They also indicate that taking dietary supplements can prevent progression in patients with existing macular disease, but it does seem clear that certain dietary supplements can reduce your risk of Macular Degeneration. The Age-Related Eye Disease Study (AREDS), which was sponsored by the National Eye Institute, showed that taking high levels of antioxidants and Zinc could reduce the risk of developing Age Related Macular Degeneration by about 25%. This is not a cure, but we need to consider this as a possible way to help patients who are at risk for Age Related Macular Degeneration prevent vision loss.
A very specific formulation was used in this study.
BEFORE patients begin taking any course of vitamin or antioxidant supplements, you should fully discuss the risks and benefits with Dr. Kelly, who will determine in consultation with your family physician or Internist if necessary, whether this is safe and effective for you.
Macular Degeneration is a complex eye disease. Fortunately, with early diagnosis it is possible to have treatment options available to help preserve your vision.
If you, a family member or friend needs an eye exam, diagnosis or treatment of Macular Degeneration (AMD) or have not had a recent eye exam and feel that you may be at risk for Macular Degeneration (AMD), please schedule an appointment by calling Center for Sight in Fall River, Massachusetts at 508-730-2020.
