Macular degeneration

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 11, 2016
StartDiseasesMacular degeneration

Macular degeneration is an eye disease that is incurable but treatable. Involving the deterioration of the retina, the patient with macular degeneration experiences visual impairment and possibly blindness. Macular degeneration is also called age-related macular degeneration or AMD. Due to the severe impact it can have on a person's visual perception, it’s a serious health concern.

Contents

Definition & Facts

Macular degeneration is a condition that develops within the eye that causes vision problems and potential blindness. A small area near the retina called the macula is affected. It causes normally sharp vision to deteriorate.

There are two categories: dry AMD and wet AMD. Dry AMD is present when there are yellow-color deposits on the retina. Wet AMD is caused by blood vessels that become abnormal and begin to leak blood into the retina of the eye. 90% of those with AMD have the dry form.

Some people have macular degeneration for many years without any issues as it can progress very slowly for some. Others are diagnosed and their vision becomes worse very quickly. Those over 50 are almost twice as likely to develop macular degeneration than anyone in a younger age range.

Symptoms & Complaints

Symptoms rarely occur during the early onset of this disease. More often than not, a person is unaware of the presence of macular degeneration until experiencing symptoms such as straight lines appearing distorted. Even this symptom is sometimes ignored for a long time because it can easily be explained as the result of exhaustion, exposure to sunlight or a different eye-related issue.

Other symptoms of macular degeneration include a distorted center of vision, white outs in the middle of vision and dark and blurry areas at the center of vision. Sometimes those with AMD experience impaired color perception, which may be mistaken for sudden color blindness. Other symptoms include blind spots, moving spots that can be either black or white, and the appearance of certain shapes as different.

Causes

There are certain factors that contribute to the increased risk of macular degeneration as a whole, but none are the complete cause of this age-related disease. Smoking can increase a person’s risk by more than double. Caucasians are more at risk than any other race, and genetic factors and family history play a role. No one knows what causes either wet AMD or dry AMD to form - only that it seems to develop with age.

Diagnosis & Tests

Most cases of macular degeneration are diagnosed during the course of an annual eye examination. Even those without vision problems should seek an annual eye exam from a licensed optometrist to check for the onset of vision problems and eye disease. An optometrist might notice drusen in the eye, which appear as small, yellow deposits that sit beneath the retina and alert the doctor to the onset of AMD.

If drusen are detected by a doctor, patients are asked to view an Amsler grid which is a test that shows a series of straight lines. If they appear wavy to the patient, it may demonstrate macular degeneration. Additionally, some patients are asked to undergo a fluorescein angiography and/or and optical coherence tomography to detect the presence of macular degeneration.

Treatment & Therapy

Treatment cannot cure AMD. However, there are many treatments available that might slow down the progression of blindness. One treatment might be the use of angiogenesis inhibitor drugs. These are designed to block leakage from blood vessels into the eye to stop wet AMD. It’s injected directly into the eye.

Another treatment is laser coagulation therapy to cauterize abnormal blood cells causing leakage. Photodynamic laser therapy helps slow the progression of wet AMD. It involves an injection into a patient’s bloodstream that damages abnormal blood vessels. Once damaged, a laser is used to activate the medication that has been injected into the eyes to help kill the abnormal cells and slow down potential vision loss.

Research suggests that the use of vitamin C, vitamin E, as well as zinc and copper can help slow down the progression of vision loss as a result of AMD. Some doctors prescribe supplements to patients designed specifically to slow down the damage to the eye caused by this disease.

Prevention & Prophylaxis

The most important preventative measure is an annual eye exam. While it might not prevent a patient from developing MD, it can catch the disease early and allow doctors to begin treating it and slowing down the progression. Annual exams are recommended for all.

Smokers are more likely than anyone else to develop AMD, which is why optometrists recommend that their smoking patients quit smoking as soon as possible and other patients refrain from taking up the habit.

Overall good health is another preventative measure, as a person with a healthy weight and active lifestyle is less likely to develop MD than someone overweight and sedentary. Omega-3 fatty acids are thought by some to reduce a person’s chances of developing this disease.