Macular degeneration, a common eye condition in people over the age of 50, is the leading cause of severe vision loss in Caucasians over 65 years old. With mild cases of macular degeneration, often there are no symptoms. The impact on one's vision is more noticeable, however, with more advanced cases.
Due to the dynamic nature of macular degeneration, the topic naturally elicits questions from those who are concerned, at risk or already diagnosed. Here are the answers to some of those most frequently asked questions.
Who is at risk?
Macular degeneration is more common as we age. Caucasians, as well as people with a family history of macular degeneration, are more at risk. Smoking also increases the risk of macular degeneration.
What are the symptoms?
When the macula does not function properly, you can have difficulty performing activities such as driving, reading, recognizing faces, or using a computer. You may notice a blurred spot in the center of your vision, or straight lines may look distorted. Macular degeneration usually does not affect the peripheral vision, and does not result in total blindness.
How is macular degeneration diagnosed?
Your ophthalmologist will dilate your pupils and carefully examine the macular directly with a microscope. Other testing, such as Ocular Coherence Tomography (OCT) or Fluorescein Angiography, may be beneficial.
OCT uses light waves to produce high definition images of the macula. OCT can help detect microscopic swelling or fluid in the macula. Fluorescein angiography uses a special retinal camera to delineate the abnormal vessels in wet macular degeneration.
What are the different forms of macular degeneration?
Macular degeneration is divided into 2 forms:
The dry form occurs in about 90% of patients, and is caused by aging and thinning of the macular tissues. Drusen, which are yellow deposits under the retina, start to accumulate. The vision loss is usually gradual.
Wet (neovascular or exudative)
The wet form is the more severe form, and accounts for about 10% of all patient with macular degeneration. The wet form develops from the dry form. In wet macular degeneration, abnormal blood vessels start to grow under the macula. They can bleed, leak fluid, or cause swelling in the macula. The wet form can be associated with more rapid and severe vision loss.
What can be done for wet macular degeneration?
Treatment for wet macular degeneration has undergone a revolution over past several years. The most common treatments for wet macular degeneration are injections of medications called AntiVEGF's (anti-vascular endothelial growth factor drugs).
Anti-VEGF drugs reduce the growth of the abnormal blood vessels in wet macular degeneration, and can reduce their associated leakage and swelling in the macula. The three commonly used drugs are Avastin, Lucentis, and Eylea. These drugs are injected directly into the eye in the office using anesthetic drops. They can be given as frequently as once a month, and usually multiple injections are required.
Are vitamins helpful?
A large scientific study called "The Age Related Eye Disease Study" (AREDS), evaluated the benefits of antioxidants and zinc. The AREDS2 study found that a high dose combination of vitamin C, vitamin E, lutein, zeaxanthin, copper, and zinc, lowered the risk for developing advanced macular degeneration by 25% in patients who already had intermediate stages of macular degeneration.
One such commercially available preparation is called Preservision AREDS2. Diet alone will not provide the same high levels of antioxidants and minerals as found in the AREDS formulation. Vitamin supplementation will not restore the vision lost from macular degeneration, nor will it cure macular degeneration.