Macular Degeneration

AGE-RELATED MACULAR DEGENERATION (ARMD or AMD)

What is ARMD?

Macular degeneration is a deterioration the central area of the retina called the macula. The macula is responsible for our detailed vision. Age-related Macular Degeneration typically occurs in older adults. It can affect both eyes and is a progressive disease that results in loss of central vision. Macular Degeneration alone does not result in total blindness.

Types of AMD

There are two forms of AMD. The first form, dry AMD, is typically due to the formation of small deposits in the macula. It will generally cause a slow, progressive loss of central visual acuity. The second form, wet AMD, is characterized by sudden, acute loss of vision. Abnormal blood vessels form underneath the retina grow and leak fluid and blood, resulting in permanent damage to the retina.

The risk for AMD is increased for those with a family history of AMD, those who smoke and for Caucasian patients.

Symptoms of AMD

AMD has few symptoms in the early stages and may not be noticeable. However, it can cause blurred or distorted vision in which straight lines appear curved.

Detection of AMD:

Only a comprehensive dilated exam can detect AMD. Your doctor can perform this exam which may include:

  • Viewing the retina with special magnification
  • Amsler grid: A test that looks like graph paper
  • Optical Coherence Tomography (OCT): A non-invasive and painless imaging technique that captures images of the macula at microscopic levels.
  • Fluorescein Angiography (FA): A vegetable based dye is injected into the arm, and produces images of the retinal circulation to identify abnormal blood vessels.

Treatment for AMD

There is currently no cure for AMD; however, we have a few ways of managing it. We recommend getting a dilated exam, as there may be no initial symptoms. AMD occurs less often in people who exercise, avoid smoking and eat nutritious foods, including green leafy vegetables and fish.

  • Vitamin supplements: Antioxidant vitamins may reduce the impact of AMD in certain groups of people. The Age-Related Eye Disease Studies (AREDS) clinically tested a combination of Vitamin C, Vitamin E, Zinc Oxide, Copper, beta-carotene, lutein and Zeaxanthin. A number of manufacturers offer supplements based on the studies and the label may refer to them as “AREDS” or “AREDS2.” Consult your eye doctor to learn if supplements are recommended for you; however, no prescription is necessary.
  • Intra-ocular injections: A class of drugs known as anti-VEGF is the primary treatment for wet AMD. You may hear names such as Avastin, Lucentis or Eylea. Patients typically require injections every 4-6 weeks until the leakage is brought under control. The goal of the injections is to improve, stabilize and optimize vision.
  • Laser Therapy: This form of treatment is not used as often, though there are certain patients that may benefit from it. It can also be used alongside intraocular injections
  • “Hot” laser: It involves aiming an intense “hot” laser at the abnormal blood vessels in the eyes to destroy them.
  • “Cold” laser: It is a combination of a light-sensitive intravenous drug (Visudyne or Verteportin) and the light from a laser to activate the drug.
  • Intra-ocular surgery: Various complex forms of intraocular surgery are available for complicated forms of bleeding wet AMD.
  • Vision rehabilitation and low vision aids: For those who have developed vision loss from AMD, there are an array of visual aids available. There are also therapists who can assist with learning how to maximize current vision and master the functions of daily living.

Your doctor will coordinate your care for you so that you see the correct specialist when needed.


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