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Macular Degeneration

Macular Degeneration or Age Related Macular Degeneration (ARMD) is a disease that causes progressive damage to the macula. The Macula is the central part of the retina that allows us to see the fine details. When the macula degenerates, people experience blurring or darkness in the center of their vision. Macular degeneration leads to loss of central vision needed for activities requiring fine vision such as reading, driving and recognizing faces. The words on a page may look blurred, or straight lines may look distorted. Peripheral vision is retained in macular degeneration; therefore blindness (inability to see all light) does not occur even in advanced/end-stage macular degeneration. However, the central vision loss impairs proficiency in performing most activities of daily living and can make it more difficult for people to live independent lives.

Dry Macular Degeneration

Dry Macular degeneration is the more common form of the disease and accounts for 85-90% of all AMD. The classic lesion in dry macular degeneration is geographic atrophy that causes central visual loss. There is no treatment, laser or other, that can halt or reverse the progression of dry macular degeneration.

Precursor lesions that can herald to the development of A.R.M.D. are small yellowish macular lesions called ‘drusen’. Drusen are pale yellow deposits between the retinal layers.

Many people over the age of 55 begin to display some drusen as they age. Drusen are not of significance to your vision unless they are large or confluent. If you have Drusen, we may ask you to schedule eye examinations more frequently to monitor them as there is some possibility that Dry Macular Degeneration will progress to Wet Macular Degeneration over a period of time.

Wet Macular Degeneration

Wet Macular Degeneration only accounts for about 10-15% of cases of Macular Degeneration but is likely to cause far more serious vision loss that Dry Macular Degeneration. Wet Macular Degeneration is characterized by an abnormal growth of new blood vessels under the retina. These new blood vessels are called “neovascularization”. Neovascularization is not made up of normal blood vessels in that they are unusually weak in their structure. In fact, they are quite fragile and are prone to be leaky and can easily break and bleed. If leakage occurs, the macula may begin to swell. If neovascularization breaks and bleeding occurs, it can result in scarring. Scarring of the macula can cause rapid, severe, and irreversible loss of central vision.

Treatment Options for Macular Degeneration

If Wet Macular Degeneration is diagnosed early enough, there are a number of treatment options that may help to slow or even halt the progression of vision loss. However, patients must understand that once the macula has been damaged, there is no treatment that currently can reverse that damage and the associated loss of vision. Early diagnosis and treatment to prevent or halt vision loss must be the approach that we take.

Nutrition and Age Related Macular Degeneration

Clinical trials have demonstrated a relationship between nutrition and the likelihood of developing Macular Degeneration. It appears that people who have a diet rich in fruits and vegetables, particularly green leafy vegetables, have a considerably lower incidence of Macular Degeneration. It is not yet clear whether taking dietary supplements can prevent progression in patients with existing macular disease, but it does seem clear that supplements can reduce your risk of Macular Degeneration. The Age Related Eye Disease Study, which was sponsored by the National Eye Institute (http://www.nei.nih.gov/amd/summary.asp), showed that taking high levels of antioxidants and Zinc could reduce the risk of developing Age Related Macular Degeneration by approximately 25%. A very specific formulation was used in this study, so before taking any course of vitamin or antioxidant supplements, you should fully discuss the risks and benefits with the doctor.

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