What is Age Related Macular Degeneration?

Age-related macular degeneration (ARMD) is a degenerative condition of the macula (the central retina). It is the most common cause of vision loss in the United States in those 50 or older, and its prevalence increases with age.

What are the types of ARMD?

ARMD is classified as either Wet (neovascular) or Dry (non-neovascular). The Wet ARMD is found in about 10% of patients who suffer from macular degeneration. This type occurs when new vessels form to improve the blood supply to oxygen-deprived retinal tissue. However, the new vessels are very delicate and break easily, causing bleeding and damage to surrounding tissue causing severe visual loss. This causes hemorrhage, swelling, and scar tissue but it can be treated with laser in some cases.

Dry ARMD, although more common, typically results in a less severe, more gradual loss of vision. The dry type is much more common and is characterized by drusen and loss of pigment in the retina. Drusen are small, yellowish deposits that form within the layers of the retina.

What Causes Macular Degeneration?

Macular degeneration may be caused by variety of factors. Genetics, Age, Nutrition, Smoking, and Sunlight exposure may all play a role.

What are the Signs and Symptoms of ARMD?

Macular degeneration varies widely in severity. In the worst cases, it causes a complete loss of central vision, making reading or driving impossible. For others, it may only cause slight distortion.Fortunately, macular degeneration does not cause total blindness since it does not affect the peripheral vision.

Loss of central vision may be gradual for those with the dry type but patients with the wet type may experience a sudden decrease of the central vision. ARMD patients have a difficulty in reading or performing tasks that require the ability to see detail. Some may experience distorted vision (Straight lines such as a doorway or the edge of a window may appear wavy or bent.)

How to Detect and Diagnose ARMD?

Your eye specialist will usually diagnose AMD after a comprehensive examination. Some special test like Fundus Fluorescein Angiography or Indocyanine Green Angiography may be needed to confirm the diagnosis of ARMD.

What is the Treatment of ARMD?

In selected cases of wet macular degeneration, Laser Photocoagulation is effective for sealing leaking or bleeding vessels. Unfortunately, laser photocoagulation usually does not restore lost vision, but it may prevent further loss.

Photodynamic therapy (PDT) is a treatment for the classic Wet form of macular degeneration. A drug comprised of a light-absorbing dye is injected into the bloodstream. A low intensity laser activates the drug, which helps destroy abnormally leaking blood vessels in the eye. Treatment with PDT does not prevent the re-growth of vessels and therefore vision may continue to deteriorate even if there is an initial improvement in vision. Treatments may need to be repeated up to three to four times to keep the abnormal blood vessels and leakage from reappearing.

Transpupillary Thermotherapy (TTT) is another laser procedure that can be used to treat cases of Wet ARMD. There are no external drugs used in conjunction with this laser treatment as there are in PDT. The treatment itself is relatively quick and painless; with the laser energy will be applied for about 60 seconds.

There is no proven medical therapy for dry macular degeneration. Several recent studies have indicated a strong link between Nutrition and the development of macular degeneration. It has been scientifically demonstrated that people with diets high in fruits and vegetables (especially leafy green vegetables) have a lower incidence of macular degeneration. More studies are needed to determine if nutritional supplements can prevent progression in patients with existing disease.

What to do if Diagnosed with ARMD?

The patients are encouraged to monitor his or her vision daily with an Amsler Grid. By checking your vision regularly, changes that may require treatment can be detected early.

Take a multi-vitamin with Zinc.(check with your eye physician for a recommendation). Antioxidants, along with zinc and lutein are essential nutrients, all found in the retina. It is believed that people with AMD may be deficient in these nutrients.

Incorporate dark leafy green vegetables into your diet.

Always protect your eyes with sunglasses that have UV protection. Ultraviolet rays are believed to cause damage to the pigment cells in the retina.

Quit smoking. Smoking impairs the body's circulation, decreasing the efficiency of the retinal blood vessels.

Exercise regularly. Cardiovascular exercise improves the body's overall health and increases the efficiency of the circulatory system.