Age-related macular degeneration is the most common cause of impaired reading in the United States for people 50 or older. It is a disease that typically affects both eyes, one usually worse than the other. The Retinal Pigment Epithelium (RPE) is the primary tissue affected with this disorder with secondary degenerative effects upon the overlying retina and underlying choroidal vessels. As a result, central vision deteriorates sometimes with profound effects.

Wet AMD


Though macular degeneration is a common diagnosis describing a large amount of patients, it has many different forms with widely varying severity. For some people the disease causes only slight distortion, but in the worst cases it can lead to a complete loss of central vision, making reading or driving impossible. Patients diagnosed with macular degeneration often fear that they will go completely blind, but fortunately in most cases AMD does not cause total blindness since it usually does not affect the peripheral vision.

 

 

  • Smoking. Smoking increases the risk of AMD.
  • Obesity. Research studies suggest a link between obesity and the progression of early and intermediate stage AMD to advanced AMD.
  • Race. Whites are much more likely to lose vision from AMD than African Americans.
  • Family history. Those with immediate family members who have AMD are at a higher risk of developing the disease.
  • Gender. Women appear to be at greater risk than men.

 


Your lifestyle can play a role in reducing your risk of developing AMD.

  • Eat a healthy diet high in green leafy vegetables and fish.
  • Don't smoke.
  • Maintain normal blood pressure.
  • Watch your weight.
  • Exercise.


Macular degeneration is classified as either wet (neovascular) or dry (non-neovascular). The wet type usually leads to more profound vision loss. Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision is gradually lost in the affected eye. The amount of vision lost depends on the severity of the disease. Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye. Damage to the macula occurs rapidly.

Dry Macular Degeneration

This type of macular degeneration is the most common, and typically results in a gradual loss of vision usually over years to decades. One of the possible characteristics of this disease is the presence of drusen which are small, yellowish deposits that form within the layers of the retina. Another sign is loss of pigment in the retina with thinning of the tissue.

 Dry AMD


Wet Macular Degeneration

Though only 10 percent of patients who suffer from macular degeneration have wet AMD, it is responsible for the more advanced amounts of vision loss. Even with aggressive treatment these patients can loose vision permanently in their central field. However, new treatments have been shown to increase the chances of regaining some vision, maintaining the patient's current residual vision, and/or decreasing the chances of losing further vision. The cause of the wet form is from growth of new, abnormal vessels in the area of the macula. These can scar and destroy the macular tissue causing vision to be distorted and blurred. It is this scar tissue that can cause central vision to be severely affected in some cases.

Wet AMD
 

 

  • Loss of central vision.
  • This is usually gradual for patients with dry macular degeneration. Patients with the wet type may experience a sudden decrease of central vision.
  • Distorted vision.
  • Straight lines may appear wavy or bent.
  • Difficulty reading or seeing details.
Use of an Amser Grid is commonly used for self evaluation of a macular problem. These are commonly given out by you ophthalmologist to check on yourself between visits. Please click here for a printable handout of this.
 Amsler Grid
 


Though there is no cure for macular degeneration, the treatment options we offer at our Tampa Bay area practice may reduce the chances that the disease will get worse or may even improve vision.

Dry Macular Degeneration Treatment

Your doctor will make sure that your vision is monitored closely for signs of wet macular degeneration. You may should routinely check your vision at home using an Amsler Grid. Your doctor may also suggest that you take antioxidant vitamins and zinc, as studies have proven that these supplements can lower your chances of converting from dry to wet AMD.

Wet Macular Degeneration Treatment Anti-Vascular Endothelial Growth Factor (Anti-VEGF) LUCENTIS™, AVASTIN®, MACUGEN®

Many patients with wet macular degeneration receive treatment with anti VEGF medicines at our Tampa Bay area practice. These medicine treatments help to slow vision loss and can sometimes restore some of the lost vision. Injected into the eye, these drugs work by blocking an essential signal that causes abnormal blood vessels to grow and leak.

For more information about LUCENTIS™, AVASTIN® and/or MACUGEN®, contact our Florida practice.

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Laser Photocoagulation

In some cases of wet macular degeneration, laser photocoagulation is used to seal leaking or bleeding vessels, which are located outside of the center of the macula (fovea). Laser photocoagulation usually does not restore lost vision, but it may prevent further loss for some patients.

Photodynamic Therapy (Visudyne® Drug Treatment)

Photodynamic therapy is a newer type of laser treatment that is sometimes preferred over photocoagulation when the target pathology is involving the center of the macula (fovea) and is not involving the optic nerve, and is not larger than the laser's maximum beam size. It involves using the light activated drug Visudyne® combined with a laser to stop abnormal blood vessel growth in some patients with wet AMD. However, it only works for patients with a well-defined, distinctive pattern of new blood vessel growth under the retina.

If you undergo photodynamic therapy, Visudyne® will be injected into your arm. As the drug passes though the retinal blood cells, your doctor will shine a non-thermal laser into your eye to activate it. This produces a chemical reaction that destroys abnormal blood vessels.

Vitamin Supplements

Recent studies have revealed that people with a diet high in fruits and vegetables (especially leafy, dark green vegetables) are less likely to suffer from macular degeneration. Studies have also shown that taking supplements such as vitamins C and E, beta-carotene (not to be used by actively smoking patients), and zinc may lower the chances that macular degeneration will get worse in some patients. Therefore, we suggest that patients with this condition consider taking antioxidant and zinc supplements. However, more research needs to be done on this subject and supplements are not recommended for all patients. Please speak to your doctor for more information.