Macular Degeneration

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over the age of 50. The Centers for Disease Control and Prevention estimate that 1.8 million people have AMD and another 7.3 million are at substantial risk for vision loss from AMD.

Caucasians are at higher risk for developing AMD than other races. Women also develop AMD at an earlier age than men.

This eye disease occurs when there are changes to the macula, a small portion of the retina that is located on the inside back layer of the eye. AMD is a loss of central vision that can occur in two forms: “dry” (atrophic) and “wet” (exudative).

Most people with macular degeneration have a dry form. While there is no specific treatment for dry AMD, studies have shown a potential benefit from vitamin supplements a Mediterranean diet, and cessation of smoking. The less common wet form may respond to intraocular injections of anti-VEGF medications if detected and treated early.

Symptoms and Diagnosis of AMD

In its early stages, the following signs of macular degeneration can go unnoticed.

• Gradual loss of ability to see objects clearly.

• The shape of objects appears distorted.

• Straight lines look wavy or crooked.

• Loss of clear color vision.

• A dark or empty area in the center of vision.
  
  

If you experience any of the above signs or symptoms, contact your doctor of optometry immediately for a comprehensive eye examination. Your optometrist will perform a variety of tests to determine if you have macular degeneration or any other eye health problems.

Central vision that is lost to macular degeneration cannot be restored. However, low-vision devices, such as telescopic and microscopic lenses, can maximize existing vision.

Treatment of AMD

With “dry” macular degeneration, the tissue of the macula gradually becomes thin and stops working properly. There is no cure for dry AMD, and any loss in central vision cannot be restored.

However, researchers and doctors believe there is a link between nutrition and the progression of dry AMD. Making dietary changes and taking nutritional supplements can slow vision loss.

Less common, “wet” macular degeneration occurs when fluids leak from newly formed blood vessels under the macula. This leakage blurs central vision. Vision loss can be rapid and severe.

If detected early, wet AMD can be treated with intraocular injections of anti-VEGF medications.

Researchers have linked eye-friendly nutrients such as lutein and zeaxanthin, vitamin C, vitamin E, and zinc to reducing the risk of certain eye diseases, including macular degeneration. For more information on the importance of good nutrition and eye health, please see the diet and nutrition section.

Macular Degeneration is best diagnosed with a comprehensive dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view your eyes. The drops may cause your close vision to blur until they wear off, several hours later.

During the exam, your eye doctor will look for:

• Abnormal blood vessels

• Swelling, blood, or fatty deposits in the retina

• Growth of new blood vessels and scar tissue

• Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous)

• Retinal detachment
  
  

With your eyes dilated, your doctor takes pictures of the inside of your eyes. Your doctor can use the images to pinpoint blood vessels that are closed, broken down, or leaking fluid.

Optical coherence tomography

Your eye doctor may request an optical coherence tomography (OCT) exam. This imaging test provides cross-sectional images of the retina that show the thickness of the retina, which will help determine whether fluid has leaked into retinal tissue. Later, OCT exams can be used to monitor how the treatment is working.

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