Macular degeneration is a disease that is the leading cause of central vision loss for people over the age of sixty. Because it’s mostly common to people over the age of sixty, it is often referred to as age related macular degeneration (AMD). The condition affects the macula, which is the tiny central area of the retina responsible for sharp vision in the eye. Although peripheral tissue is left intact, macular degeneration can make it impossible to do daily functions such as driving or reading.
Wet Condition versus Dry Condition
There are two types of macular degeneration that will decide a patient’s treatment. Wet macular degeneration involves the growth of blood vessels that feed the retinal tissue with oxygen and nutrients. Researchers believe that current vascular tissue is destroyed causing loss of oxygen to the retina. The body attempts to compensate by growing new blood vessels to feed the retinal tissue. Unfortunately, these blood vessels are delicate and often leak into the macula causing scar tissue to form and blurry vision to develop. Wet macular degeneration is a rare occurrence accounting for only ten percent of the disease onslaught.
Dry macular degeneration is the more common form affecting up to ninety percent of the reported cases. Patients with dry conditions develop small, yellow pigments in the layers of the retina called drusen. Drusen development is slow, so dry macular degeneration is a more gradual form of the disease.
Macular Degeneration Symptoms and Diagnosis
Macular degeneration is usually a slow and gradual loss of central vision. Patients often see blurry vision in the central eye that gradually becomes darker and fuzzier. Small percentages of patients with the wet condition have a faster loss of central vision since the leakage into the retinal tissue is more destructive. Patients may also have a more difficult time focusing in dark areas and more light is needed even in illuminated areas. Dry condition sufferers may also experience hallucinations as vision is lost.
The sooner macular degeneration is diagnosed, the earlier treatment can be prescribed to save damaged retinal tissue. In most cases, tissue damage is already developed and the lost sight cannot be restored, but further damage can be eliminated.
Physicians who detect possible macular degeneration will perform a quick, painless test using an Amsler Grid. You can also print a home form of the Amsler Grid to do your own test. The Amsler grid is a simple white background image with black lines drawn in squares with a dot in the middle. A person who has macular degeneration will see fuzzy, wavy lines in the middle of the image. If you see any distortion in an Amsler Grid, it is imperative to contact a physician for an official eye exam.
Treatments and Preventative Methods
Researchers continue to perform studies on macular degeneration treatments. The disease is considered a genetic disease, so patients who have the condition present in other family members should ensure that eye exams are regularly performed. Treatment methods are also dependent upon the condition – wet or dry.
Dry macular degeneration is a form of the disease that is slower in progression. Dry condition patients are often prescribed high doses of vitamins A, C, E, and the mineral Zinc. These four supplements are common anti-oxidants and cofactors that are responsible for eye development and function. Studies have found that a large percentage of patients who develop dry macular degeneration have low levels of these supplements. High doses of these vitamins show that the disease is dramatically slowed in progression, and patients are able to continue normal lives.
Patients with wet macular degeneration have three options – laser surgery, photodynamic therapy, or anti-VEGF drugs. Laser surgery, or laser photocoagulation, uses a high-energy laser that uses coagulation that stunts further growth of the blood vessels that leak into retinal tissue. This was the first treatment available since the 1990’s, but it rarely restores damaged sight and is no longer the preferred treatment.
Photodynamic therapy is similar to laser photocoagulation except it uses a cold laser rather than heat. The treatment is combined with a drug that is injected into the patient and activated when the cold laser is beamed onto retinal tissue. The laser treatment prevents further growth of blood vessels saving tissue from further damage.
Finally, the latest drug therapy for wet macular degeneration is considered the best treatment currently available. Anti-VEGF treatment, called Lucentis, is injected into the eye, and it has been shown in clinical studies to prevent further tissue damage with the safest side effects. This method of treatment has become a widely preferred treatment throughout the medical community.
References
http://www.amdalliance.org/information/treatments/treatments.php
http://www.nlm.nih.gov/medlineplus/maculardegeneration.html
