Facts about Macular Degeneration
Macular Degeneration Facts
The leading cause of vision loss is macular degeneration (AMD), which affects more than 10 million Americans. This number is more than glaucoma and cataracts combined. This condition is considered incurable. The Center for Disease Control and Prevention (CDC) and researchers from the University of Wisconsin have concluded that 6.5% of Americans over the age of 50 have some degree of macular degeneration.
In England and Wales, 50% of patients with severe visual impairment is caused by AMD, which is an estimated 1.5 million people. The prediction of people that will be affected worldwide by 2020, is 196 million people, and by 2040, it will be 288 million.
Physical Manifestations of Macular Degeneration?
The central portion of the retina, which is called the macula deteriorates with this disorder. The back layer in the eye records images we see; then, the images are sent via the optic nerve to the brain. The macula is the portion of the eye responsible for focusing vision in the eye.
The macula is responsible for central vision giving us the ability to focus, and it also controls our ability to recognize colors or faces and to see objects in fine detail. The ability to read or drive a car is impacted severely by this disorder.
Age Related Macular Degeneration (AMD) - Elliott Sohn, MD
Three Stages of Age-Related Macular Degeneration (AMD)
The greatest risk factor for Macular Degeneration (AMD) is advancing age as the risk increases for people over the age of 55 and older.
The stages of Age-related of Macular Degeneration includes:
- Early AMD typically does not include vision loss, and this is certainly a good reason to get regular eye examinations. This is especially important if you have one of the risk factors, which are listed below. Early AMD is diagnosed by the presence of medium-sized drusen, which are yellow deposits beneath the retina.
- Intermediate AMD may involve some vision loss, but there are no other symptoms that are noticeable.
- Late AMD will have very noticeable symptoms.
Two Forms of Macular Degeneration
The dry form of this disease has yellow deposits called drusen in the macula. As the drusen grow and increase in numbers, they will probably cause a distortion or dimming of the vision. A thinning of the light-sensitive layer of macula cells occurs as this disease advances, which results in atrophy or tissue death. Blind spots in the center of the vision may occur in advanced states of this disease, therefore, patients lose central vision. Peripheral vision is not affected. Most patients have the dry form of macular degeneration.
The wet form of macular degeneration has abnormal blood vessels growing from the choroid that is underneath the macula, and it is called choroidal neovascular. These blood vessels leak fluid and blood into the retina and fluid can buildup in the back of the eye. This process causes visual distortions, causing straight lines to look wavy. There are also blind spots in the central vision. A scar is formed eventually that will cause permanent loss of central vision.
While most people have the dry form of AMD, it can eventually lead to the wet form. Approximately 10% of patients end up with the wet form of AMD, and they are the ones that have the greatest degree of visual loss. Social isolation and depression can be other effects of this disease. Patients may also experience visual hallucinations, known as the Charles Bonnet syndrome.
Macula of the Retina
Risk Factors for AMD
There is a genetic component as people with a family history are at an increased risk. Caucasians are also at a higher risk.
Other factors that may increase your risk of macular degeneration include:
- People that are over the age of 50.
- Smoking doubles the risk of getting AMD.
- Obesity increases the chance of eye or intermediate macular degeneration, and it will often progress to a more severe form of this disease.
- Hypertension and cardiovascular disease may also put you at a higher risk.
- Exposure to UV light directly from the sun or blue light is also weakly associated.
Mayo Clinic Minute: Treating age-related macular degeneration
Common Symptoms of Wet Macular Degeneration
A decreased intensity and brightness of color
Looking at straight lines that seem curved
Reduced central vision out of one or both eyes
Blind spots or well-defined blurry spots in the field of vision
The overall vision will have a general haziness
An abrupt onset and rapid worsening of symptoms
Can You Prevent AMD?
Routine eye exams will help identify any abnormalities in the eyes, and the ophthalmologist will certainly recognize early symptoms, which can help prevent the development of wet AMD. It is not preventable, but it may be slowed.
Some things that may reduce the risk of AMD include:
- Seek to manage any other medical conditions, such as taking prescribed medications to treat hypertension or cardiovascular disease.
- Stop smoking as that certainly puts you at a higher risk of AMD.
- Exercise regularly and maintain a normal weight.
- Eat a healthy diet with fresh fruit and vegetables. Nuts and fish are beneficial due to omega-3 and fatty acids.
There are some medications that are used when treating wet macular degeneration, and they include:
- Bevacizumab (Avastin)
- Aflibercept (Eylea)
- Ranibizumab (Lucentis)
These medications are injected directly into the affected eye, and they may be needed as often as every 4 weeks. If the blood vessels shrink or the fluid under the retina absorbs, then the vision may improve. There are some possible side effects that include conjunctival hemorrhage, floaters, eye pain, increased eye pressure or inflammation.
Another therapy is photodynamic therapy, which treats abnormal blood vessels in the macula. Verteporfin (Visudyne) is injected in the vein, then a special laser light is shone on the abnormal blood vessels in the eye. Abnormal blood vessels close and leakage stops. Repeated procedures may need to be used if the blood vessels reopen.
Photocoagulation therapy uses a high-energy laser beam to seal abnormal blood vessels. There is also an Implantable Miniature Telescope that magnifies images onto the retina, which actually reduces the size of the central vision blind spot. This telescope is about the size of a pea, and it is for end-stage macular degeneration. The patient can recognize people and see facial expressions with this device.
Ideally, macular degeneration is detected early, so a patient can be monitored closely. If wet macular degeneration occurs treatment may be started earlier to reach a better outcome.
Have you had an experience with macular degeneration?
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Pamela Oglesby