Untreated macular degeneration is one of the leading causes of blindness in those over 65 years old.
While researchers have not yet discovered a cure for age-related macular degeneration (AMD), there are treatment options which prevent the disease from progressing to blindness, and in some cases, they can even improve vision. It’s important to have an open discussion with your eye doctor about the risks and limitations of AMD treatments.
Types of Macular Degeneration:
There are two basic types of AMD, the wet form and the dry form.
- Dry macular degeneration is considered the less aggressive form of AMD. It typically progresses much more slowly, and the level of eyesight damage is less severe. Dry AMD is detected during routine eye exams, which is why it’s important to have yearly testing. Treating Dry AMD often involves high doses of zinc and antioxidants which have been shown to slow diseases progression.
- Wet macular degeneration is the more severe form of AMD. It occurs when there is abnormal blood vessel growth (angiogenesis), and leakage, which can cause scar tissue to develop. Treatments include laser surgery, injecting light sensitive dyes, or AMD medication injected directly into the eye to inhibit angiogenesis.
More About Age Related Macular Degeneration
Age-related macular degeneration (AMD) is the leading cause of blindness in North America. Canada is experiencing a demographic shift with an overall aging of the population, and at the same time, people are living longer. As a result, it is expected that the prevalence of AMD will increase in the future.
Macular degeneration is an eye disease that causes damage in the central area of the retina (macula). The retina is the light sensitive, inner lining at the back of the eyeball, with the macula being responsible for our fine detail vision, allowing us to read, recognize faces and drive. Generally, macular degeneration affects only the central vision with peripheral (side) vision being preserved. Typically a person with advanced, end-stage AMD will still be able to move around adequately, but will be unable to drive, watch television or read. Currently, with improved diagnostic testing
, it is possible to identify patients with AMD earlier so that strategies can be implemented to maintain vision for as long as possible.
Dry and Wet MD
Macular degeneration is divided into two categories, dry and wet. It is estimated that 90% of people diagnosed with AMD have the dry form. The dry form tends to lead to a gradual loss of vision over time, while the wet form can be associated with a sudden, rapid decrease in vision. The dry form of AMD is due to a slow deterioration of the retina with permanent damage occurring to the macula, while the wet form is due to a sudden bleed under the macula from leaky blood vessels causing extensive damage to the macula. Anyone diagnosed with the dry form has an increased risk of developing the wet form in the future.
The cause of AMD is unknown at this time, but a number of risk factors are associated with macular degeneration. Some of the risk factors are non-modifiable, for example: age, sex (females have a greater risk), family history, eye colour (blue eyes have a greater risk) and ethnicity (Caucasians are more at risk).
Other risk factors associated with AMD that may be modified include: obesity, a poor diet, a history of smoking, high blood pressure, cardiovascular disease and anyone with extensive UV exposure
. There is also ongoing research into genetic testing, using a cheek swab, to look for variations in specific genes associated with an increased relative risk of developing or experiencing progression of AMD.
Periodic eye exams
, every 2 years for adults from 19-64 years of age, and annually for those over 65 years of age, are the best way to diagnose AMD. Just having ‘good’ vision; for example, 20/20 vision, does not guarantee good eye health. Early macular degeneration often occurs without any awareness of visual symptoms. Your Chase optometrist
will be able to discover early retinal changes associated with macular degeneration by examining the retina inside the eyeball, taking photos of the retina and using an OCT machine to image the individual layers of the retina (like a ‘CAT’ scan or MRI of the retina). Once a baseline health status of the eye is established, it is important, and easy, to follow for changes in the future by repeating an eye exam regularly.
During an eye exam, the eye doctor can also review any risk factors with an individual and discuss appropriate strategies for maintaining vision in the future. Eventually, a cheek swab, for genetic testing may be available to provide a more individual, specific risk analysis.
Treating Macular Degeneration
Treatment options for macular degeneration typically involve minimizing risk factors, taking vitamins or using medications (injections) and laser therapy. Livelong UV protection (sunglasses), having an active lifestyle with plenty of exercise, eating a healthy diet and not smoking can all reduce the risk of developing AMD. A diet high in antioxidants (typically found in fruits and dark green leafy vegetables) and omega 3 fatty acids (in fish and flax seed), along with minimizing the intake of processed foods is recommended.
Anyone diagnosed with intermediate or advanced dry or wet AMD can also benefit from taking specific ocular vitamin supplementation according to the AREDS2 study
(conducted by the National Eye Institute). Currently, only wet AMD may be treated with medications or laser therapy. Medications are injected directly into the eye to stop leaking blood vessels and may actually improve a person’s vision, while laser is used to stop severe bleeding and may slow further loss of vision.
Anyone with vision loss may benefit from specific visual aids to help enhance distance and reading vision. Technology is improving rapidly and your eye doctor may be able to help with visual aids or a referral to the local CNIB (national organization for vision rehabilitation) office for a consultation.
Early diagnosis of AMD is critical in order to preserve vision, minimize risk factors and receive prompt treatment. Everyone can benefit from wearing UV protection, getting plenty of exercise, eating a healthy diet, smoking cessation and maintaining good cardiovascular health (keeping blood pressure under control and reducing intake of fatty foods). A comprehensive eye examination, with an eye doctor, can reveal any early changes of macular degeneration and provide a personalized care plan to help prevent the progression of macular degeneration.