Age-Related Macular Degeneration (AMD)

What is Age-Related Macular Degeneration (AMD)?

As the name implies this condition affects the macula. The macula is the part of the eye that gives you sharp vision and allows you to read, drive and recognize faces. As the second part of the name implies it degenerates or gets worse over time. Macular degeneration may result in the loss of the central portion of your vision but rarely leads to complete blindness. Preservation of the peripheral (side) vision will allow you to continue to do most daily routines. The rapidity of progression is extremely variable. AMD may advance so slowly that it has little effect on your vision as you age. But in others, the disease progresses faster and may lead to a loss of vision in one or both eyes resulting in "legal" blindness. More than 13 million people in the United States have AMD, which is the leading cause of severe vision loss (legal blindness) in the western world.

There are two forms of AMD:

  • Dry AMD - accounts for 90 percent of all cases. Studies suggest that the area at the back of the eye (called the retina) becomes diseased, leading to a gradual loss of central vision.
  • Wet AMD - Although only 10 percent of all people with AMD have the wet form, it accounts for 90 percent of all severe vision loss from the disease. As dry AMD worsens, new blood vessels may begin to grow and cause "wet" AMD. Because these new blood vessels tend to be very fragile, they often will leak blood and fluid which can cause the loss of central vision in a short period of time.

What Causes AMD?

The greatest risk factor is age. People over the age of 60 are clearly at greater risk than other age groups and the risk increases with age. Women, Caucasians, lightly-pigmented people (blond hair, fair skin, blue-eyed) and those who have a family history of the disease also are more likely to develop AMD. Other risk factors may include diet, heart disease, sun exposure and smoking. However, the exact cause is still poorly understood.

What are the Symptoms of AMD? What You Can Do to Protect Your Vision?

If you have dry AMD, you should have a dilated eye examination by your retina doctor at least once each year. It is recommended that you do three things to try to slow down the progression of the disease and recognize changes: 1) Eat a health well balanced diet with plenty of fruits and vegetables or take vitamins every day, 2) Wear protection from the UV (ultra-violet) light, and 3) Monitor your Amsler grid chart every day.

Depending on the severity of your macular degeneration your doctor may recommend taking certain vitamins containing high levels of vitamin C, vitamin E, beta-carotene, and zinc can slow the progress of the dry type of the disease if you are at high risk for developing advanced stages of AMD. Consult your physician before starting or changing any vitamin or supplement regime. If you have wet AMD, it is important not to delay evaluation and treatment if your retina specialist has advised you to have it. After treatment, you will need to have frequent eye examinations to detect any recurrence of leaking blood vessels. People with wet and dry AMD also should monitor their own eyesight at home each day by checking the Amsler grid given to you by Retina Consultants of Nevada. You should notify the office immediately if you detect any changes on the Amsler grid card or in your vision.

What are the Treatment Options?

Dry AMD currently cannot be cured. But this does not mean that you will lose your sight. Fortunately, dry AMD develops very slowly. You may lose some of your central vision over the years. However, most people are able to lead normal, active lives – especially if AMD affects only one eye.

The dry form of AMD may change to the wet form overnight. It is important to recognize it and seek treatment in a timely manner. There are several options for treating wet AMD:

  • Thermal Laser Treatment – This treatment involves aiming a precise laser light beam onto the new blood vessels to destroy them. The major value of the treatment is that it may prevent further vision loss.
  • Transpupillary Themotherapy- this treatment involves placing laser over the area of abnormal blood vessels causing them to close down. This may require repeated treatments. This therapy may help to stabilize the vision.
  • Photodynamic Therapy –This treatment involves injecting a photo-sensitive drug into the arm, which travels to the abnormal blood vessels. The drug then is activated by a laser light and seals the abnormal blood vessels. This may require repeated treatments. This therapy may help to preserve vision.
  • Injection of medication in the eye- There are several treatments available that involve injecting a medication into the eye. This treatment works to stop blood vessels from leaking into the part of the eye responsible for central vision. In some cases, patients have even reported improvements in their vision. First, the eye is numbed and then the drug is injected into the side of the eye. The treatment may need to be repeated every four to twelve weeks for an indefinite period of time. Each of these procedures is done in the Retina Consultants office and lasts a short time. Although a person may go home the same day, he or she will need to return for follow-up exams and/or treatments.

How is AMD Detected?

Your eye doctor may suspect AMD if you are over age 60 and have had recent changes in your central vision. To look for signs of the disease, he or she will use eye drops to dilate, or enlarge, your pupils. Dilating the pupils allows your eye doctor to view the back of the eye better. You also may be asked to view an Amsler grid, a pattern that looks like a checkerboard. Early changes of AMD may cause the grid to appear distorted, or have blank areas.If AMD is suspected, you may need testing, including a fluorescein angiography. In this test, a diagnostic drug is injected into a vein in your arm. As the drug passes through the blood vessels in the retina, pictures are taken that help your eye doctor determine if treatment is needed.

Making the Most of Your Remaining Vision

Early detection and treatment may reduce the loss of vision from macular degeneration. However, if some loss of vision should occur, it doesn’t have to rob you of life’s simplest pleasures if you learn how to use your remaining eyesight to see your best. Low vision aids, special lenses, or electronic systems and training can maximize your ability to read and perform other activities. Ask your doctor about additional information on low vision aids.

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