Age-related macular degeneration (ARMD or AMD) is the number one cause of vision loss in people over age 65. About 10% of people 66-74 years of age will have findings of macular degeneration. In those ages 75-85, this percentage jumps to 30%.* AMD is a degeneration of the central part of the retina called the macula, which is responsible for the crisp central vision we use every day to see faces, read a book and drive. In addition to a decrease in the sharpness of the central vision, macular degeneration can also cause distorted vision and straight lines may appear wavy.
Dry macular degeneration
There are two types of macular degeneration, the dry form and the wet form. The dry form is by far the most common of the two types (about 85-90% of AMD patients) and tends to cause less dramatic vision loss. The underlying finding in dry macular degeneration is the collection of abnormal deposits and pigment underneath the retina in the area of the macula. These yellowish spots are called drusen and no one is quite sure why they form. We do know that the vision loss seen in dry macular degeneration is typically slowly progressive and most people maintain some degree of central vision. However, in a small percentage of people with dry AMD, the disease will progress to the end-stage form called geographic atrophy (GA). In GA, large portions of the macula have been entirely degraded and the vision loss is severe.
Dry AMD treatment
Unfortunately, there is no cure for either form of macular degeneration. A landmark study performed at the National Eye Institute showed that certain nutritional supplements are useful for slowing down the progression of dry AMD. This study, called the Age-Related Eye Disease Study (AREDS) found that the combination of specific amounts of vitamins A, C, and E, zinc and copper reduced the rate of advanced AMD in people at high risk by about 25% over a 6-year period.** A second version of the AREDS study, AREDS2, is currently underway. AREDS2 added the antioxidants lutein and xeaxanthin, as well as the omega-3-fatty acids derived from fish oils, to the original formulation of vitamins in the first AREDS study. The clinical results from AREDS2 are expected in 2013.
Wet macular degeneration
Wet macular degeneration affects approximately 10% of patients with AMD. The primary finding in wet AMD is a group of abnormal blood vessels underneath the retina that leak fluid and blood into the retina, damaging critical areas of the macula. There have been great strides made in the treatment of wet AMD over the last 10 years. The current mainstay of treatment is an ongoing series of injections into the eye itself that allow delivery of the drug precisely to the vitreous cavity. These medications include Avastin, Lucentis and, most recently, Eylea.
What can I do if I have been diagnosed with AMD?
Treatment will be individualized for each unique patient. However, there are certain recommendations that pertain to all patients with AMD.
• Take your AREDS-formulation vitamins consistently
• If you are a smoker, stop! Smoking is associated with progression of AMD.
• Eat lots of green, leafy vegetables and fish (rich in antioxidants)
• Check your Amsler grid (pictured below) frequently. If you have a sudden change, call the office.
• Wear sunglasses