WHAT IS MACULAR DEGENERATION?
Macular degeneration — also called age-related macular degeneration (AMD or ARMD) — is a vision change that can gradually create blurry vision over time.
AMD affects the macula, the small central area of the retina that maintains our sharpest vision. The health of the macula determines our ability to read, recognize faces, drive, watch television, use a digital device, and perform any other detailed visual task.
A patient with AMD gradually loses central vision but maintains peripheral or side vision. Blindness is rare in AMD.
Macular degeneration is the leading cause of vision loss among older Americans. According to statistics, one-third of males and one-quarter of females over 75 have some form of AMD.
The prevalence of AMD and the severity of vision loss increases with age, according to the American Optometric Association.
RISK FACTORS
The main risk factor of AMD is aging
Family history of AMD
Smoking
Caucasian
what to expect at a macular degeneration workup?
At your macular degeneration workup, we will be performing the following tests as a baseline:
Ocular Coherence Tomography (OCT)- Captures cross section images of the macular region of the retina
Opthalmoscopy- In depth examination of the macular region
Amsler grid- Subjective testing of central vision distortions
Genetic testing- Genetic testing offered to identify individual genetic markers that assist with 1-10 year progression risk analysis. Testing also pinpoints which variation of vitamin supplements would be the most effective for each genotype.
STAGES OF MACULAR DEGENERATION
Category 1 (early AMD):A few (5-15), small (<63µm) or no drusen without pigment changes.
Category 2 (early AMD): Several small drusen, few intermediate-sized (63-124µm) drusen, and/or pigmentary changes in one or both eyes
Category 3 (Intermediate AMD): Extensive (i.e., 20 soft or 65 hard without any soft) intermediate-sized drusen, one large (>125µm) druse, and/or geographic atrophy not involving the macula in one or both eyes
Category 4 (Advanced unilateral AMD): Advanced dry form (i.e., macula-involving geographic atrophy) or exudative form with choroidal neovascularization in one eye
Category 4a: Advanced AMD in one eye with category 1, 2, or 3 AMD in the fellow eye
Category 4b: Advanced AMD in one eye and decreased visual acuity (<20/32) secondary to AMD in the fellow eye; however, advanced AMD is not present in both eyes
What are treament options for macular degeneration?
Treatment for Early Dry AMD
The treatment for early dry AMD is generally nutritional therapy, with a healthy diet high in antioxidants to support the cells of the macula.
If AMD is further advanced but still dry, supplements are prescribed, to add higher quantities of certain vitamins and minerals which may increase healthy pigments and support cell structure.
Treatment for Advanced AMD
In advanced stages, new fragile blood vessels grow in the choroid layer behind the retina. These vessels are stimulated to grow by a molecule known as (VEGF) vascular endothelial growth factor. These weak blood vessels can cause damage by leaking blood, lipids, and serum into the retinal layers. Currently, the most common and effective clinical treatment is anti-VEGF therapy – which is periodic intravitreal (into the eye) injection of a chemical called an “anti-VEGF.”