Age-Related Macular Degeneration (ARMD or AMD) is a common eye disease that affects a tiny area in the center of the retina known as the macula. The retina is the nerve layer at the back of the eye that transmits images from light to the brain. The macula is made up of millions of light-sensing cells that produce the sharp central vision. ARMD breaks down these cells, gradually destroying central vision.
It is estimated that over 13 million Americans over the age of 40 show early signs of ARMD, and it is the leading cause of legal blindness and vision impairment in the senior population. Smokers, people with light colored eyes, and individuals with a family history of ARMD are more at risk for developing this condition.
With ARMD, central vision decreases. Side vision is almost never affected. In other words, macular degeneration carries good news and bad news. The good news is that people diagnosed with this disease almost never go completely blind. The bad news is that when central vision is severely affected, driving vision and more importantly reading vision become limited.
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How Is ARMD Diagnosed?
ARMD is detected during a comprehensive eye examination during which your eye doctor will examine the health of your retina. Once detected, your doctor may recommend additional testing. The most common test is called a “Fluorescein Angiography”. A special dye is injected into the vein and pictures are taken of the dye traveling through the retina in the back of the eye. This test is used to assess the type of the disease, monitor progression and determine treatment. The newest technology for ARMD at MECA is the OCT (Optical Coherence Tomography) Imaging, which gives us a cross-sectional image of the retina and macula. This allows us to even better assess any potential macular or retinal disease.
Types of Macular Degeneration
Macular degeneration occurs in two forms: dry and wet.
Dry Age-Related Macular Degeneration
Ninety percent of individuals diagnosed with ARMD have the dry form. The light-sensitive cells in the macula slowly break down, affecting central vision over time. Dry ARMD often occurs in just one eye at first, and slowly progresses with time to involve the second eye.
The most common symptom of dry ARMD is slightly blurred vision. Dry ARMD develops very slowly over many years and most people are able to lead normal, active lives, especially if the disease affects only one eye. As the disease progresses, a blurred spot forms in the center of the vision, gradually becoming larger and darker, reducing central vision.
Currently, there is no treatment for dry ARMD. Recent studies have revealed that vitamins rich in anti-oxidants, such as Vitamin C, Vitamin E, zinc and lutein, decrease the incidence of dry ARMD and can limit its progression. These vitamins can be safely taken in addition to the regular daily multivitamin therapy.
There are a number of common health risks that are closely linked with macular degeneration. These risks can be avoided by stopping smoking, controlling cholesterol and blood pressure, protecting the eyes from ultraviolet (UV) rays, and making sure that the diet is high in fruits and green, leafy vegetables.
Wet Age-Related Macular Degeneration
Although only 10 percent of all people with ARMD have this type, it accounts for 90 percent of all blindness. New blood vessels behind the retina begin to grow toward the macula. These vessels are very fragile and often leak blood and fluid under the macula, rapidly causing the damage that leads to loss of central vision.
All patients with ARMD should monitor their vision with an Amsler grid which can help detect the early signs of ARMD. In wet ARMD, straight lines can take on a "curved" or "wavy" appearance and the Amsler grid helps detect this change.
Now, more than ever before, early detection of the conversion of dry ARMD into wet ARMD is important as the treatment for wet ARMD has improved greatly in recent years. The new treatments for ARMD consist of intraocular injections to inhibit and cause regression of ARMD.
Frequently Asked Questions about Macular Degeneration
What is macular degeneration?
Macular degeneration is the gradual breakdown of the macula, the central region of the retina that is responsible for clear central vision. As the macula deteriorates, central vision is destroyed.
Is macular degeneration always caused by advancing age?
Although most cases of macular degeneration affect adults over the age of 50, age is not the only risk factor. People with a family history of the disease, those that smoke or those that take certain medications may also be at a higher risk for developing ARMD. Some doctors also think that too much exposure to ultraviolet light may increase the risk of developing the disease.
What are the symptoms of macular degeneration?
The most common symptoms of macular degeneration include the following:
- Blurry or shadowy areas in the central field of vision
- Distortion in the central visual field
- Straight lines start to look wavy
- Poor vision at night
Regular eye exams can detect macular degeneration before any symptoms appear.
Does macular degeneration always affect both eyes?
Some people develop ARMD in only one eye, but those that do are more likely to eventually develop it in the other eye.
Can macular degeneration be prevented?
Although there is no guaranteed way to prevent macular degeneration, many doctors agree there are steps you can take to reduce your risk, or to slow the progression of the disease:
- Not smoke
- Exercise regularly
- Eat foods with antioxidants and essential fatty acids
- Take nutritional supplements
- Wear sunglasses with UV protection whenever going outdoors
What are the best supplements to take for macular degeneration?
The best supplements to take are formulated based on the results of the Age-Related Eye Disease Study, a large clinical trial sponsored by the National Eye Institute. AREDS supplements are not clinically proven to prevent macular degeneration, but in some cases they can slow the progression of the disease and stave off noticeable vision loss.
These supplements are designed specifically for macular health, and contain ingredients like lutein, zeaxanthin, omega-3 fatty acids and other nutrients with demonstrated eye benefits. The AREDS2 formula is considered to be an improvement upon the original AREDS1 formula.
What treatments are currently available for macular degeneration?
Although there is currently way to cure macular degeneration or completely restore vision lost to the disease, people diagnosed with ARMD, particularly wet macular degeneration, have some options.
For example, injections of special drugs like Lucentis or Eylea are able to inhibit the growth of new, abnormal blood vessels. Alternatively, some patients see results with photodynamic therapy, which entails injecting a drug into the veins and activating it with a low-energy laser beam to destroy abnormal blood vessels. Another laser option is laser photocoagulation, which uses laser energy to seal off or destroy leaking blood vessels.
Each of these treatment options comes with its own set of benefits and limitations, which can be discussed during a one-on-one appointment. Our eye physicians can recommend the treatment or combination of treatments most likely to slow down the progression of your disease after determining the type and severity.
Contact Memphis Eye and Cataract Associates
The eye physicians at MECA routinely check the retina looking for the slightest signs of age-related macular degeneration. If it is suspected, thorough testing will be performed to evaluate the extent of the damage and establish a course of action. Our eye surgeons are highly experienced in medical and laser treatment of the retina.