Macular Degeneration

     What is Macular Degeneration? You may commonly see it as AMD, which stands for Age-Related Macular Degeneration.  AMD is a deterioration or breakdown of the eye's macula.  The macula is a small area in the retina which is responsible for your central vision.  The most common symptoms are blurriness, dark areas in your central vision, or distortion.

Amsler Grid.gif

     There are two types of AMD: dry and wet.  Dry AMD is caused by aging and thinning of the macula.  It usually begins when tiny yellow or white pieces of fatty protein, called drusen, form in the macula.  Vision loss is usually gradual.  Ophthalmologists and Optometrists will ask you to monitor an Amsler Grid (which you can see to the right).  The grid should look like it has been drawn with rulers.  If you have AMD and ever notice any distortions, you will be advised to contact your Ophthalmologist or Optometrist as soon as possible.  This could be an indicator that the AMD is progressing to the wet form.  The only thing that physicians have found that you can do is take eye vitamins.  These are not a cure for AMD, but may help prevent further damage from occurring.   When looking for vitamins, it is important to make sure you select the AREDS 2 formula.  AREDS stands for Age Related Eye Disease Study.  These consists of 500 mg of Vitamin C, 400 IU of Vitamin E, 10 mg of Lutein, 2 mg of Zeaxanthin, 80 mg of Zinc, and 2 mg of Copper.  The Copper is to help prevent copper deficiency from taking too much Zinc.  Some studies aside for the AREDS 2, show that women over 40 who have a history of, or at risk for heart disease, should also be taking Folic Acid and Vitamins B6 and B12.  Also, if you can't stomach the vitamins, you can incorporate certain things into your diet: dark green leafy greens (cooked kale or spinach), and yellow, orange, and other colorful fruits and vegetables (yellow peppers for example).  Both of these groups are rich in Lutein and Zeaxanthin, which are pigments in your macula.  If you decide to incorporate these into your diet, you must add them daily.  

    Wet AMD is when abnormal blood vessels begin growing under the retina.  The abnormal blood vessels may leak fluid or blood, which will causing blurring or distortion of central vision.  It can progress faster than the dry AMD.  The longer you wait to have it treated, the higher risk you are at losing your central vision.  Symptoms of wet AMD are distorted vision, straight lines appearing bent or crooked, dark gray spots in vision, loss of central vision, size of objects may appear different for each eye, and colors lose brightness; colors do not look the same for each eye.  The main treatment for wet is AMD is injections.  The most common injections now are Avastin, Lucentis, or Eylea.  If you begin injections, you will most likely get a series of one per month for three months in a row.  You will be rechecked after those three months, and depending on the severity, you may receive more.  

    Who is at risk?  Approximately one in three Caucasians have genetic changes that make them more prone to damage from oxidative stress which can lead to AMD.  Oxidative Stress is essentially an imbalance between the production of free radicals and the ability of the body to counteract or detoxify their harmful effects through neutralization by antioxidants.  You will also be at a higher risk if a close family member has AMD.  And also, if you smoke, have high blood pressure or abnormal cholesterol, you are at a higher risk.

    How is it diagnosed?  The only way to diagnose AMD is routine eye exams.  After the age of 60, it is best to have an eye exam every year.  You don't want to wait to catch AMD until it's too late.  There is also a test that we do in office called an OCT (Ocular Coherence Tomography).  The OCT is able to show us any abnormalities in the retina, more specifically to any abnormal thicknesses.  

     See below for a view of normal vision vs. AMD.

Bonnie Bradley