Macular Degeneration

What is Macular Degeneration?

Macular degeneration, often referred to as Age Related Macular Degeneration (AMD), is one of the leading causes of blindness and vision impairment in people over 50 years of age. This debilitating eye condition has even been known to affect vision in patients as young as their 40s, and often starts with symptoms like mild blurriness or distortion, and gets progressively worse over time. The macula is a small spot close to the center of the retina that allows you to clearly see textures, colors, and fine details. Macular degeneration is characterized by the gradual breaking down of the eye’s macula.

At Riverside EyeCare, our board-certified ophthalmologists offer many effective treatment options to slow the progression of macular degeneration. It is very important to identify this condition in its earliest stages in order to prevent serious vision damage from occurring. Routine eye exams and certain preventative measures may also minimize the health risks associated with macular degeneration, helping you preserve your vision for the future.

• Macular Degeneration Causes
• Macular Degeneration Symptoms
• Macular Degeneration Stages
• Macular Degeneration Types
• Wet Macular Degeneration Treatment
• Macular Degeneration Prevention & Detection
• Additional FAQs

What Are the Causes of Age-Related Macular Degeneration?

Research shows that the causes of macular degeneration are complex, but that both genetics and the person’s environment play a role. While the exact cause of age-related macular degeneration remains unknown, there are some commonalities among men and women who develop the disease.

Men and women over the age of 55 are more likely to develop AMD. In addition to the natural aging process, risk factors for the development of macular degeneration may include:

• Sun and UV ray exposure
• Obesity
• High blood pressure
• High cholesterol
• Smoking

Those who have a family history of macular degeneration are considered at a higher risk of developing age-related macular degeneration, as well. In addition, cases of AMD are more prevalent among Caucasian men and women compared to African-Americans, Hispanics, or Latinos.

What Are the Symptoms of Macular Degeneration?

The symptoms of macular degeneration can start very simply, and therefore may be difficult for you to even realize they are happening. This makes it vital to have regular eye exams performed by a qualified eye doctor at the first hint of the slightest vision irregularity.

Common symptoms of macular degeneration include:

• Blurry vision
• Blind spots in the center of your vision
• Loss of visual acuity
• Trouble seeing dark or light colors

Additionally, some individuals suffering from macular degeneration may notice objects and lines that are straight taking on a curved or bent appearance. They may also become aware that the size or color of an object can vary depending upon which eye is being used to view the object.

What Are The Stages of Age-Related Macular Degeneration?

Age-related macular degeneration can be broken down into three main stages, as described below:

• Early AMD: Many people do not notice the initial symptoms of AMD or consider them significant. Vision loss during early-stage AMD is rare, making routine eye exams particularly valuable. Patients who are considered at a higher risk for developing the disease should be especially vigilant. When a patient is diagnosed with early-stage AMD, the eye doctor can detect a medium-sized yellow deposit beneath the retina, known as drusen.
• Intermediate AMD: Even at the intermediate stage, some patients with AMD may have no noticeable symptoms. However, the size of the drusen will likely have increased by this stage and may be accompanied by pigment changes to the retina.
• Late AMD: Late-stage AMD is characterized by significant, noticeable vision loss in one or both eyes. This stage can be avoided or delayed by prompt diagnosis and treatment when the disease first begins to develop.

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What Types of Macular Degeneration Are There?

Macular degeneration typically develops into one of two types: dry (non-neovascular) or wet (neovascular) macular degeneration:

Dry Macular Degeneration

Dry macular degeneration is the most common type, and unfortunately, there are currently no effective surgical treatment options available. The dry form, however, typically progresses very slowly, and vitamin therapy and vision aids may be able to reduce some of the symptoms. Antioxidants, beta-carotene, and other vitamins and minerals may also be useful in the prevention of dry macular degeneration. We recommend taking care to protect your eyes when you are out in the sun, especially if you are at high risk for macular degeneration. Routine eye exams are particularly important for the detection, monitoring, and treatment of this form of macular degeneration.

Wet Macular Degeneration

Although less common, wet macular degeneration progresses much faster than the dry form, and often causes extreme vision impairment early in its development. Consequently, patients typically notice these changes in vision and are more likely to seek out the assistance of an eye doctor. When wet macular degeneration develops, blood vessels form abnormally between the layers of the retina and begin to leak blood or fluid, ultimately leading to scarring and permanent tissue damage. The major signs of wet macular degeneration includes loss of central vision and a reduction in the ability to see fine detail. When wet macular degeneration develops in one eye, the risk of the condition developing in the other eye is significantly increased. If the condition is detected in its earliest stages, treatments are available that can slow the progression of vision loss or even improve the vision.

If you are experiencing any signs or symptoms of these conditions, you should immediately seek the advice of an experienced eye doctor for proper diagnosis and treatment.

How Is Wet Macular Degeneration Treated?

When patients are diagnosed with wet age-related macular degeneration (AMD), Dr. Sumsion often treats the condition with a series of intravitreal injections, which have been proven to stop bleeding and prevent further retinal damage for many individuals. There are three similar intravitreal injections available, including Avastin^®, Lucentis^®, and Eylea^®, which are all considered anti-vascular endothelial growth factor (anti-VEGF) drugs:

• Avastin^®: Avastin is an FDA-approved cancer drug that is approved for “off-label” use to treat wet macular degeneration. Avastin is injected into the eye to slow vision loss caused by growth of blood vessels at the back of the eye. These blood vessels can leak and negatively affect vision. Growth is prevented by blocking VEGF (vascular endothelial growth factor), a necessary protein for blood vessel development. Patients are often attracted to the comparatively lower price of Avastin, and Avastin is commonly recommended as the first line of treatment for wet AMD.
• Lucentis^®: Lucentis is an injectable drug that works similarly to Avastin; however, Lucentis was developed and FDA-approved for the sole purpose of blocking blood vessel growth behind the retina to treat wet AMD. Both Lucentis and Avastin have shown similar rates of efficacy in patients.
• Eylea^®: Like Lucentis and Avastin, Eylea also blocks VEGF to prevent further vision loss from wet AMD edema. Eylea was developed and FDA-approved for the specific purpose of treating wet AMD.

To determine which wet macular degeneration treatment is best for your needs, your ophthalmologist will conduct a thorough eye exam, carefully review your medical history, and discuss your expectations. The injections of anti-VEGF drugs into the eye use very small needles and are completed very quickly. It is common to feel intimidated at first by the prospect of an eye injection, but most patients find the treatment to be far easier to tolerate than expected. Each patient can respond differently to each of the drugs and figuring out which is most effective helps determine the most appropriate course of therapy. Your ophthalmologist will guide you toward the medication that is well-suited to your individual needs and budget.

How is Macular Degeneration Prevented & Detected?

A healthy diet is considered one of the best methods for risk reduction and prevention of macular degeneration. A diet rich in vitamins, minerals, and antioxidants consisting of foods such as leafy green vegetables, carrots, melons, citrus, and fish can be highly beneficial. Vitamins and nutrients such as vitamin A, C, E, lutein, zeaxanthin, folic acid, and beta-carotene with zinc have been shown to slow the development of macular degeneration. Reducing levels of harmful UV exposure with protective eyewear, refraining from smoking, and exercising regularly can also help you maintain good eye health.

Additionally, routine eye exams give your eye doctor the opportunity to detect macular degeneration in its earliest stages and may help improve your chances of preserving your eyesight. The Amsler Grid, a common test utilized to monitor changes in the eye, is easy to administer, and can lead to a prompt diagnosis (and subsequent treatment) as soon as macular degeneration begins to develop.

Additional Macular Degeneration FAQs

What does macular degeneration look like?

Dry AMD: In the early stages, someone with dry macular degeneration typically sees an area of his or her central vision becoming blurry in the early stages. As the condition slowly advances, the region of blurring expands/worsens, blind spots can develop, and differentiating colors and contrast becomes increasingly challenging.

Wet AMD: With wet macular degeneration, pressure placed on the retina by new blood vessels creates distortions in vision that appear wavy or bent. Unfortunately, wet macular degeneration tends to progress much more quickly than dry macular degeneration. In the latter stages of wet macular degeneration, the central vision develops severe blind spots that can expand and the remaining vision becomes increasingly more distorted.

Without detection and treatment, macular degeneration can ultimately lead to severe vision impairment and/or blindness.

Is macular degeneration hereditary?

Genetic predisposition can increase your risk-level for developing certain types of macular degeneration; however, it is usually a combination of factors that lead to the condition. If someone in your immediate family has had AMD, it is important to remain in good overall health, take care of your vision with regular exams, and eliminate preventable risk factors like smoking and obesity.

How fast does macular degeneration progress?

While dry macular degeneration may progress slowly over the course of many years, vision loss related to wet macular degeneration can advance quite quickly. Every individual with AMD is different, so it is important to rely on the findings of your ophthalmologist to track the progression of your condition.

Can I reverse macular degeneration naturally?

While there is no natural cure for AMD, changes in your diet and daily nutrition may help prevent dry macular degeneration from progressing into wet macular degeneration. There are therapies involving prescription medications that have been proven to improve vision for individuals with wet AMD.

Can vitamins and supplements help with macular degeneration?

Good nutrition and the addition of certain supplements/vitamins have been shown to help prevent increased risk of developing AMD and/or help slow disease progression. Maintaining a healthy weight with a balanced diet is important, as obesity can add significant risk for developing AMD. Increased consumption of omega-3 fatty acids, lutein, and zeaxanthin supplements are often recommended to protect the eyes from AMD. A diet or supplement regimen in antioxidants, beta-carotene, folic acid, zinc, vitamin A, vitamin C, and vitamin E can also be beneficial to the eyes.

For more information on dry or wet macular degeneration, or if you would like to schedule an appointment to evaluate the health of your macula, please contact Riverside EyeCare Professionals today. Together, we can help preserve your eye and vision health long-term.