What is Macular Degeneration?
Macular degeneration is the leading cause of impaired reading or detailed vision. It is caused by the breakdown of the macula, the central portion of the retina. Although macular degeneration causes distortion of central and color vision, side vision is not affected.
What is the Retina?
The retina is a thin layer of light sensitive tissue which lines the back of the eye. When light enters the eye, it is focused by the cornea and the lens onto the retina. The retina then transforms the light images into electrical impulses which are sent to the brain through the optic nerve.
What is the Macula?
The macula is a very small area of the retina which is responsible for central and color vision. The macula allows us to read, drive, and perform detailed work. Surrounding the macula is the peripheral retina which is responsible for side and night vision.
What causes Macular Degeneration?
Macular degeneration is most commonly a natural result of the aging process. With time, the retinal tissues break down and become thin. This deterioration causes a loss of function of the macula. In about 10% of cases of macular degeneration, aging of the retina is compounded by leakage of the tiny blood vessels which nourish the retina. Growth of new, abnormal blood vessels in the scar tissue that forms from the leaking blood vessels is also common. Blood and leaking fluid destroy the macula, causing vision to become distorted and blurred. The formation of dense scar tissue blocks out central vision to a severe degree. Occasionally, macular degeneration is caused by injury, infection, or inflammation. The disease may also be hereditary.
How is Macular Degeneration diagnosed?
A lighted instrument called an ophthalmoscope is used to examine the retina. With this instrument the ophthalmologist can see areas of the retina that might be affected. In addition, some special tests may be administered. The Amsler Grid test, in which a patient looks at a page similar to graph paper, is used to detect blind spots or distortion of central vision (printable Amsler Grid). A color vision test will indicate damage to the macula if the patient cannot detect symbols or letters camouflaged in color patterns.
As a patient at Eye Consultants, you will also benefit from state of the art equipment, such as our OCT (Optical Coherence Tomography) machine, to assist in the early detection of Macular Degeneration. In our digital angiographysuite, fluorescein dye is used to detect the presence of the leaking blood vessels that are characteristic to this disease. Since the images are digital, they are available for immediate interpretation by our retinal specialist.
How is Macular Degeneration treated?
A) Dry Age-Related Macular Degeneration (AMD):
Unfortunately, there is no cure for dry macular degeneration. There is no known treatment that can prevent the early stages of AMD. However, researchers with the Age-Related Eye Disease Study (AREDS) reported that a nutritional supplement called AREDS formulation can reduce the risk of developing advanced AMD. The AREDS formulations may delay the progression of advanced AMD and help keep your vision longer if you have intermediate AMD, or advanced AMD in one eye. The participants in the first AREDS trial have now been followed for 10 years and the benefits of the AREDS formulation have persisted over time.
B) Wet Age-Related Macular Degeneration:
1) Avastin / Lucentis / Eylea Intrevitreal Injection
Avastin / Lucentis are treatments that have become a breakthrough in slowing the progression of wet Macular Degeneration, and in some cases, even the slight reversal of existing damage. Originally developed for the treatment of cancer, Avastin / Lucentis slow the abnormal growth of blood vessels in the eye, slowing or stopping leakage. This treatment has actually given hope to possible vision recovery in some patients.
2) Laser Photocoagulation
This procedure involves using a hot laser to concentrate a beam of high-energy light to destroy abnormal blood vessels. Unfortunately, this also creates a permanent blind spot in the field of vision. The loss of vision, however, is usually less severe than the eventual loss of vision associated with the disease itself.
Prevention is the best medicine . . .
Regular eye examinations are the only means of detecting macular degeneration, as the symptoms of the disease often go unnoticed. Early detection may prevent further vision loss, since treatment is only effective when started early.