Macular Degeneration Has Two Forms: Dry and Wet

 

Andrew Bainnson, M.D.

Macular degeneration is the leading cause of decreased vision in people over 65 years of age. Along with glaucoma and cataracts it is one of the most frequent diseases diagnosed by eye doctors. Macular degeneration is an age-related condition of the macula, an area of the retina at the back of the eye that is responsible for seeing fine detail when reading or looking straight ahead.  In order to see 20/20 the macula must be functioning perfected.  The vast majority of cases of macular degeneration are the dry type, in which there is thinning or deterioration of the tissues of the macula or the formation of abnormal yellow deposits called drusen.  Progression of dry macular degeneration usually occurs very slowly and does not always affect both eyes equally.  Wet macular degeneration occurs when abnormal or leaking blood vessels grow underneath the retina in the area of the macula.  These changes can lead to distorted or blurred vision and, in some cases, a rapid and severe loss of straight ahead vision.

Macular Degeneration Diagnosis

Macular degeneration is usually diagnosed by direct observation.  Usually these changes can be seen through the use of several instruments.  A chart known as an Amsler Grid can be used in the office and at home to pick up subtle changes in your vision.  Photographs and fluorescein angiography are also commonly used.  Angiography provides an image of the circulation in the eye as the dye flows thru the blood vessels.  Optical Coherence Tomography or OCT uses light waves to create a contour map of the retina and can show areas of thickening or fluid accumulation.

In the early stages of macular degeneration, regular eye check-ups, attention to diet and nutritional supplements as well a home monitoring of vision with an Amsler grid is recommended.  There has been active research on the use of vitamins and antioxidants in an attempt to prevent or slow macular degeneration.

Antioxidants are thought to protect against the damaging effects of oxygen charged molecules called free radicals.  An important group of antioxidants are called carotenoids.  These are pigments which give fruits and vegetable their color.  Two such carotenoids are lutein and zeaxanthin.  Some research studies suggest that people who have diets high in lutein and zeaxanhthin may have a lower risk of developing macular degeneration. Kale, raw spinach, and collard greens are notably high in lutein and zeaxanthin.  There are many nutritional supplements that are high in lutein and other antioxidants that are based on those vitamins used in the research studies.

Macular Degeneration Treatment

Treatment for macular degeneration, essentially the wet form, had traditionally relied on laser therapy.  Abnormal blood vessels were destroyed in an attempt to improve the surrounding retinal tissues.  Today while laser therapy is still used it has been supplanted by injectable medications that help to stop the formation of new blood vessels and dry up those that are present.In terms of vision unfortunately once vision is lost due to macular degeneration we are unable to substantially recover it.  Low vision aids- strong magnifiers and special glasses can be utilized to help improve function from the loss of vision.  Having lots of good light and using e-books which allow magnification of reading material in a snap are two easy ways to improve function.

The exact cause of macular degeneration is not known.  Age is the most significant risk factor.  Women may be at slightly greater risk and the risk seems to be higher in Caucasians than in African Americans.  Smoking has been shown to be a major risk factor.  High blood pressure, long term sun exposure and high cholesterol may also be factors. SightMD has locations all across Long Island and even Queens and Manhattan.  Call today to be evaluated for macular degeneration.

 

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