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Macular Degeneration

Age-related macular degeneration is the most common cause of vision loss in the United States for people 50 or older, and the chance of getting the disease increases with age. It is a primary bilateral disease of the Retinal Pigment Epithelium (RPE) with secondary degenerative effects upon the overlying retina and underlying choroidal vessels. As a result, central vision may deteriorate.

Macular degeneration varies widely in severity. For some people, the disease causes only slight distortion. In the worst cases, it can lead to a complete loss of central vision, making reading or driving impossible. Fortunately, in most cases AMD does not cause total blindness since it usually does not affect the peripheral vision.

Signs and Symptoms
The following factors can contribute to macular degeneration:

Dry vs. Wet Macular Degeneration
Macular degeneration is classified as either wet (neovascular) or dry (non-neovascular).

Dry Macular Degeneration
This type of macular degeneration is the most common, and typically results in a gradual loss of vision (usually over years to decades). One of the characteristics of this disease is the presence of drusen, small, yellowish deposits that form within the layers of the retina. Another sign is loss of pigment in the retina. With treatment, the chances that the dry form of macular degeneration may progress to the wet form are significantly reduced.

Wet Macular Degeneration
About 10 percent of patients who suffer from macular degeneration have wet AMD. Wet AMD is a serious condition that can lead to substantial vision loss even with aggressive treatment. However, treatment has been shown to increase the chances of regaining some vision, maintaining the patient's current residual vision, and/or decreasing the chances of losing further vision. It occurs when new vessels form to improve the blood supply to oxygen-deprived retinal tissue. Because the new vessels are very delicate, they break easily and cause bleeding and damage to surrounding tissue.

Treatment
Though there is no cure for macular degeneration, the treatment options offered at your doctor's office may reduce the chances that the disease will get worse or may even improve vision.

Dry Macular Degeneration Treatment
Currently, there are no proven medical therapies available to cure or halt dry macular degeneration. However, if this problem is detected, your doctor will make sure that your vision is monitored closely for signs of wet macular degeneration. You may be asked to routinely check your vision at home using an Amsler Grid . Your doctor may also suggest that you take antioxidant vitamins and zinc, as some studies have proven that these supplements can lower your chances of converting from dry to wet AMD.

Wet Macular Degeneration Treatment
Many patients with wet macular degeneration receive treatment with anti VEGF medicines. These medicine treatments help to slow vision loss and can sometimes restore some of the lost vision. Injected into the eye approximately every six weeks, these drugs work by blocking an essential signal that causes abnormal blood vessels to grow and leak.

Photodynamic Therapy (Visudyne Drug Treatment)
Photodynamic therapy is a newer type of laser treatment that is sometimes preferred over photocoagulation when the target pathology is involving the center of the macula (fovea) and is not involving the optic nerve, and is not larger than the laser's maximum beam size. It involves using the light activated drug Visudyne® combined with a laser to stop abnormal blood vessel growth in some patients with wet AMD. However, it only works for patients with a well-defined, distinctive pattern of new blood vessel growth under the retina.

If you undergo photodynamic therapy, Visudyne will be injected into your arm. As the drug passes though the retinal blood cells, your doctor will shine a non-thermal laser into your eye to activate it. This produces a chemical reaction that destroys abnormal blood vessels.

Vitamin Supplements
Recent studies have revealed that people with a diet high in fruits and vegetables (especially leafy, dark green vegetables) are less likely to suffer from macular degeneration. Studies have also shown that taking supplements such as vitamins C and E, beta-carotene (not to be used by actively smoking patients), and zinc may lower the chances that macular degeneration will get worse in some patients. Therefore, doctors suggest that patients with this condition consider taking antioxidant and zinc supplements. However, more research needs to be done on this subject and supplements are not recommended for all patients. Please speak to your doctor for more information.

Article Source:
St. Lukes Eye

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