Age-Related Macular Degeneration (ARMD)

Newspaper article from The Second Wind

Dear Doctor Weaver,

I have a relative that was recently diagnosed with macular degeneration. What is the risk of getting this disease? Also, I’ve heard that there are two types, dry and wet. What’s the difference and is there any treatment for either?

Annie

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Dear Annie,

Macular degeneration describes a condition in which the area of the retina responsible for your central vision (the macula) undergoes changes. Essentially, the longer that you live, the more likely you are to develop macular degeneration. Also, long-term UV exposure has been thought to be a risk factor for macular degeneration. Individuals with high blood pressure, high cholesterol and heart disease also have a higher risk. Current smokers or any history of smoking has been shown to increase the risk of developing the disease.

There is a normal pigment contained beneath the retina called the retinal pigmented epithelium (RPE), and macular degeneration causes a change in this pigment as well as the formation of crystal-like deposits of varying shapes and sizes called drusen. This actually causes damage to the nearby retina, resulting in blurry or distorted central vision. This is called Dry Age-Related Macular Degeneration. Sometimes, this damage can also result in the formation of fluid (edema). When this occurs, the condition is named Wet Age-Related Macular Degeneration.

The dry form requires careful monitoring by an eyecare professional. If there are signs of early macular degeneration, the patient may be given a testing device containing crossed lines, like a checkerboard. This is called an Amsler Grid. Following the instructions of the doctor, the Amsler Grid is checked every day for any perceived changes in those crossed lines and is an important tool in detecting any subtle change in vision. There is no surgical treatment for dry macular degeneration. However, there was a study called the Age-Related Eye Disease Study (AREDS) that showed a certain combination of specific vitamins could slow down the progression of advanced disease. Two common over-the-counter multivitamins include Ocuvite Preservision by Bausch & Lomb and ICaps by Alcon. (You should first consult with your eye doctor if any of these multivitamins are right for you.)

The wet form requires the referral to a retina specialist for evaluation and treatment. The development of fluid greatly increases the risk of retina damage, which can lead to blindness. The fluid typically develops from the formation of leaky blood vessels that grow in the macula as a response to the degenerative changes. A retina specialist may use a laser to seal off the leaky blood vessels to reduce the fluid accumulation. An injection with a steroid or a compound that prohibits blood vessel formation may also be used.

To conclude, it is important for you to get a yearly eye examination in order to detect any signs of macular degeneration, or any other eye conditions that can cause blurry vision. Any history of smoking increases the risk of developing macular degeneration, so halting this habit is beneficial to the health of your body and eyes. Also, seeing your family doctor on a regular basis will allow him/her to diagnose, treat and monitor health conditions (such as high blood pressure, high cholesterol and heart disease) that are risk factors for macular degeneration.