Macular Degeneration

Macular degeneration, also known as age-related macular degeneration (AMD), due to its prevalence in people over 50 years of age, is an eye disease that impairs straight-ahead, fine detail vision. The macula is located at the back of the eye near the center of the retina. When it deteriorates, patients may have difficulty with activities that require the central vision, such as: reading, sewing, driving, and recognizing faces.

AMD varies in severity – from blurry vision to complete loss of central vision, can affect one or both eyes, and can be classified as either the wet type or dry type of macular degeneration.

Types of AMD

Dry – The dry type of macular degeneration is the most common form of AMD and affects central, or straight-ahead, vision. Yellow deposits, called drusen, found under the retina cause the patient to have blurred or distorted vision. The breakdown of particular cells and tissue in the macula is thought to be the cause of these deposits. Dry AMD advances to Wet AMD in about 10 percent of patients.

Wet –  Wet macular degeneration is more advanced than dry macular degeneration. The body attempts to heal the damaged retinal tissue generated in dry AMD by forming new blood vessels under the retina. Due to their fragility, these new vessels can leak blood and fluid, causing more damage to the tissues. This causes distortion to the macula and results in decreased vision. Although wet AMD is the less common form of macular degeneration, it is considered severe and can cause rapid loss of central vision.


Symptoms and Signs

  • Wavy or distorted vision
  • Difficulty with activities requiring fine detail vision, such as reading or sewing
  • A smudge or blurriness in the central vision of the affected eye

  • Blind spots
  • Difficulty recognizing faces
  • Presence of drusen – yellow spots under the retina that can only be detected by a comprehensive eye exam

 


Risks and Contributing Factors

  • Aging
  • Heredity
  • Smoking

  • High Blood Pressure
  • Light Eye Color
  • Obesity and Inactivity

Diagnosis

Dr. Smith diagnoses AMD by first performing a comprehensive, dilated eye exam. He then uses ocular coherence tomography (OCT) and/or fluorescein angiogram for a more conclusive evaluation of the macular degeneration.

  • OCT – Provides cross-sectional views of the interior of the eye by using light waves.
  • Fluorescein angiography – A type of high contrast, imaging test used look at the blood vessels in the back of the eye.


Treatment

Treatment of macular degeneration can cause significant improvements in vision, sometimes even to excellent levels and usually slows or stops the progression of the disease. Upon diagnosing a patient with AMD, Dr. Smith may perform a laser procedure, prescribe treatment such as an anti-VGEF medication (Eylea, Lucentis or Avastin), and follow the patient carefully to monitor the condition.

  • Anti-VGEF Injection – This medication is normally used in the treatment of cancer; however, it has been found to be very successful in the treatment of wet AMD. It inhibits the formation of the blood vessels that grow and leak under the retina.

Early diagnosis is critical for the successful treatment of AMD. Having regular eye exams with Dr. Smith is essential to total eye health, including prevention, diagnosis, and treatment of conditions such as AMD.