Macular degeneration is the leading cause of severe, irreversible vision loss in people over age 60. It occurs when the small central portion of the retina, known as the macula, deteriorates. The retina is the light-sensing nerve tissue at the back of the eye. Because the disease develops as a person ages, it is often referred to as age-related macular degeneration (AMD). Although macular degeneration is almost never a totally blinding condition, it can be a source of significant visual disability.
What Are the Symptoms of Macular Degeneration?
In its early stages, macular degeneration may not have symptoms and may be unrecognized until it progresses or affects both eyes. The first sign of macular degeneration is usually blurred vision with a dim, blurry spot in the middle of your vision. This spot may get bigger or darker over time.
What Treatments Are Available for Macular Degeneration?
There is currently no cure for macular degeneration, but treatments may prevent severe vision loss or slow the progression of the disease considerably. Several options are available, including:
Anti-angiogenesis drugs. These medications (Avastin, Eyelea, Lucentis, Macugen) block the development of new blood vessels and leakage from the abnormal vessels within the eye that cause wet macular degeneration. This treatment has been a major change in the treatment of this condition and many patients have actually regained vision that was lost. The treatment may need to be repeated during follow-up visits.
Vitamins. A large study performed by the National Eye Institute of the National Institutes of Health, called AREDS (Age-Related Eye Disease Study), showed that for certain individuals, vitamins C, E, beta-carotene, zinc and copper can decrease the risk of vision loss in patients with intermediate to advanced dry macular degeneration. However, the ingredients of vision supplements may change with the completion of the AREDS2 study. This study sought to see if adding other vitamins and mineral to the supplement would improve results of the AREDS. The first addition was omega-3 fatty acids (fish oil), and the second was a combination of two carotenoids, lutein and zeaxanthin, which are found in leafy green vegetables and highly colored fruits and vegetables. The research showed:
- Beta-carotene did not reduce the risk of progression of AMD.
- Adding omega-3 to the AREDS formula did not reduce risk of progression of AMD.
- The AREDS formula was still found to be protective with less zinc added.
- People that took a formula with lutein and zeaxanthin and who may not have been taking enough in their diet showed further improve with the new AREDS formula.
In general, people who took lutein and zeaxanthin instead of beta-carotene had more of a benefit.
Laser therapy. High-energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur in macular degeneration.
Photodynamic laser therapy. A two-step treatment in which a light-sensitive drug (Visudyne) is used to damage the abnormal blood vessels. An eye doctor injects the drug into the bloodstream to be absorbed by the abnormal blood vessels in the eye. The doctor then shines a cold laser into the eye to activate the drug, damaging the abnormal blood vessels.
Low vision aids. Devices that have special lenses or electronic systems that produce enlarged images of nearby objects. They help people who have vision loss from macular degeneration make the most of their remaining vision.
What Is the Outlook for People With Macular Degeneration?
People rarely lose all of their vision from age-related macular degeneration. They may have poor central vision, but they are still able to perform many normal daily activities.
The wet form of macular degeneration is a leading cause of irreversible vision loss. When both eyes are affected, you may experience a significant decrease in your quality of life.
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