Age-related Macular Degeneration (AMD) is the most common cause of vision loss in the senior population, especially in those over the age of 75. In AMD, there is damage of one sort or another to the macula of the eye (the central part of the retina where clearest vision is produced). While AMD is primarily related to the genetics of aging, environmental risk factors such as smoking, excessive sunlight, poor nutrition, severe myopia, and trauma have been identified.
There are many forms of macular degeneration. Here is some information on the most common kinds and the treatments we offer. When in doubt, there are tests (fluorescein dye tests and OCT laser scans) which help provide useful information about your AMD.
First, there are several different kinds of "dry" AMD. Dry means that there is no bleeding involved: The dry form is usually milder, and more slowly progressive than the wet. However, advanced dry AMD can lead to blindness.
- Atrophy: This is a gradual deterioration of the cells. There is no specific treatment. Often we may recommend a vitamin supplement to help maintain macular health. Severe atrophy can result in profound loss of central vision, gradually progressive. There is no approved treatment, however it is an active area of research.
- Macular hole: This may be due to internal tissue contraction in the eye. Surgical treatment may help.
- Macular wrinkling (pucker): This is also related to tissue contraction. It may lead to a hole. Often, no treatment helps. Sometimes, if fluid is present, an injection of medication can help. If a thick membrane forms, it can sometimes be removed surgically.
- Macular drusen: These are creamy deposits that form in the macula. They appear to result from waste products in the macula that have not been cleared and build up. They often cause little or no vision loss on their own but are ominous in that they increase the risk of the wet form developing. We often prescribe a vitamin supplement.
The "wet" form is diagnosed when testing and exams show there is leakage of fluid (or bleeding) into the macula. This may be "occult" (i.e. it may not bother your vision) but more commonly it can produce a severe loss of central vision.
There are now several possible treatments for the wet kind, and new ones are also being developed. Unfortunately, no treatment is usually curative. More advanced injection therapies using "AntiVEGF" agents can sometimes stabilize or even improve the vision, especially if caught early on before scarring has occurred. It inhibits the growth of abnormal vessels.
Careful monitoring of your vision is helpful to catch the wet form early on. We use a special test called OCT scanning to try to pick up the wet form at its earliest, most treatable stage. This is done at our Runnemede office.
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