Macular Degeneration

It is likely that someone you know has age-related macular degeneration (ARMD)–this condition is one of the leading causes of vision impairment in the United States. While some patients can lose significant vision from macular degeneration, early detection and treatment can help prevent vision loss, and in many cases, help restore vision, as well.

Vision Loss Can Be Prevented

As with many health conditions, lifestyle changes and healthy living can reduce the risk of vision loss from macular degeneration. Factors such as control of blood pressure, smoking cessation, ultraviolet blocking sunglasses, consuming a diet rich with green, leafy vegetables and deeply colored fruits are all helpful. But like many conditions of the retina, proper early detection and treatment by a retina specialist is most important.

Diagnosis of Macular Degeneration

Age-related macular degeneration is typically seen in persons sixty years and older. Many cases can be very subtle to detect, and identified by little yellow spots in the back of the eye (macula) that are called drusen. Many people can have these drusen, and be completely free of symptoms.Over time, drusen can increase, or grow larger, and a person may develop symptoms, such as crooked or wavy lines (metamorphopsia).

On an initial visit, patients with macular degeneration may benefit from a test called a fluoroscein angiogram (FA), where a small amount of dye is injected into the vein, and pictures are taken of the macula. This helps your doctor determine if the macular degeneration is of the dry (nonexudative) type, or the wet (exudative) type. On follow-up visits, this test may be periodically repeated, but more likely, another photographic test, called an OCT (optical coherence tomogram), is used; this quick and noninvasive test can help detect any changes, and is also very useful in monitoring a patient’s response to treatment.

In between office visits, persons with macular degeneration are often advised to monitor their vision with the use of a test at home called an Amsler grid; this test involves looking (with each eye separately) at a square box with lines running across, and if used a few times a week, can be effective in detecting metamorphopsia, that may require an earlier visit to the retina specialist.

Treatment of Macular Degeneration

While there are currently no FDA approved treatments for the dry (nonexudative) type of ARMD, there are options for the wet type. While in some cases, a patient may benefit from laser treatment, most will likely benefit from the administration of one of several different types of drugs that are administered into the eye in the office setting. Whichever medication is chosen, the treatment can last months to years– some patients may require treatment for longer than others, while some may eventually need only periodic treatment.

There are several types of drugs that can be used, usually alone, but sometimes in combination; some of these medications include Macugen,  Avastin, Lucentis and Eyelea.  The subtype/extent of wet ARMD, and overall health risk factors, can affect which medication is selected.
Your retina specialist should review with you your type of macular degeneration, risk factors for progression, steps to avoid vision loss, and if necessary, all the therapeutic options that are now available.

Nader Moinfar, M.D., M.P.H., F.A.C.S.
Retina Specialist
Lakeland | Winter Haven
Zephyrhills | Lake Mary