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Home > Eye Care > Eye Problems and Diseases > Age related macular degeneration
Age related macular degeneration
Age related macular degeneration is a medical condition which usually affects older adults that results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of visual impairment in older adults (>50 years). Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.
The inner layer of the eye is the retina, which contains nerves that communicate sight; behind the retina is the choroid, which contains the blood supply to the macula (the central part of the retina). In the dry (nonexudative) form, cellular debris called drusen accumulate between the retina and the choroid, and the retina can become detached. In the wet (exudative) form, which is more severe, blood vessels grow up from the choroid behind the retina, and the retina can also become detached. It can be treated with laser coagulation, and with medication that stops and sometimes reverses the growth of blood vessels.
Although some macular dystrophies affecting younger individuals are sometimes referred to as macular degeneration, the term generally refers to age-related macular degeneration (AMD or ARMD).
Age-related macular degeneration begins with characteristic yellow deposits in the macula (central area of the retina, which provides detailed central vision, called the fovea) called drusen between the retinal pigment epithelium and the underlying choroid. Most people with these early changes (referred to as age-related maculopathy) have good vision. People with drusen can go on to develop advanced AMD. The risk is considerably higher when the drusen are large and numerous and associated with disturbance in the pigmented cell layer under the macula. Recent research suggests that large and soft drusen are related to elevated cholesterol deposits and may respond to cholesterol-lowering agents.
Picture of the fundus showing intermediate age-related macular degeneration. In recent years with the advancements in the medical industry a new group of drugs are introduced that actually help with the symptoms of wet macular degeneration. These medicines are called Anti VEGF medicines. These medicines are injected into the eye by your doctor. Before the injection, your doctor will numb the eye with eye drops.
How It Works
When wet age-related macular degeneration (AMD) develops, weak abnormal blood vessels grow under the retina and lead to vision loss. The growth of these vessels is triggered by a protein called vascular endothelial growth factor (VEGF). Anti-VEGF medicines block the effects of VEGF. Blocking this protein slows the growth of the abnormal blood vessels. This slows the vision loss linked to wet AMD.
Why It Is Used
Anti-VEGF medicines are used to slow the vision loss caused by wet AMD. These medicines slow the growth of abnormal blood vessels that leads to wet AMD.
How Well It Works
Anti-VEGF medicines can slow the vision loss that is linked to wet AMD.1 They may also improve vision for people with wet AMD.2 Because these medicines are relatively new, long-term effects are not yet known.
Side Effects
The common side effects of bevacizumab, pegaptanib, or ranibizumab injections include:
• Changes in vision, or trouble seeing.
• Inflammation of different parts of the eye.
• Bleeding.
• Eye discharge.
• Eye pain or discomfort.
• Increased pressure inside the eye.
• Increased sensitivity to light.
• Headache.
• Painful urination.Ranibizumab (Lucentis) may raise the risk of stroke in elderly people, especially if they have already had a stroke.
Many side effects may be caused by the actual injection procedure rather than the drug itself. For example, the injections have a risk of infection.
Long-term effects of these medicines are not yet known.
What To Think About
You will likely get the injections on a regular basis, such as once a month.
Anti-VEGF medicines may help stop vision loss in people who cannot benefit from other treatments such as laser photocoagulation or photodynamic therapy.
Other types of anti-VEGF drugs are currently being studied, including some that may be injected into a vein (intravenously) rather than into the eye.
General Eye Care Tips
In General the best treatment is prevention. The only known preventions are eating a healthy diet, including a lot of green leafy vegetables like spinach and swiss chard also wearing polarized sun protection is always good for the eye.
Special vitamins are available in the market which include lutein and zeaxanthin
- Don't smoke. Period.
- Eat plenty of dark, leafy green vegetables, such as raw spinach. Just a half cup of raw spinach three times a week is good.
- Take a multivitamin/multimineral supplement, such as Centrum Silver, unless your doctor advises otherwise.
- If you already have AMD, ask your doctor about one of the AREDS formulations, such as Alcon I-Caps, Bausch & Lomb Ocuvite PreserVision or ScienceBased Health MacularProtect Complete.
- Eat fish or take a fish oil supplement. I recommend taking two enteric-coated fish oil capsules every day on days you don't eat fish. Why enteric-coated? Because it's designed to help the capsule pass through your stomach unaltered until it finally breaks apart in the intestines; that way, you won't belch up that fishy taste!
- Exercise regularly, and stay at a healthy weight.
- Eat fruit and nuts daily.
- Reduce refined carbohydrates (high-glycemic index foods).
- Keep your blood pressure and cholesterol under control. Regular exercise and weight control can help manage your blood pressure and cholesterol.
- Wear appropriate sunglasses outdoors to block UV and blue light that may cause eye damage.
- Have regular eye exams.
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