Posted by: courtneygrapperhaus | February 14, 2016

Age Related Macular Degeneration (AMD)

February is Age Related Macular Degeneration/Low Vision Awareness Month. You may have heard about AMD before, but many people don’t know a whole lot about it.

amdIn simplistic terms, AMD is a breakdown of the macula (a small area of the retina responsible for central vision). According to Wikipedia, “It is the foruth most common cause of blindness after cataracts, preterm birth and glaucoma. About 0.4% of people between 50 and 60 have the disease, while it occurs in 0.7% of people 60 to 70, 2.3% of those 70 to 80 and nearly 12% of people over 80 years old.”

According to the NEI, “There are three stages of AMD defined in part by the size and number of drusen under the retina. It is possible to have AMD in one eye only, or to have one eye with a later stage of AMD than the other.”

  • Early AMD. “Early AMD is diagnosed by the presence of medium-sized drusen, which are about the width of an average human hair. People with early AMD typically do not have vision loss.”
  • Intermediate AMD. “People with intermediate AMD typically have large drusen, pigment changes in the retina, or both. Again, these changes can only be detected during an eye exam. Intermediate AMD may cause some vision loss, but most people will not experience any symptoms.”
  • Late AMD. “In addition to drusen, people with late AMD have vision loss from damage to the macula.”

There are two types of late AMD:
Dry (a.k.a. atrophic or non-neovascular):

* Begins with drusen (yellow deposits) in the macula

* Vision loss usually gradual and vision must constantly be monitored (often by using an Amsler Grid).

* Can change into wet macular degeneration

Wet (a.k.a. exudative or neovasular):

* Causes vision loss due to choroidal neovascularization (the growth of blood vessels) that leak blood and other fluids beneath the macula

* Damage can be quick and severe

“It is possible to have both geographic atrophy and neovascular AMD in the same eye, and either condition can appear first.” (NEI)

Don’t wait to go see your doctor! If you have any kind of distorted or blurred vision, decreasing visual acuity, or any other vision changes make an appointment with your ECP immediately. Your doctor will perform a comprehensive eye exam, which may include a visual acuity test, dilating your pupils, amsler grid test, fluorescein angiogram and optical coherence tomography (OCT).

You can help prevent AMD by living a healthy lifestyle, which includes not smoking, exercising and eating a well-balanced healthy diet (see our blog titled “Your eyes are what you eat! Resolve to eat well for your eye health“). Doing these things not only helps prevent AMD, but also a wide variety of other diseases and conditions (heart disease, depression, and osteoporosis to name a few). Research also suggests that genetics are linked to AMD. However, just because you have the gene variants does not mean you will develop AMD, and genetic testing to screen for AMD is not recommended.

Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies (AREDS and AREDS2). They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate AMD, and those who have late AMD in one eye.

“Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies (AREDS and AREDS2). They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate AMD, and those who have late AMD in one eye.” (NEI)

There is no cure for AMD. Early AMD has no known treatment but it is highly recommended that you get a regular eye exam to monitor the condition.

For advanced neovascular (wet) AMD, vision loss is typical. However, there are several therapies that may stop further vision loss. Anti-VEGF therapy blocks the growth of new abnormal blood vessels. Photodynamic therapy uses a “cold” laser to activate a drug injected into your arm called verteporfin which slows the growth of destructive blood vessels. Laser therapy uses a “hot” laser to destroy destructive blood vessels. Even after using one of these treatments, AMD may progress.

You can cope with vision loss using a variety of resources. One of these is vision rehabilitation, which helps train you for using magnifying devices, helps you go about daily tasks and assists you in making modifications to your home. There are several low vision devices on the market including computer aids, handheld magnifiers, large-print reading materials and high-power reading glasses. Another helpful resource is AMD.org.


Sources:

NEI

Wikipedia

AAO

 

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