Robert K. Maloney (Ophthalmologist) gives expert video advice on: Who is likely to suffer macular degeneration?; What treatments are available for macular degeneration? and more...
What is "macular degeneration"?
In age-related macular degeneration, which we call macular degeneration for short, the RPE cell layer deteriorates. Then the retina's not properly supported and nourished and it starts to die. The effect is loss of central vision, so that when you have macular degeneration, when you look straight ahead if it's severe enough, there's a black spot in the center of your vision, and that follows you wherever you look. Macular degeneration incredibly disabling, because you lose your ability to drive, to read, to watch TV.
Who is likely to suffer macular degeneration?
Age related macular degeneration is the most common cause of irreversible blindness in the United States. About a third of all caucasions over the age of seventy have some evidence of this condition. It turns out, if you're a darkly pigmented individual, black, hispanic, native american, you are at a much lower risk of developing macular degeneration. That extra pigment seems to be protective.
What are the most common symptoms of macular degeneration?
As AMD advances, you go from blurring of vision to actual loss of central vision or patchy loss of vision. Hopefully it's been caught long before that because there are some things that can be done to reduce the progression. The earliest symptom of macular degeneration is just blurry vision. As it advances, it sometimes causes straight lines to appear crooked, or you can see breaks in lines. So, a straight line will appear to have a break in the middle. If you see that, it's important to get to your eye doctor quickly, because if caught early enough, certain types of macular degeneration, particularly the wet type, can be treated.
What are the differences between "dry" and "wet" macular degeneration?
There are 2 kinds of macular degeneration. The most common form affecting about 90 or 95 percent of people is the dry form, and that's a deterioration of the outer cell layer, the RPE layer. And, as you look in the eye, as an eye doctor, we see little white spots that are a sign of macular degeneration of the dry form. The other kind is called the wet form. That involves blood vessels, new blood vessels, growing through the RPE layer under the retina. That tends to cause much more severe visual loss because these blood vessels bleed, and when they bleed they destroy large areas of retina all at once. Fortunately the more severe form, the wet form, is also a more rare form.
How will I know if I have age-related macular degeneration (AMD)?
There is no way for you to tell if you have age-related macular degeneration (AMD). The first signs are a mild blurring in vision. Lots of things can cause that, including cataracts. So really your eye doctor has to make the diagnosis.
What treatments are available for macular degeneration?
If you have the dry form of macular degeneration, there's certain vitamin supplements that will help reduce the progression of the disease. These supplements include zinc, copper, and beta-carotene. They need to be, or they should be prescribed by an eye doctor because the proper mix of supplements is changing as we learn more. If you have the wet form of macular degeneration, there's a variety of treatments that are now available. These include photodynamic therapy, which involves using a laser in combination with medicines injected in your veins, and certain drugs that interfere with the growth of blood vessels that are injected directly into your eye or around your eye. These drugs have revolutionized the treatment of wet macular degeneration and, in fact, can reverse the visual loss in many patients.