Dr. Whitman: Hello, I’m Dr. Jeffrey Whitman and I am being joined today by several
of the physicians at Key-Whitman who treat patients with Macular Degeneration.
What Is Macular Degeneration?
Dr. Haq: Macular degeneration is the leading cause of severe vision loss in people
over age 60. This occurs when the macula, very central part of the retina,
deteriorates. The retina is located in the back of the eye and is responsible
for receiving the light rays as they enter the eye. The disease is also
known as Age-Related Macular Degeneration (AMD), because it usually develops
as a person ages. Although macular degeneration does not result in total
blindness, it can be a source of profound visual disability.
How is it diagnosed?
Dr. Hong: Age-related macular degeneration or AMD can be detected in a routine eye
exam. If we detect AMD, you may have a procedure called angiography. During
this procedure, a fluorescein dye is injected into a vein in the arm.
Photographs are taken as the dye reaches the eye and flows through the
blood vessels of the retina. If there are new vessels or vessels leaking
fluid or blood in the macula, the photographs will show their exact location
and type. Optical coherence tomography or OCT may also be performed which
is a noninvasive test that produces a cross-sectional image of the retina.
This is helpful in identifying abnormalities or distortions in the layers
of the retina and whether treatment is improving the condition.
Dr. Whitman: Early detection of age-related macular degeneration is very important because
there are treatments that can stop, delay or reduce the severity of the
disease. In its early stages, macular degeneration may not have symptoms
and may be unrecognized until it progresses or affects both eyes. The
first sign of macular degeneration is usually a dim, blurry spot in the
middle of your vision. This spot may get bigger or darker over time.
What are the symptoms?
Dr. Whitman: Symptoms of macular degeneration may include:
- Dark, blurry areas in the center of vision
- Diminished or changed color perception
- Straight lines appear wavy
If you experience any of these symptoms, call us as soon as possible.
Dr. Whitman: There are two main types of age-related macular degeneration:
Dry form. The "dry" form of macular degeneration is characterized by the
presence of yellow deposits, called drusen, in the macula. A few small
drusen may not cause changes in vision; however, as they grow in size
and increase in number, they may lead to a dimming or distortion of vision
that people find most noticeable when they read. In more advanced stages
of dry macular degeneration, there is also a thinning of the light-sensitive
layer of cells in the macula leading to atrophy, or tissue death. In the
atrophic form of dry macular degeneration, patients may have blind spots
in the center of their vision. In the advanced stages, patients may lose
most of their central vision.
Wet form. The "wet" form of macular degeneration is characterized by the
growth of abnormal blood vessels underneath the macula. This is called
choroidal neovascularization. These blood vessels leak blood and fluid
into the retina, causing distortion of vision that makes straight lines
look wavy, as well as blind spots and loss of central vision. These abnormal
blood vessels eventually scar, leading to permanent loss of central vision.
Dr. Whitman: Most patients with macular degeneration have the dry form of the disease
and usually will not have a profound loss of central vision. However,
the dry form of macular degeneration can lead to the wet form. Although
only about 10% of people with macular degeneration develop the wet form,
they make up the majority of those who experience serious vision loss
from the disease.
Who is at risk?
Dr. Haq: Macular degeneration may rarely be hereditary, meaning it can be passed
on from parents to children. If someone in your family has or had the
condition you may be at higher risk for developing macular degeneration.
Talk to your eye doctor about your individual risk. Smoking, high blood
pressure, high cholesterol, obesity, and being Caucasian are also risk
factors for macular degeneration.
What can be done to treat it?
Dr. Hong: It is very important for people with macular degeneration to monitor their
eyesight very carefully and to return to see the doctor as directed. Along
with regular follow-up, your doctor may suggest you begin to improve your
diet by adding lots of green, leafy vegetables and perhaps introducing
vitamins and supplements that are especially formulated for patients with AMD.
Dr. Whitman: Additionally, we may suggest medications and therapies such as Avastin
which block the development of new blood vessels and leaking from the
abnormal vessels within the eye that cause wet AMD. This treatment has
been revolutionary in the treatment of AMD and many patients have actually
regained vision that was lost. It is important to note, results will vary
and this treatment will likely be repeated on a regular basis.
Dr. Whitman: I hope you have found this information useful. We look forward to taking
care of you.