Here’s a shocking figure: more than 10 million Americans are living with macular degeneration. It is the leading cause of vision loss in the United States, affecting more people than cataracts and glaucoma combined. What’s more sobering is that, although researchers are working on new treatment options, as of today, macular degeneration is considered to be incurable.
Even though there is no cure for macular degeneration, there are choices you can make to reduce your risk or that may slow the disease’s progression once you’ve been diagnosed.
First, though, let’s talk about the basics of age-related macular degeneration.
Think of the eye as being like a camera. In the back of the eye is the retina which acts like the film of that camera, collecting light and recording the images we see. The macula is the central and most sensitive part of that film, sending images to our brains through the optic nerve.
For complex reasons scientists are still working to understand, sometimes the cells of the macula begin to deteriorate. At first, people who are experiencing macular degeneration don’t typically notice anything different about their vision, but over time the disease progresses. Macular degeneration always occurs in both eyes — never in just one.
There are three stages of age-related macular degeneration (AMD):
- Early AMD – This is the beginning stage of macular degeneration. Vision is not usually affected in this stage, but a well-trained optometrist or ophthalmologist will notice small white or yellow deposits beneath the retina called “drusen” in an eye exam. For many people, the disease does not progress beyond this stage.
- Intermediate AMD – Many patients experience wavy or blurred vision in this stage. Straight lines may appear to be curvy, objects may appear smaller than they are in reality, or colors may be less vivid than usual. Many things can cause these vision changes, so it is important to see a doctor for any vision changes. A comprehensive eye exam can detect larger drusen at this stage, as well as pigment changes in the retina that indicate AMD.
- Late AMD – At this stage, central vision loss has become obvious. Because the rest of the retina remains intact, peripheral vision remains. Late AMD can progress to legal blindness.
Wet and Dry Macular Degeneration
Eye doctors talk about macular degeneration terms of “dry” and “wet” AMD. Both types are manifestations of the same disease, and people with either type can progress through each of the three stages.
The majority of people with AMD — 80 to 90 percent — experience the dry, or atrophic type. It tends to progress relatively slowly. At this time, there is no cure; however, if you have been diagnosed with AMD, there are some interventions that show promise for slowing disease progression.
The Age-Related Eye Disease Study (AREDS) conducted by the National Eye Institute found that AMD symptoms could be delayed or prevented by taking nutritional supplements with a specific high-dose formulation of antioxidants (vitamins C and E and beta-carotene), zinc, and copper. A follow-up study showed that lutein and zeaxanthin were better substitutes for beta-carotene, which increases the risk of lung cancer for people who smoke or ex-smokers. Click here for supplement information and other details of this study.
- Implantable Miniature Telescope
In 2010, the FDA approved an implantable miniature telescope called the CentraSight that can be used in patients who are in late-stage AMD. The device is implanted in one eye and can potentially restore some central vision in that eye while the other provides peripheral vision.
Wet AMD affects one in every nine to 10 people with AMD (10 to 15 percent) but accounts for 90 percent of cases that result in severe vision loss. In this manifestation of AMD, unhealthy blood vessels begin to grow beneath the macula. These vessels tend to break, bleed, and leak fluid. Much like a blister, the leaked fluid damages the macula and causes it to lift away from its base. This can result in a rapid and severe loss of central vision.
Wet AMD can be treated with intervals of so- called anti-VEFG inections, which do not cure it, but can restore some of the vision lost. Lasers have also been used to essentially cauterize errant vessels, but this treatment has the potential of damaging healthy retinal tissue.
To find out more about treatments for wet or dry AMD, contact a retina specialist whose practice has a focus on AMD.
Risk Factors for AMD
No one knows for sure what causes AMD, but it is clear that the answers are complex. Macular degeneration is now believed to be caused by a combination of hereditary and environmental factors, which is why finding a cure is such a challenge. Risks include:
The biggest risk factor for AMD is age. The older we become, the greater the likelihood that we will develop AMD. Most people who develop AMD are 55 years or older.
People with a family history of AMD have a greater risk of developing it. In addition, light-skinned people are more likely to develop the disease than people with darker skin.
Smokers are twice as likely to develop AMD than their non-smoking counterparts.
To find out more about clinical trials for macular degeneration, visit these informative sites:
- Clinical trial research on the VisionAware blog
- Macular degeneration research on the VisionAware blog
- The National Eye Institute website for information on clinical studies.
- Clinicaltrials.gov provides a searchable list of all current clinical trials related to AMD.
- Macular Degeneration Partnership provides information on clinical trials for wet AMD, dry AMD, and a list of frequently asked questions about clinical trials.
St. Louis LASIK surgeon Dr. Jason P. Brinton, MD is an internationally recognized specialist in the field of refractive surgery. He is a graduate of Harvard College, earned his medical doctorate from the Harvard Medical School, and is board certified by the American Board of Ophthalmology. He has been inducted to America’s Top Ophthalmologists by the Consumer Research Council of America, Leading Physicians of the World by the International Association of Healthcare Professionals, and Top Doctors in America by Castle Connolly. In 2015, he received global recognition as the recipient of the Visian ICL Young Ophthalmologist Award in Barcelona, Spain, and in 2016 was named Ocular Surgery News’ Premier Surgeon 300 Innovators in Refractive Cataract Surgery. In 2017, he was named in Top Doctors in St. Louis. He is a dedicated husband, father of four beautiful children, and is passionate about his life, his work, and service to others.