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TREATMENT OF
MACULAR DEGENERATION
 
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MACULAR DEGENERATION INFORMATION

Age-Related Macular Degeneration is an eye condition in which a senstitive area in the center of the retina, known as the macula, becomes damaged. Because the macula is responsible for central and detail vision, this may cause loss of central vision, such as inablity to read or recognize faces.

The more common form is Dry Macular Degeneration, in which the retinal tissue thins and becomes atrophic, often with the appearance of DRUSEN, which are fine deposits of a fatty substance known as lipufuscin. Most cases of Dry Macular Degeneration are mild, resulting in mild vision loss. However, not all cases of Dry Macular Degeneration are mild. One form, known as Geographic Retinal Atrophy, can result in severe vision loss. Furthermore, approximately 10% of patients with Dry Macular Degeneration progress to the more severe Wet Macular Degeneration, also known as Exudative Macular Degeneration. The only successful treatment of Dry Macular Degeneration is with high dose Nutritional Supplements.

Wet Macular Degeneration involves the growth of abnormal new blood vessels below the retinal surface. Also known as choroidal neovascularization, these tiny fragile and abnormal blood vessels can bleed and leak protein below and into the retina, causing abrupt loss of central vision.

Formerly, these areas of neovascularization were treated with laser light, which cauterized the blood vessels so they would not leak at the expense of burning the central retina, resulting in a permanent blind spot.

There has been much new exciting research with Wet Macular Degeneration focusing on drugs that can block the action of harmful molecules called Vascular Endothelial Growth Factors (VEGF). These include, Macugen, Lucentis and Avastin. Macugen and Lucentis are FDA approved for injection into the eye, while Avastin, a colon chemotherapy agent, is used off-label. All these medications have been shown to shrink the abnormal blood vessels, and as a result, reduce the bleeding and protein leakage. Lucentis and Avastin, coincidentally both manufactured by Genentech, have actually been shown to improve vision, heretofore an unachievable feat.

Recommendations

  • For patients over the age of 60 years-old, in whom macular degeneration is most common, yearly examinations by an eye doctor are recommended. Eye Doctors include both optometrists (O.D.'s) and ophthalmologists (M.D.'s).  Both are specially trained to detect many vision-threatening conditions even before you develop symptoms. The earlier the problems are detected, the better chance of preventing vision loss.
  • Protection from UV-A and UV-B rays. Some studies have suggested that prolonged or frequent exposure to UV-A and UV-B rays may be a factor in macular degeneration and other eye conditions, so always wear your sunglasses that block 99 to 100% of UV rays when outdoors.
  • Proper nutrition. Nutrition plays a role in macular degeneration, but only when high levels of eye supplements are ingested, as shown by studies such as the National Eye Institute's Age Related Eye Disease Study and the Lutein Antioxidant Supplementation Trial. Ordinary daily vitamins, which generally contain many nutrients but only at doses that are 100%-200% of recommended daily allowance, have no benefit.

There is a great deal of research and several major scientific studies being conducted to find the causes and develop effective treatments for all types of macular degeneration. Visit the National Eye Institute Web site for additional information, .

Be wary of any treatment that promises to restore vision, or cure or prevent macular degeneration. There are so many so-called "miracle cures" advertised (often in magazines or on the Internet) that have not been adequately tested for safety or efficacy. These treatments may be expensive and are generally not covered by insurance. If you are considering trying a new or untested treatment, make sure you talk to your Eye Doctor to ensure they are safe and won't interfere with the timely and effective treatment of any eye problems.

Low Vision Rehabilitation can help people who have experienced mild to severe vision loss adjust to their condition and continue to enjoy active and independent lifestyles. Rehabilitation may involve anything from adjusting the lighting in your home to learning to use low vision aids to help you read and perform daily tasks. Your Eye Doctor can arrange rehabilitation or refer you to organizations that can help.

Adjusting to vision loss can be difficult at first. Your Eye Doctor may be able to recommend some support groups for people with low vision. You can support friends and family by encouraging them in their rehabilitation efforts and providing help (such as rides to appointments) when needed.