ASG is equipped with most modern diagnostic tools and treatment modalities for macular degeneration. Macular degeneration is a deterioration or breakdown of the macula. The macula is the central portion of the retina and is responsible for detailed vision and color vision, the vision we use to read, thread a needle, sign a check, or recognize faces.

What is Age related Macular Degeneration?

There are two types of age-related macular degeneration :

Dry (atrophic) form: This type results from the gradual breakdown of cells in the macula, resulting in a gradual blurring of central vision. Single or multiple, small, round, yellow-white spots called drusen are the key identifiers for the dry type.

Wet (exudative or neovascular) form: In the wet form of macular degeneration, vision distortion usually starts in one eye and may affect the other eye later. In contrast to the dry type, vision loss may be rapid in the wet type of macular degeneration.

FAQ's

What causes Macular Degeneration?

Macular degeneration often runs in families. There may be a wide variety of different genes and proteins associated with dry and wet macular degeneration. Many older people develop macular degeneration as part of the body’s natural aging process. Exactly why it develops is not known, and no macular degeneration is the leading cause of severe vision loss.

Many of the following risk factors have been found to be associated with age-related macular degeneration:

  • Age: The likelihood of developing macular degeneration increases with age.
  • Race: Macular degeneration is more common in whites but occurs in all races.
  • Pigmentation: Macular degeneration is more common in lightly pigmented people.
  • Iris color: As a corollary of skin pigmentation, people with a more lightly colored iris are more likely to develop some forms of macular degeneration.
  • Gender: Women seem to be at greater risk.
  • Smoking is a well-established risk factor for both forms of macular degeneration.
  • Obesity and syndrome X, or metabolic syndrome, are also associated with the condition.
  • Sleep apnea may be associated with macular degeneration independent of the obesity risk factor.
  • Exposure to sunlight: Those with lifelong outdoor careers or hobbies as well as those living near the equator and at high altitudes are at greater risk.
  • Medications: Some medications like Fosamax for osteoporosis may predispose to macular degeneration.
  • High degrees of myopia may be associated with age-related macular degeneration or a similar condition called myopic degeneration.
  • Family history is perhaps the most important risk factor other than age.

Macular Degeneration Symptoms?

Macular Degeneration can cause different symptoms in different people. The condition may be hardly noticeable in its early stages. Following are the common ways vision loss is detected:

  • Blurred or decreased central close-up and distance vision
  • Blind spots, or scotomas, are a direct result of lost macular function.
  • Straight lines look irregular or bent, called metamorphopsia, and objects appear a different color or shape in each of the eyes.
  •  Objects appearing smaller in one eye than the other.

How it has been diagnosed?

Initial tests include measurement of the sharpness of vision, or visual acuity, and an examination of the retina. Multiple spots in the macular region known as drusen are the hallmark of the dry form of age-related macular degeneration. Another sign of age-related macular degeneration is degeneration of the pigmented layer itself. Degeneration appears as thinning and loss of the retina, the pigment layer, and the choroid, the intermediate layer of the eyeball. In eyes that become complicated by the wet form of age-related macular degeneration, exudates (fluid), blood, scarring, and new blood vessel membranes below the retina might be seen.

  • Visual acuity test. This eye chart test measures how well you see at various distances.
  • Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
  • Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional also may do other tests to learn more about the structure and health of your eye.

Macular Degeneration Treatment

During an eye exam, you may be asked to look at an Amsler grid. The pattern of the grid resembles a checkerboard. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD.

Amsler Grid

If your eye care professional believes you need treatment for wet AMD, he or she may suggest a fluorescein angiography. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

If signs of macular degeneration are found, ophthalmologist may take detailed pictures of the retina for future comparison. Tests may also include:

  • Fluorescein angiography
  • Indocyanine Green
  • Optical coherence
  • Visual field testing

Treatment

  • Antioxidants: Deficiencies in antioxidants (specifically zinc and vitamins A, C, and E, selenium, copper, lutein, and zeaxanthine) have been noted in some people with age-related macular degeneration. Antioxidants may protect against age-related macular degeneration by preventing free radicals or unstable oxygen from damaging the retina.
  • Laser treatment: Laser treatment may stop or lessen vision loss in early stages of the disease. It is performed with a specific wavelength designed to cauterize the abnormal blood vessels. Argon and krypton lasers are most commonly used for treating macular degeneration.

Medications

Anti-VEGF therapy: Vascular endothelial growth factor (VEGF) causes new blood vessels to develop and increases leakage and inflammation of blood vessels. Most of these drugs are insoluble and therefore cannot be given as eyedrops.

Surgery

A diversity of surgical treatments are being investigated for exudative age-related macular degeneration lesions that may not qualify for laser treatment, including macular translocation to a healthier area of the eye, displacement of submacular blood using gas, and removing membranes by surgery.

What can I do if I have already lost some vision from AMD?

If you have lost some sight from AMD, don”t be afraid to use your eyes for reading, watching TV, and other routine activities. Normal use of your eyes will not cause further damage to your vision. If you have lost some sight from Age-related Macular Degeneration, ask the eye care professional about low vision services and devices that may help you make the most of your remaining vision.