As I stated in Part 1 – Cataracts, your eyes are very important, and as you only have one pair, you can’t afford not to take care of them.
This particular subject is near and dear to my heart, as my mother had Wet Macular Degeneration and lost her sight in her 70’s.
With Macular Degeneration, it’s very important to make sure to see your eye doctor/specialist on a regular basis, before it happens, because he/she can help to determine if the disease is going to become an issue.
Macular Degeneration (MD) or Age Related Macular Degeneration (ARMD) is the leading cause of vision loss among older Americans, and the number of people affected by it is expected to increase significantly in the coming future, due to the aging of our population. It is estimated that about 6.5% of Americans aged 40 and older suffer from some level of macular degeneration. It is estimated that approximately 17.8 million people in the USA will suffer from this eye disease by the year 2050 (don’t think I’ll be around, but who knows!).
There are two major types of MD – Dry and Wet Forms of Macular Degeneration.
Dry Macular Degeneration (non-neovascular) is the early stage of the disease and could result from the aging and thinning of macular tissues. depositing of pigment in the macula or a combination of these two processes.
It is diagnosed when yellowish spots known as “drusen” begin to accumulate in and around the macula and it is believed these spots come from deteriorating tissue. The central vision loss may occur gradually with dry macular degeneration, but in the late stage over time geographic atrophy (GA) will degrade the retinal cells causing severe vision loss.
There is no “approved” treatment for dry macular degeneration at this time, but a few are in clinical trials. However, two five-year clinical trials – the Age Related Eye Disease Studys (AREDS in 2001 and AREDS2 in 2013) have shown that nutritional supplements containing antioxidant vitamins and multivitamins containing lutein and zeaxanthin can help reduce the risk of dry AMD progressing to sight-threatening wet AMD. But the study didn’t prove any preventative benefit of these supplements against developing dry AMD in healthy subjects’ eyes.
It is currently believed that eating a healthy diet of dark leafy vegetables, exercise and wearing sunglasses are the best protection for your eyes against dry macular degeneration.
Wet Macular Degeneration (neovascular) – About 10% of dry AMD progresses to the more advanced and damaging form of this eye disease. In wet macular degeneration, new blood vessels grow beneath the retina and leak blood and fluid, causing permanent damage to the light sensitive retinal cells that die off and create blind spots in central vision. Unfortunately, the body thinks it’s doing the right thing by creating a new network of blood vessels, but instead it creates scarring, then leading to severe central vision loss.
WMD has two categories: Occult – where new blood vessel growth is not as pronounced, and leakage is less evident producing less severe vision loss; and Classic – where the blood vessel growth and scarring are very pronounced and will produce more severe vision loss.
The Amsler Grid is used to help determine if there is some vision loss due to AMD. The vision loss is usually painless and very slow, but in some cases the vision loss can be very sudden. Some early signs of vision loss are shadowy areas in your central vision or unusually fuzzy or distorted vision. The Amsler Grid can help you determine if there is a problem and the need to see your eye doctor/specialist right away.
There are two genes that have been found in people who have macular degeneration – one is called the complement factor H(CFH) which is associated with almost half of all potentially blinding cases of MD. The other is complement factor B which may be involved in the development of AMD. These genes play a role in the body’s immune responses and have been found in about 74% of AMD patients who were studied.
There may be other complement factors that may be associated with an increased risk of AMD. Another factor is oxygen-deprived cells in the retina that produce a type of protein called vascular endothelial growth factor (VEGF) that triggers the growth of new blood vessels in the retina. Too much VEGF in the eye causes the development of unwanted blood vessels in the retina which can easily break open and bleed causing damage to the macula and surrounding retina.
Macular Degeneration affects older populations, whites and females in particular. It can result as a side effect of some drugs. It also seems to run in families. Smoking is high on the list of risk factors, as well as having a family member with it, high blood pressure, lighter eye colour and obesity.
There is no outright cure for macular degeneration, but some treatments may delay its progress or may even improve vision. The treatments used depend on what stage the disease is in – dry or wet. There are no treatments for dry AMD, but nutritional intervention may help prevent it progression to the wet form. According to CNIB – Wet AMD treatments include some drug therapies – Lucentis, Avastin, and Eylea are some of these treatments, but you would have to speak with your eye doctor/specialist to determine what is best for you if you suffer from this disease.
Research has revealed positive association between good nutrition and reduced risk of AMD. Eating plenty of salmon and other coldwater fish containing high amounts of Omega-3 fatty acids may help prevent AMD or reduce the risk of its progression. Supplements containing lutein and zeaxanthin help increase the density of pigments in the macula associated with protecting the eyes from AMD.
Although vision lost to AMD is very unlikely to be returned, there has been progress in AMD treatment. Your doctor will likely have you check your vision regularly with the Amsler grid (shown above). Covering one eye and viewing the grid, then doing the same for the other eye separately. This is a very sensitive test and may help reveal vision problems before your doctor even sees AMD related damage to the macula in their routine eye exam.
There are many low vision devices available to help those who suffer from vision loss due to macular degeneration. I remember 20 years ago, my dad bought a mouse for the TV, so my mom could read her newspaper on a big screen. I’m sure in 20 years, those devices have improved greatly. If you need any help in that respect, get in touch with the CNIB or a similar agency to help locate the right piece of equipment for you. Some of these devices are: eyeglasses with high-powered lenses; large-print reading materials; clocks and phones; closed circuit television magnifiers; hand-held and desk-top magnifiers; telescopic devices; reading devices; computer software.
I hope these Eye Health posts have helped you in some way and should you ever suffer any of the symptoms associated with any of these ailments, that you contact your eye doctor/specialist immediately.
Have a wonderful day and week ahead.