Macular Degeneration

" Macular degeneration: the loss of central vision through the age-related deterioration of the macula."

Today, with a simple google search, one can find volumes of information about macular degeneration. Some excellent links are provided at the end of this post. This is a disease we have come to understand fairly well, and a disease we have found dramatic new medical treatments for that now preserve vision much better than in the past.

Here are the things that you really need to know that will help you limit your risk of vision loss to macular degeneration.

There are two types of age related macular degeneration (ARMD):

Roughly 90% of all ARMD is dry. Dry ARMD is the progressive, slow depositing of metabolic waste in the macula which disrupts and damages the finely ordered photo receptors that give you detail-oriented vision. Current treatment is preventative in nature--there are no medical treatments at this time. But prevention works, and the earlier you start, the better.

About 10% of dry ARMD turns into wet ARMD, which is the active leakage of fluids and growth of new blood vessels in the macula. Wet ARMD can cause the rapid loss of central vision. A wide range of new medical treatments exist that can mitigate your vision loss if the wet ARMD is detected at the right time.

Prevention:

To understand prevention, you need to understand that the causes of ARMD are both genetic, and environmental. A family history of ARMD certainly increases your risk, and you can't control who your parents are, but the environmental factors that increase your risk can be controlled. All known environmental risk factors generate Free radical based oxydative damage in the macula.

Here are the main environmental risk factors:

1. Age-- environmental factor? Maybe more than we realize...
2. Smoking
3. Exposure to UV light
4. Poor nutrition
5. Neglecting your eye doctor

Here are the steps to prevent ARMD, slow its progress, or reduce your risk for vision loss:

1. Physical activity goes a long way to slowing the aging process in your body. Research now suggests it may also be an important factor in slowing ARMD.
2. Stop Smoking.
3. Wear a hat with a brim and Quality Sunglasses. You are never too young to start this habit.
4. Eat 12-15 servings of fresh fruits and vegetables a day with a variety of raw nuts and grains. Cornell University has a wealth of research on the overall benefit of getting your nutrition this way. It is difficult, but possible which is a subject for a future post. You may also follow the vitamin supplement path suggested in the AREDs study and others. With some of the recent unrelated findings on possible harm from vitamins, you need to exercise caution using Vitamin E, and beta carotene--especially if you are a smoker.
5. Only your eye doctor can help you monitor your maculae and get you timely help if your ARMD turns wet. See your doctor a minimum of once a year to start with, and follow his/her recommended schedule for return visits.

Medical intervention:

A new generation of drugs that inhibit the growth of new blood vessels have improved outcomes in patients compared to earlier laser treatments that indiscriminately damaged retinal tissue adjacent to the treatment area. Lucentis, Avastin, and Macugen are all drugs that are injected into the eye, sometimes repeated in series over weeks or months. Sometimes steroids can be injected into the eye to reduce edema in the macula as well. When your doctor sees evidence of wet macular degeneration, he/she may send you to a Retinal Specialist who will make the proper decisions about which treatment or combination of treatments will best reduce your vision loss from wet ARMD.

Patients who lose vision to ARMD voice significant frustration. It's like being blind without being blind. The peripheral vision that remains after you lose your central vision is not capable of seeing fine detail. Taking the necessary steps to prevent ARMD and having your eye checked yearly are a small price to pay for sight. http://www.allaboutvision.com/conditions/amd.htm

http://www.mayoclinic.com/health/macular-degeneration/DS00284

http://www.mayoclinic.org/macular-degeneration/prevention.html

http://vivo.library.cornell.edu/lifesci/individual/vivo/individual365 (access nutritional research by following the work of individual scientists)