Macular degeneration is one of the leading causes of blindness in individuals over the age of 60. Also called age-related macular degeneration (ARMD or AMD), it occurs due to a breakdown of the normal retina structures and accumulation of waste products, known as drusen, in the center of the retina, also known as the macula. Risk factors include age, history of smoking, Caucasian race, family history, female gender, and hypertension.
ARMD can occur in two distinct forms. About 90% of individuals with ARMD have the dry form with the presence of drusen and loss of their normal retinal pigment. The other 10% develop the wet form with the growth of new blood vessels, known as neovascularization, under the retina. In the wet or neovascular form, these blood vessels can leak fluid or bleed underneath retina. Both forms can lead to vision loss. Symptoms of ARMD can vary from decreased vision to distortions in central vision. Patients may describe the presence of wavy lines or that objects in their central vision are missing or bending. With the wet form of ARMD, central vision loss can be sudden and sometimes even severe.
Individuals over the age of 60, especially with a family history of ARMD, should be evaluated by an eyecare professional to look for signs of ARMD. During the examination, your eyes will be dilated and further testing, including retinal photographs and retinal imaging scans, may be done to evaluate the structural integrity of your retina.
Treatment varies depending on the form of ARMD. For the dry form, specifically formulated vitamins are recommended. Based on the Age-Related Eye Disease Study (AREDS), this formulation consists of vitamin C, vitamin E, zinc, copper, lutein, and zeaxanthin. These vitamins have been shown to slow down the progression of ARMD. Patients with the wet form are referred to a retina specialist for further evaluation and treatment. Evaluation may include additional testing, such as fluorescein angiogram, where IV dye is used to look closely for the presence of neovascularization and the site of leakage within the macula. If confirmed to be the wet form, patient will be advised to receive a series of eye injections, known as intravitreal injections. These intravitreal injections may be done monthly to stabilize the patient’s vision. Finally, all patients with ARMD are advised to quit smoking.