February is National Macular Degeneration
Awareness Month

Age-related macular degeneration (AMD) is the leading cause of blindness in people over the age of 60.  It s estimated that 1 in 3 people 80 years of age and older have some form of AMD.  Unfortunately, there is no cure for this blinding disease and the result for many is legal blindness. 

What exactly is macular degeneration?

AMD is a disease of the retina.  The retina is a thin neurological tissue in the back of the eye that converts light into an image, much like the film in the back of a camera.  The macula is the most central portion of the retina responsible for very detailed vision and color vision.  You can imagine the macula as the “bulls-eye” of the retina.  As we age, many tissues throughout the body start to break down, including the macular area.  As the macular tissue continually degenerates, patients will notice subtle losses of central vision.   This process can occur over the course of years depending on a patient’s given risk factors. 

There are two categories of macular degeneration.  The first is called the dry stage, which encompasses about 85-90% of AMD.  During the dry stage, the macular tissue slowly atrophies, or breaks down.  This process can happen for many years before symptoms of vision loss are appreciated.  Once enough tissue degenerates, abnormal blood vessels can migrate into the macular area.  In the wet stage, abnormal blood vessels encroach into the macular area and eventually hemorrhage, causing total destruction of tissue and devastating central vision loss.  Once this process occurs, the patient is usually left with very little functional vision and there is nothing we can do for recovery.  At this point, patients are often left in despair and depression as a result of this loss of vision and independence.

Treatments for AMD

Unfortunately, there are no cures for this debilitating eye disease.  However, there are many treatment alternatives that can help slow the disease process down or in some cases halt it for a significant amount of time (years).  Several years ago, a land-mark study titled the Age Related Eye Disease Study (AREDS) conducted by the National Institute of Health, clearly demonstrated that certain stages of dry AMD can be slowed down by 25% with dietary supplementation of vitamins A,C,E, zinc, and copper.  Of important note, those who smoked were at higher risk of developing lung cancer due to the vitamin A, so it is now recommended that patients with AMD who smoke take a similar supplement WITHOUT the vitamin A.  The AREDS part II is also looking at additional supplements including lutein and omega-3 fatty acids and their role in treating dry AMD.  It seems that the addition of Lutein, Zeaxanthin and Omeag-3 fatty acids (fish oil) also help slow down the progression of dry AMD.  Lutein, along with other potent anti-oxidant vitamins, are found in dark green vegetables such as spinach and broccoli.

During the wet stage, we have excellent medications that are injected directly into the eye.  These drugs (Lucentis, Avastin) are known as anti-VEGF medications.  They can make the abnormal blood vessels retract and prevent hemorrhaging and further damage to the macular tissue.  While the goal is to delay further vision loss, some patients have actually regained some vision as a result of these procedures.  What is very exciting and prmising is the concept of stem cell implantation to re-grow retinal tissue in the macular area to CURE AMD!  Research is underway and in my life time, I believe we will have a cure for AMD with this controversial, yet exciting Bio-technology!

Risk Factors

As its name implies, AGING is the most influential risk factor for AMD.  Having a positive family history is another risk factor as is smoking!  We all know the effects smoking has on cardiovascular health and cancer - it can also contribute to blindness!  Other less influential risk factors include having blue eyes, high triglyceride levels and possibly blue-light radiation (from the sun) over a lifetime.  It is crucial that adults have their eyes thoroughly examined to look for signs of AMD.  If you have a family history of AMD you are at risk of developing this disease and smoking compounds that risk exponentially.  If any of our patients, even young ones, have any of the aforementioned risk factors, we recommend a healthy lifestyle along with vitamin supplementation to hopefully decrease their risk of developing AMD.  If you would like more information or have any questions about AMD, please call our office or email us.