Macular Degeneration is the Leading Cause of Blindness in Older Americans

Sunday, April 20, 2008

In the past, macular degeneration was poorly understood and there were no treatment options. Recently, there have been dramatic improvements in the treatment of the wet type of the disease, which can result in rapid visual loss if left untreated.

Research is also being conducted to help slow down the visual loss associated with advanced dry AMD.

The macula is the center of the retina responsible for sharp vision. It is critical for tasks such as reading and driving.
Aging changes in the macula include deposits underneath the retina, called drusen, and pigment alterations that may result in reduced oxygen and nutrient exchange. As a result, retinal function is impaired and retinal tissue may be lost, in a process called atrophy. These changes constitute dry AMD, which affects 90 percent of patients with the age-related macular degeneration. Generally, dry AMD causes a very slow loss of vision. However, when atrophy is extensive or involves the center of the macula, severe loss of vision may occur.

Although there is no treatment for the slowly progressing dry type of AMD, there are some things you can do to protect your vision. If you smoke, you should try to quit, since smoking doubles your risk for developing the disease and for further loss of vision. A healthy diet that includes green leafy vegetables and low fat intake has been shown to slow down the progression of the condition as well.

A large clinical study, called the AREDS study, showed that supplemental vitamins containing high concentrations of vitamins A, C, E and zinc can slow down the progression of the condition.

Lutein and omega-3 fatty acids may be beneficial for the retina. A large-scale clinical study sponsored by the National Eye Institute is being conducted to determine whether these vitamins can benefit patients with AMD.

For the wet type of AMD, an exciting new drug was approved by the Federal Drug Administration in June 2006 called Lucentis. For the first time in the history of treating wet AMD, Lucentis offers a 30 percent to 40 percenOften, patients require three treatments initially, and then they are monitored. If leakage recurs, treatment is re-administered.

With all forms of AMD, there are three important guidelines.
First, it is critical to catch the disease early.
Second, it is important to start any treatments as soon as any leakage or bleeding begins to preserve as much vision as possible. This means regular eye exams are vital for anyone over age 55, especially for anyone with a family history of retinal disease.
Third, you should try to reduce your risk factors by watching your diet, avoiding smoking and second-hand smoke exposure and taking vitamin supplements if advised by your ophthalmologist.



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