What is Macular Degeneration?
Macular degeneration, also known as Age Related Macular Degeneration or AMD, is an eye disease that is a major cause of visual loss for older patients. Macular degeneration is connected to a variety of factors including genetics and inflammation, but the precise cause of this disease is unknown. AMD causes impairment to the macula, which is the central portion of the retina. The macula is in charge of the focusing direct vision needed for activities such as driving at night, reading, or seeing details at a distance. At Orange County Retina, our AMD patients are typically 65 years or older as this disease is commonly related to aging.
Types of Macular Degeneration
Macular degeneration is often grouped into two qualifying categories, dry and wet types of AMD. The dry form, which is the most common type, can include the loss of retinal pigment and deposit of material in the tissues underlying the macula. These changes can lead to distorted or decreased vision as pigment fades and the materials build up. As the disease progresses, changes in the blood vessels underlying the retina can cause bleeding, which is the wet component of wet macular degeneration. Wet macular degeneration is less common in patients but can have serious effects on the eyes such as overall vision loss.
What are Macular Degeneration Symptoms to look for?
- Blurred Vision
- Wavy lines
- Blind spots
- Long distance vision issues
Schedule your Evaluation
A thorough eye examination at Orange County Retina offices, including a detailed examination of the retina, is recommended for all persons 40 years or older, especially those with a family history of eye disease such as AMD to reduce your risk of developing vision loss from this potentially serious eye condition.
Risk factors for macular degeneration include:
- Age over 60
- Family history
- Smoking cigarettes
- Caucasian race
- Female gender
- Extensive sun exposure
- High blood pressure
How do you treat Macular Degeneration?
Your Orange County Retina eye specialist may recommend the daily use of supplements, which have been comprehensively studied in large clinical trials and have been shown to reduce the risk of developing more severe forms of AMD. You may be provided with an Amsler grid, a piece of graph paper with thick, dark lines that you can use to test your vision each day. This grid can be used at home to monitor for the progression of AMD. If the lines appear wavy or distorted, you should see your eye doctor immediately because it may be a sign that your condition has grown worse.
Laser treatment to prevent the blood vessels from leaking is one form of therapy for wet AMD that your Orange County Retina specialist may recommend. A second mode of treatment involves the injection of medication into the eyeball. Macugen is an FDA approved medication and has been shown to significantly slow vision loss in patients with the wet form of AMD.
Newer medications such as Avastin and Lucentis are likely to become the treatment of choice for many patients with wet AMD. The injection of these medications may need to be repeated several times to obtain their full effect, however, and it should be emphasized that none of these treatments is likely to improve vision in AMD. They have been shown to slow the progression of vision loss, and further loss of vision may still occur despite these treatments.
Orange County Retina offers Avastin therapy for several problems including the treatment of wet macular degeneration, macular edema associated with vein occlusion, diabetes, cataract surgery, and uveitis. It does require dilation of the pupils and it is administered as painless eye injection. A series of treatments may be required.
This drug was originally used for cancer patients but is now used to treat wet macular degeneration and works by inhibiting the growth of abnormal blood vessels in the back of the eye.
The objective of the Avastin™ is ultimately to prevent further vision loss. Some patients have reported some regained vision but the medication should not be expected to restore vision that has already been lost due to macular degeneration.
The FDA has recently approved Eylea for the treatment of the wet form of age-related macular degeneration (AMD). The blood vessels can leak blood and fluid, causing damage to the retina. Eylea blocks all forms of this factor, called VEGF, and also blocks a second similar factor. In June 2011, an FDA advisory panel unanimously recommended approval of Eylea, previously called VEGF Trap-Eye. The generic name for Eylea is aflibercept.
Although the FDA has ruled that Eylea’s benefits outweigh its risks, the drug can cause some serious side effects:
- Bleeding in the white part of the eye at the site of injection
- Eye pain
- Vitreous detachment
- Increased pressure within the eye
Lucentis® Treatment works by preventing the growth of abnormal blood vessels while treating the swelling of the macula. Most likely the vision loss caused by wet Macular Degeneration can’t be fully regained, but Lucentis® works to prevent any further vision loss, while in some cases, reversing some vision lost with Macular Degeneration.
Administering Lucentis® is an in office procedure where the pupil must be dilated and the eye is numbed with anesthesia before the Lucentis® is injected into the vitreous, which is the clear jelly-like fluid that fills the inside of your eye. The injections will need to take place on a regular basis, generally every four weeks, but it is important to speak directly with your Orange County retina specialist to determine the exact treatment calendar for you.