Haims: The two types of age-related macular degeneration
Macular degeneration is a progressive disease that impacts a person’s central vision and ability to see fine details. It occurs when there is damage to a critical part of the retina, known as the macula. The macula is located at the back of the eyeball and is responsible for the ability to perceive color and sharp central vision. It translates light from the images we see into electrical impulses, which are sent via the optic nerve to the brain, which interprets them as sight.
I recently spoke to Dr. Jonathan Owens at Rocky Mountain Vision about a specific diagnosis of macular degeneration called age-related macular degeneration. He was happy to share his knowledge with me and the readers of this paper.
Owens explained to me that there are lots of things that can affect the macula — two of which are macular dystrophy and degeneration. With macular dystrophy, a pigment builds up in cells of the macula and causes damage to light-sensitive cells known as, “cones.” Often, macular dystrophies are inherited, bilateral, and not linked to environmental factors.
Macular degenerations frequently result from a slow and ongoing deterioration of the eye tissues and when fatty deposits called drusen develop on the macula. Macular degeneration is often not hereditary but due in part to genetic and/or environmental factors like UV light. Unlike dystrophies, macular degenerations frequently are unilateral (occurring in one eye at a time).
There are two types of macular degeneration, dry and wet. Dry is the most common and is usually less severe. Owens said that “close to 90% of the cases are of the dry form.” It frequently starts with the unilateral thinning of eye tissue in one eye before the other. Often, there are no symptoms and having dry macular degeneration doesn’t mean a loss of all your sight will occur. However, some people may notice mild blurriness in their central vision or have trouble seeing in low light.
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Wet age-related macular degeneration is less common and usually causes more aggressive vision loss. This type of age-related macular degeneration occurs later in the stages of development.
“It compromises vision to a much higher extent,” Owens said. Wet age-related macular degeneration occurs when oxygen to the macula is impeded causing the body to develop abnormal cell growth. These abnormal cells grow into the macula and leak blood or fluid. When this occurs, scarring of the macula causes a loss of central vision.
Symptoms of age-related macular degeneration include:
- Blurry or fuzzy vision
- Difficulty recognizing familiar faces
- Straight lines appear wavy
- A dark, empty area or blind spot appears in the center of the vision
- Loss of central vision, which is necessary for driving, reading, recognizing faces and performing close-up work
Although researchers currently have not found a cure for either dry or wet macular degeneration, there are treatments for both wet and dry age-related macular degeneration that can slow the disease progression. Owens informed me that Denver’s Webb-Waring Center has data that suggests high levels of antioxidants can slow the progression of dry age-related macular degeneration in about 30% of patients.
Although research provided by the American Academy of Ophthalmology suggests that daily consumption of the following supplements may assist in the slowing of the disease, you should consult your eye doctor to see if you can benefit from:
- Vitamin C (ascorbic acid) 500 mg
- Vitamin E 400 international units (IU)
- Lutein 10 mg
- Zeaxanthin 2 mg
- Zinc (as zinc oxide) 80 mg
- Copper (as cupric oxide) 2 mg
Wet age-related macular degeneration treatments include medications that are injected into the eye and laser treatments. The first line of defense for wet age-related macular degeneration are medications called anti-VEGF. These medications are injected into the eye and assist in shrinking blood vessels and enabling fluid under the retina to be reabsorbed.
The second line of defense for wet age-related macular degeneration is a laser treatment whereby a medication called verteporfin (Visudyne) is injected into a vein in the arm and travels to the blood vessels in the eye. When the doctor shines the laser onto the abnormal vessel in the eye, the medication closes the leaky blood vessels and stops leakage.
Rocky Mountain Vision group has offices in Vail, Basalt, and Denver. While the doctors within the group do not perform injections and laser procedures themselves, they do work with providers that come to the mountains to offer such services.
When diagnosed and treatment is started early enough, existing vision can be preserved and, in some cases, there can be a recovery of some vision.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and available to answer questions. His contact information is VisitingAngels.com/comtns and 970-328-5526.