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Age-Related Macular Degeneration
 
Age-related macular degeneration (AMD) is a disease that damages the macula in the eye. The retina is the back part of the eye and the macula is in the center of the retina. The macula is responsible for helping you see fine details in the center of your vision. The loss of central vision can make it difficult to read, drive, or recognize faces.

AMD is a common problem for many people as they get older. It usually affects both eyes, but one eye may be affected before the other.

How does it occur?
There are two forms of AMD: wet and dry. The wet form of AMD occurs when new, fragile blood vessels grow under the macula. These vessels leak blood and fluid and cause unwanted scarring. This can cause rapid vision loss. In the dry form, the light-sensitive cells in the macula gradually break down. In both cases, a blind spot forms in or near the center of vision. The dry form is more common and causes a much slower and often less severe loss of vision.

The cause is not known. Smoking may contribute to the problem. Smoking may contribute to the problem. You may also be at greater risk if you smoke, are obese, have high blood pressure, or have family members with AMD. It is also more common in people of European decent and women.

What are the symptoms?
AMD does not cause pain. Most people with AMD in an early to intermediate stage do not have any symptoms and have good vision. Only people with advanced AMD have symptoms. These symptoms may include:
  • blurred vision
  • wavy appearance to straight lines (for example, a telephone pole may appear to be bent)
  • a dark patch in the middle of words as you read
  • a worsening of your color vision.

If just one eye is affected, you may not notice the loss of vision when you are using both eyes. Usually your side (peripheral) vision is not affected.

How is it diagnosed?
Your eye doctor can diagnose this disease with a complete eye exam. Sometimes a special test called fluorescein angiography is needed. In this test a dye is put into a vein in your arm. The dye travels to blood vessels in your retina. Then pictures can show where the leaking blood vessels are.

How is it treated?
AMD in its early stage does not need treatment. If you are at high risk for AMD, your health care provider may suggest specific nutritional supplements to decrease your chance of vision loss.

There is no treatment for dry AMD at this time, no matter how severe it is.

There are several treatment options for wet AMD. If the abnormal blood vessels under the retina are not under the very center of the macula, then laser treatment can be done. For this treatment, a laser is used to seal the blood vessels. This will help decrease the chance of vision loss.

If your blood vessels are growing under the center or very close to the center of your macula, your eye doctor may recommend a "cold laser" treatment. It is also called photodynamic therapy. This treatment must be used instead of the "hot laser," to try to protect the macula. For this procedure, a laser-activated dye is injected into your bloodstream. When the dye reaches the retina, a "cold" laser is used to activate the dye to close the leaking blood vessels. This procedure may need to be repeated depending on how well it works. This treatment may limit the amount of vision loss. It does not improve vision in most cases.

Medicines that shrink the blood vessels are becoming available. Macugen is a drug that needs to be injected into the eye every 6 weeks for 2 years. It may help decrease vision loss. It may be used in types of wet AMD where laser treatments are not possible. Other medicines may soon be available.

If you have advanced AMD, low vision aids may help you with your daily activities. Low vision aids include:
  • magnifying glasses and telescopes
  • closed-circuit TV
  • clocks and phones with large numbers and reading material printed in large type.

Ask your health care provider for help in finding which low vision aids may be helpful for you.

How can I take care of myself?
  • Tell your doctor if your vision changes in any way.
  • Never ignore blurred vision, lines that appear wavy, blind spots, or loss of color vision.
  • A generally healthy lifestyle, including good nutrition and good control of blood pressure may improve the chances of keeping good vision.

Reviewed and approved by the Wilmer Eye Institute of The Johns Hopkins Medical Institutions, Baltimore, MD. Web site: http://www.wilmer.jhu.edu




Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File eye4228.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.


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