Age-related Macular Degeneration (AMD) is the most common cause of vision loss in the senior population, especially in those over the age of 75. In AMD there is damage of one sort or another to the macula of the eye, which is the name for the central part of our retina where our clearest vision is produced. AMD is primarily related to the genetics of aging, but environmental risk factors such as smoking, excessive sunlight, poor nutrition, and trauma have been identified.
There are many forms of macular degeneration. I will briefly comment on the most common kinds, and the treatments we can offer. When in doubt, there are tests, called the fluorescein dye test, and the OCT laser scan, that can help provide useful information about your AMD.
First, there are a number of different kinds of dry AMD. Dry means that there is no bleeding involved: The dry form is usually milder, and more slowly progressive then the wet.
---atrophy: This is a gradual deterioration of the cells. There is no specific treatment.
Often we may recommend a vitamin supplement to help maintain macular health.
---macular hole: This may be due to internal tissue contraction in the eye. A surgical treatment may help.
---macular wrinkling (pucker): This is also related to tissue contraction. It may lead to a hole. Often, no treatment helps. Sometimes, if fluid is present, an injection of medication can help. If a thick membrane forms, it can sometimes be removed surgically.
--macular drusen: These are creamy deposits that form in the macula. They appear to result from waste products in the macula that have not been cleared, and build up. They often cause little or no vision loss on their own, but are ominous in that they increase the risk of the wet form developing. We often prescribe a vitamin supplement.
The wet form can have different types of bleeding. Testing can help determine the type when this is necessary.
There are now a number of possible treatments for the wet kind, and new ones are also being developed. Unfortunately, no treatment is usually curative, but newer injection therapies using "AntiVEGF" agents
can sometimes stabilize or even improve the vision, especially if caught early before scarring has occurred. It inhibits the growth of abnormal vessels.
Careful monitoring of your vision is helpful to catch the wet form early on. We use a special new test called Preferential Hyperacuity Perimetry (PHP) to try to pick up the wet form at it's earliest, most treatable stage. This is done in Runnemede.