Important Info On Age Related To Macular Degeneration Wet
Important Info On Age-Related – Macular Degeneration Wet.
Macular degeneration is the leading cause of vision loss among older people around the world, and due to the aging of the number of people affected by AMD is expected to increase significantly in the years ahead. According to estimates from the Centers for Disease Control and Prevention (CDC). This eye disorder is more likely to occur after age 60, but it can occur at earlier ages.
AMD also called macular degeneration, causes damage to the macula, the part of the eye needed for sharp, central vision, meaning the ability to view objects that are straight ahead. Central vision is needed for the ability to read, recognize faces, drive, watch television, use a computer, and perform any other visual task that requires us to see fine detail. AMD can occur in one or both eyes, and it usually does not affect peripheral (side) vision.
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Medicine and Public Health and the U.S. Centers for Disease Control and Prevention (CDC), approximately 6.5 percent of Americans age 40 and older have some degree of macular degeneration. Other research suggests there were 9.1 million cases of early AMD in the U.S. in 2010 and this number is expected to increase to 17.8 million by the year 2050.
Types Of AMD
AMD has three stages, partially defined by the size and number of drusen beneath the retina. People in early-stage AMD have medium-sized drusen and usually no vision loss. People with intermediate AMD have large drusen, pigment changes in the retina, or both, and most of those affected don’t experience any vision loss. People with late AMD have drusen and vision loss, and can develop either dry or wet AMD, according to the NEI.
Macular degeneration mainly affects central vision, causing “blind spots” directly ahead.
The dry form is more common than the wet form, with about 85 to 90 percent of AMD patients diagnosed with dry AMD. The wet form of the disease usually leads to more serious vision loss.
1.Wet And Dry Forms Of Macular Degeneration
Wet macular degeneration (neovascular). In about 10 percent of cases, dry AMD progresses to the more advanced and damaging form of the eye disease. With wet macular degeneration, new blood vessels grow beneath the retina and leak blood and fluid. This leakage causes permanent damage to light-sensitive retinal cells, which die off and create blind spots in central vision.
Wet macular degeneration falls into two categories:
1. Occult: New blood vessel growth beneath the retina is not as pronounced, and leakage is less evident in the occult CNV form of wet macular degeneration, which typically produces less severe vision loss.
2. Classic: When blood vessel growth and scarring have very clear, delineated outlines observed beneath the retina, this type of wet AMD is known as classic CNV, usually producing more severe vision loss.
2. Dry Forms Of Macular Degeneration
Dry macular degeneration (non-neovascular). Dry AMD is an early stage of the disease and may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two processes. Most people develop very small drusen as they get older, but when drusen are numerous or large, dry AMD is usually more advanced, according to the NEI. Changes in the pigment of the retina can also be a sign of the disease.
Dry macular degeneration is diagnosed when yellowish spots known as drusen begin to accumulate in and around the macula. It is believed these spots are deposits or debris from deteriorating tissue.
Gradual central vision loss may occur with dry macular degeneration but usually is not nearly as severe as wet AMD symptoms. However, dry AMD through a period of years slowly can progress to late-stage geographic atrophy (GA) — gradual degradation of retinal cells that also can cause severe vision loss.
No FDA-approved treatments are available for dry macular degeneration, although a few now are in clinical trials.
Two large, five-year clinical trials — the Age-Related Eye Disease Study (AREDS; 2001) and a follow-up study called AREDS2 (2013) — have shown nutritional supplements containing antioxidant vitamins and multivitamins that also contain lutein and zeaxanthin can reduce the risk of dry AMD progressing to sight-threatening wet AMD.
But neither the AREDS nor the AREDS2 study demonstrated any preventive benefit of nutritional supplements against the development of dry AMD in healthy eyes.
Symptoms of AMD
Though macular degeneration is associated with aging, research suggests there also is a genetic component to the disease. Duke University and other researchers have noted a strong association between development of AMD and presence of a variant of a gene known as complement factor H (CFH). This gene deficiency is associated with almost half of all potentially blinding cases of macular degeneration. Columbia University Medical Center and other investigators found that variants of another gene, complement factor B, may be involved in development of AMD.
“If a patient notices any distortion in one eye, he or she should see an ophthalmologist immediately,” Fromer told Live Science. Visual distortions may include the symptoms described below.
According to the Mayo Clinic, symptoms of AMD include:
- Straight lines or faces appearing wavy
- Doorways seeming crooked
- Objects appearing smaller or farther away
- Increasing difficulty adapting to low light levels
- Decreasing color intensity or brightness
- Difficulty recognizing faces
- Increasing vision haziness
- Blurry or blind spots in central vision
Causes & risk factors
The exact causes of AMD aren’t known, but the risk of developing macular degeneration can increase with age. Genetics, certain physical conditions and lifestyle habits can also play a role. According to the National Eye Institute (NEI), these risk factors include:
1. Being age 65 and older (but it can occur earlier)
The prevalence of AMD increases with age. In the United States, approximately one in 14 people over the age of 40 has some degree of macular degeneration. For those over 60, the rate is one in eight (12.5 percent); and for seniors over age 80, one in three (33 percent) has AMD.
2. Family history of AMD
Heredity. As stated above, recent studies have found that specific variants of different genes are present in most people who have macular degeneration.
Smoking is a major AMD risk factor and was found in one British study to be directly associated with about 25 percent of AMD cases causing severe vision loss. The British Journal of Ophthalmologyin early 2006 also reported study findings showing that people living with a smoker double their risk of developing AMD.
Obesity and inactivity. Overweight patients with macular degeneration had more than double the risk of developing advanced forms of macular degeneration compared with people of normal body weight, according to one study reported in Archives of Ophthalmology (June 2003). In the same study, those who performed vigorous activity at least three times weekly reduced their risk of developing advanced AMD, compared with inactive patients.
5. High blood pressure
High blood pressure (hypertension). Investigative Ophthalmology and Vision Science reported the results of a European study demonstrating that high blood pressure may be associated with development of macular degeneration (September 2003).
6. High cholesterol AMD
A genetic study conducted by researchers identified genes associated with cholesterol and age-related macular degeneration (AMD) High cholesterols are responsible for transporting essential fats, such as cholesterol, through the bloodstream. A common hallmark of AMD is drusen—deposits of protein, cholesterol and other lipids, under the retinal pigment epithelium, an important structural layer of cells deep in the retina.
7. Having blue eyes
Because macular degeneration long has been thought to occur more often among Caucasian populations, particularly in people with light skin color and eye color, some researchers theorized that the extra pigment found in darker eyes was a protective factor against development of the eye disease during sun exposure. But no conclusive evidence as yet has linked excessive sun exposure to development of AMD.
8. Diet low in fruits and vegetables
Diet may affect individuals’ risks related to the development and progression of age-related macular degeneration, a progressive chronic disease of the central retina and a leading cause of irreversible, severe vision loss in Western countries, according to a review of previous studies, published in the journal Clinical & Experimental Ophthalmology. To evaluate the role of diet and food intake in age-related macular degeneration (AMD), University of Auckland researcher Naoko Chapman and colleagues conducted a systematic review of 18 high-quality studies.
“The objective of the work was to review systematically, evidence on the role of diet and food intake in AMD,” the scientists explained.
“The focus was on epidemiological studies around food intake rather than studies on supplement intervention.” Adherence to a Mediterranean diet was linked with a decreased risk of AMD progression.
Diagnosis & tests
Several eye tests can help confirm the diagnosis, including:
1. Visual acuity test: An eye chart is used to measure how well a person can see at different distances.
2. Dilated eye exam: The pupils are dilated with eye drops so that the optic nerve and retina, located in the back of the eye, can be examined for signs of AMD, according to the Mayo Clinic. A special magnifying lens is used to perform this eye exam, during which an eye doctor is looking for fluid or blood or a mottled appearance. This indicates the presence of drusen under the retina.
3. Amsler grid: People are asked to look at this grid, which resembles a checkerboard with a black dot in the center. This grid can test for defects in a person’s central vision If straight lines in the grid appear wavy or some lines appear to be missing, AMD is more likely.
4. Angiogram: During this test, a special camera can take pictures of the retina after a colored dye has been injected into a vein in the arm. This dye then travels to the blood vessels in the eye and highlights them. AMD may be present if the images show leaking blood vessels or retinal changes.
5. Tomography: This painless imaging test uses beams of light to identify whether retinal thinning, thickening or swelling associated with AMD is present, according to the Mayo Clinic.
There is currently no treatment for the dry form of AMD, but some people who have a lot of drusen may benefit from taking certain nutritional supplements. Taking a daily high-dose combination of antioxidant vitamins and minerals may slow the progression of dry AMD from the intermediate stage to the advanced stage by as much as 25 percent, according to a large study conducted by the NEI.
Dry macular degeneration can’t be cured. If your condition is diagnosed early, you can take steps to help slow its progression, such as taking vitamin supplements, eating healthfully and not smoking.
Low vision rehabilitation
Age-related macular degeneration doesn’t affect your side (peripheral) vision and usually doesn’t cause total blindness. But it can reduce or eliminate your central vision — which is necessary for driving an automobile, reading and recognizing people’s faces. It may be beneficial for you to work with a low vision rehabilitation specialist, occupational therapist, your eye doctor and others trained in low vision rehabilitation. They can help you find ways to adapt to your changing vision.
Surgery to implant a telescopic lens
For selected people with advanced dry macular degeneration in both eyes, one option to improve vision may be surgery to implant a telescopic lens in one eye. The telescopic lens, which looks like a tiny plastic tube, is equipped with lenses that magnify your field of vision. The telescopic lens implant may improve both distance and close-up vision, but it has a very narrow field of view. It can be particularly useful in an urban environment to aid in identifying street signs.
What you can do
Before your appointment with your Doctor:
1. When you make the appointment, ask if you need to do anything to prepare.
2. List any symptoms you’re experiencing, including those that seem unrelated to your vision problem.
3. List all medications, vitamins and supplements you take, including the doses.
4. Ask a family member or friend to accompany you. Having your pupils dilated for the eye exam will affect your vision for a time afterward, so you may need someone to drive or accompany you after your appointment.
List questions to ask your doctor.
For macular degeneration, questions to ask your doctor include:
- Do I have dry or wet macular degeneration?
- How advanced is my macular degeneration?
- Is it safe for me to drive?
- Will I experience further vision loss?
- Can my condition be treated?
- I have other health conditions. How can I best manage these conditions together?
- Will taking a vitamin or mineral supplement help prevent further vision loss?
- What’s the best way to monitor my vision for any changes?
- What changes in my symptoms warrant calling you?
- What low vision aids might be helpful to me?
- What lifestyle changes can I make to protect my vision?
National Eye Institute: Age-Related Macular Degeneration