Macular degeneration, also known as age-related macular degeneration (AMD) is a major cause of blindness in older adults over the age of 50. It can be classified as either dry (nonexudative) or wet (exudative) macular degeneration. Patients can report blurred or distorted vision, in which straight lines appear wavy. Another common complaint is shadows or missing areas of central vision.
Dry or nonexudative macular degeneration is the more common diagnosis. In the dry form, drusen accumulates in the macula (central area of the retina). Advanced AMD can result in atrophy of the macula causing central vision loss. No medical or surgical treatment is available at this time besides vitamin supplementation for certain degrees of severity.
In the wet or exudative form, which is more severe, blood vessels grow and bleed causing decreased vision. Bleeding, leaking and scarring form these blood vessels can result in irreversible loss of vision if untreated. Luckily only 10% of patients suffer from wet AMD. Macular degeneration by itself will not lead to total blindness. Yet, the loss of central vision profoundly affects visual functioning.
A dilated exam is used to look for drusen or evidence of bleeding in the retina. Fluorescein angiography allows identification of new blood vessels that result in leakage of blood and fluid. Optical coherence tomography is used for diagnosis and follow-up evaluation of the response to treatment of anti vascular endothelial growth factor (VEGF).
Treatment only exists for wet macular degeneration at this time. Monthly injections of anti-vascular endothelial growth factor (VEGF) has been very successful in managing wet macular degeneration. The Age-Related Eye Disease Study (AREDS) -2 formula is a high dose micronutrient supplement consisting of antioxidants and vitamins and zinc. It has been shown to reduce the progression of macular degeneration in patients with a certain degree of disease.
The Amsler Grid test is a simple and effective method for patients to detect changes in their vision. Each eye is tested individually. Normally, all the lines are straight and evenly spaced. When the grid becomes distorted or lines are missing then it is important to get examined, especially if any new changes are noted on the Amsler Grid. It is essential for patients with wet macular degeneration to seek continuous medical treatment to manage their condition and to prevent permanent vision loss.
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