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There are many types of macular degeneration, but the most commonly seen conditions are those associated with the aging process, and referred to as age-related macular degeneration (AMD). The macula is a small area in the retina (the retina functions like film in a camera; it “records” the image), but it is responsible for much of our vision, in particular the central, fine detail that we rely on for most of our daily activities. The peripheral or outer part, of the retina is responsible for our “side” vision, and allows us to see things that are not in our direct line of sight. The cause of this condition is not understood, and no treatment that has been uniformly effective. While this disease does not usually cause total blindness, it is the leading cause of severe visual impairment in patients over the age of 65 years.
Simulated loss of central vision
DRY MACULAR DEGENERATION occurs when deposits (yellow or white pieces of fatty protein) form under the retina. Over time the retina thins and doesn’t function properly. Most cases of AMD are of the dry form. Patients who have been diagnosed with dry AMD need to carefully monitor their vision for changes using an Amsler grid daily; changes may an indication that the dry form has progressed to the more severe exudative type.
Use your reading glasses, and hold the grid 14-15 inches (normal reading distance) with good lighting.
WET (EXUDATIVE) AMD results when abnormal blood vessels grow underneath the retina from a layer of the retina known as the choroid. This new growth is referred to as choroidal neovascularization (CNV). These vessels can leak fluid or blood, and interfere with the central vision. This type of AMD can happen quickly, and cause more significant loss of vision than the dry form. Early diagnosis and treatment improves the chance of preserving vision; the longer these vessels leak or grow, the higher the risk of visual loss. If this occurs in one eye, it increases the risk of occurrence in the fellow eye. Close monitoring of your vision with the Amsler grid is very important to the over-all management of this condition. Any changes you see should be reported to Dr. Ballitch immediately.
A large scientific study indicates that people at risk for vision loss may benefit from nutritional supplements. Dr. Ballitch may recommend specific types of supplements for you based on the findings of your eye exam. Vitamin supplements are not a cure for AMD, and they will not restore lost vision, but they can play a key role in the management of the disease. In more advanced cases, you may be asked to see a retina specialist for further evaluation and treatment. These additional treatments may include laser surgery, photodynamic therapy (PDT), or the administration of drugs that target a chemical in your body (vascular endothelial growth factor (VEGF))that is critical to the production of the abnormal blood vessel growth. The drugs are anti-VEGF, and block the production of VEGF, reducing the growth of the abnormal blood vessels, and slowing their leakage. In spite of advances in medical treatment, AMD continues to cause visual impairment in many people.