Wet and Dry Macular Degeneration

Definition

The leading cause of blindness in those 60 and older, macular degeneration blurs the sharp, central vision and affects the part of the eye needed to see fine detail. Macular degeneration affects both distance and close vision, and can make some activities - like threading a needle or reading - difficult or impossible.

Macular degeneration is damage or breakdown of the macula, the small area at the back of the eye that allows us to see fine details clearly. When the macula doesn't function correctly, we experience blurriness or darkness in the center of our vision.

The two most common types of age-related macular degeneration are "dry" (atrophic) and "wet" (exudative).

Symptoms

Macular degeneration can cause different symptoms in different people. You can check your vision daily by using an Amsler grid. Click here for a printable copy of the grid, or ask one of the ophthalmologists at Retina Care Specialists for a copy of the grid and instructions on how to use it. Following are some common ways vision loss is detected:

▪ Words on a page look blurred;
▪ A dark or empty area appears in the center of vision;
▪ and Straight lines look distorted.

Diagnosis

Many people do not realize that they have a macular problem until blurred vision becomes obvious. Your ophthalmologist can detect early stages of macular degeneration during a medical eye examination that includes the following:

▪ Viewing the macula with an ophthalmoscope;
▪ A simple vision test in which you look at a grid resembling graph paper;
▪ Special photographs, called angiograms, are taken to find abnormal blood vessels under the retina. A vegetable-based dye called fluorescein is injected in your arm, and your eye is photographed as the dye passes through the blood vessels in the back of the eye.

Treatment

Despite advanced medical treatment, many people with macular degeneration still experience some vision loss.

There is no cure yet for "dry" macular degeneration. Treatment of this condition focuses on helping a person find ways to cope with visual impairment.

We will advise you on appropriate antioxidant vitamins that you may take that can reduce the rate of vision loss from AMD by 25% each year. You will also receive instruction on self-monitoring with an Amsler grid.

In the early stages of "wet" macular degeneration, patients can be treated with laser surgery, which is a brief and usually painless outpatient procedure. Although a small, permanently dark "blind spot" is left at the point of laser contact, the procedure can preserve more sight overall.

Current FDA-approved drugs are designed to slow down or stabilize vision loss form wet AMD. The medications include Visudyne and Macugen. Visudyne is injected into a vein in the arm and then a laser is applied to the macula. This is called Photodynamic Therapy. Macugen is a medication that is injected directly into the eye with a tiny needle. The treatment takes just a few minutes and is painless.

We are among a relatively small group of physicians nationwide investigating a clinical trial drug for the wet form of age-related macular degeneration. Current FDA-approved drugs only slow down the loss of vision. Studies have shown that patients treated with this new class of drug (Lucentis) are experiencing improvement of vision for the first time.