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Macular Degeneration

Question: Is macular degeneration inherited? How early can it be diagnosed?

Answer: The macula is an area in the center of the retina. It helps the eye see fine details in the center of the visual field. Age-related macular degeneration (ARMD) is the most common cause of irreversible visual loss and legal blindness (20/200 vision or worse) in the elderly. The disease becomes more and more common as people age. About 1-2% of people between the ages of 52 and 64 have it. As many as 30% of all people over 75 may have the disease. About 2-3% of all people over age 65 are legally blind as a result of ARMD. Women seem to be affected more often than men.

There are two types of ARMD--"wet" and "dry." Dry ARMD accounts for 90% of all cases of ARMD. It usually progresses slowly. It is caused by a substance called drusen that can build up inside the retina. This can cause a layer of the retina to "detach." Light-sensitive cells die as a result, which damages vision. Wet ARMD is caused by the growth of fragile blood vessels beneath the retina. These weak blood vessels leak fluid within the retina and cause macular damage.

We know that smoking cigarettes and having high blood pressure increase your risk of getting ARMD. High fat intake, high cholesterol, and far-sightedness have also been linked to ARMD. There seems to be a genetic component, too. In studies of identical twins, the degree of visual loss and the appearance of the retina have been very similar. More studies are needed to see exactly how inheritance figures in ARMD.

Symptoms of ARMD include

  • Loss of vision in the center of the visual field.
  • Blurry vision.
  • Loss of color vision.
  • Straight lines appearing wavy.

We don't have an effective treatment for dry ARMD. Laser surgery may be used to treat leaky blood vessels in wet ARMD. There is no known way to prevent ARMD. Your ophthalmologist can diagnose ARMD by examining the eye and by performing tests that may involve injecting dye into the blood vessels. If you are having symptoms typical of ARMD, you should see your ophthalmologist.

Question: What is the latest treatment is for macular degeneration? How can this condition be prevented?

Answer: The macula is an area at the center of the retina that is responsible for detailed vision. Such vision is necessary for reading, driving, or watching television.

People with macular degeneration often complain of a dark or blurry area in the center of their vision. In some cases, straight lines appear distorted. But these symptoms can be insidious and difficult to detect, since a person's peripheral and color vision may remain clear.

Treatment for macular degeneration depends on what kinds of changes the eye doctor sees when looking at the back of the eye. For people with new vessel formation, laser treatment may diminish these and slow the progression of the disease. When new vessel formation is not a part of the macular degeneration, there is no current treatment that helps.

To help prevent macular degeneration, give up cigarettes if you're a smoker, because tobacco smoke can make some forms of the disease worse. The same is true for high blood pressure, so people with high blood pressure should be vigilant about taking their medication. Finally, people whose diets are rich in dark, green leafy vegetables, and vitamins C and E, seem to have a lower risk of macular degeneration.

Degeneration of the macula is the leading cause of blindness in people older than 55. The problem also occurs in younger people who have diabetes, certain infections, nutritional deficiencies, or head injuries. If you have any symptoms of macular degeneration, see an eye doctor to discuss your treatment options, and be sure to consult your doctor before beginning any nutritional therapy.

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