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Age related macular degeneration (AMD)

Age-related macular degeneration (AMD) is a troubling disease and is usually found in individuals over the age of 50. In most cases, the disease affects both eyes and progresses very slowly. Visual symptoms of AMD involve loss of central vision, affecting activities such as reading, driving and watching TV. It is important to point out that macular degeneration does not lead to blindness because peripheral vision is unaffected.

Ninety percent of patients have the so-called dry form of macular degeneration. This form is slowly progressive and patients rarely suffer from severe vision loss. There is often little that needs or can be done.

Fewer than 10 percent of all patients develop the wet form of macular degeneration. With the latter form, abnormal “leaky” vessels grow between the layers of the retina. Substantial loss of central (e.g. reading) vision may be lost in on a few weeks to months.

There are several ways to treat AMD. One of the most common treatment forms for wet macular degeneration is Photodynamic Therapy (PDT). PDT selectively inhibits growth of the abnormal blood vessels, thus usually preserving, and sometimes, improving central vision. This treatment option may require three or four treatments over the first year and about two treatments over the second year.

PDT involves injection of a medicine (Verteporfin), which will accumulate in the abnormal vascular complex. This infusion occurs over a 10-minute period. A “cold” or nonthermal laser (689 nm) is applied for 83 seconds to convert the accumulated Verteporfin to a form which is toxic to the abnormal blood vessels. In this way only the abnormal tissue is affected and surrounding normal tissue remains unaffected.

Vitamin supplements are another treatment option that has proven helpful. Vitamins can reduce the chance of severe vision loss from choroidal neovascularization by 25 percent. In addition to vitamins, both doctors and the public have shown growing interest in the relationship between diet and health. The eye, like any other part of the body, benefits from a healthy diet and proper nutrition. Although the exact causes of macular degeneration are not understood, there is some evidence that vitamins and minerals may play a preventive role.

Fluorescein angiography, a clinical test to look at blood circulation inside the back of the eye, aids in the diagnosis of retinal conditions associated with diabetes, age-related macular degeneration, and other eye abnormalities. The test can also help follow the course of a disease and monitor its treatment. It may be repeated on multiple occasions with no harm to the eye or body.

Indocyanine green (ICG) angiography is a clinical test used to detect abnormal blood vessels in the choroids, the layer of blood vessels under the retina. These abnormal blood vessels, typically associated with macular degeneration , may cause bleeding, scarring, and vision loss. If the blood vessels can be restricted by laser surgery, vision loss may be stabilized or improved.

Other common retina problems evolve from high blood pressure. Most people know high blood pressure and other vascular diseases pose risks to overall health but many may not know that high blood pressure can affect vision by damaging arteries in the eye.