For 10 million Americans ages 50 and over, macular degeneration looms on the horizon of age-related concerns. Macular degeneration is an incurable vision disease that attacks the center part of the retina (at the back of the eye) where “millions of light-sensing cells that provide the sharp, central vision” reside (National Eye Institute). The macula records the images we see and relays them to the optic nerve, which then passes the information to the brain.
These cells are responsible for our ability to read, to recognize faces, for driving, and for doing any close-up, detail work such as needlepoint. If these cells become damaged, the central field of view can become blurry, distorted, or form dark splotches.
Detection of Macular Degeneration
Comprehensive eye exams are the first line of detection for macular degeneration. During the visual acuity and eye dilation portion of the exam, eye-care professionals are able to look for yellowish deposits called drusen and for any pigment changes in the retina. The size of the drusen deposits will determine how advanced the macular degeneration (if any) has become.
Stages of Macular Degeneration
There are three distinct stages of this disease:
- Early: In this stage, the drusen deposits are medium-sized. There typically is no change in vision for the patient.
- Intermediate: At this point, the drusen will be large, and there may also be changes in the retina’s pigment.
- Late: Drusen deposits will be large, pigment changes will be present, and there will be vision loss at this stage. According to the American Macular Degeneration Foundation, the degeneration will be classified as either atrophic (dry) or exudative (wet).
- Atrophic cases tend to be age-related, and 85-90 percent of macular degeneration falls into this classification. There is no leakage of blood or serum into the eye. Vision may still be good but may be fluctuating. Patients may have limited reading ability in dim lighting (such as in restaurants at night).
- Exudative cases make up the remaining 10-15 percent. Exudative – or wet – macular degeneration occurs when abnormal blood vessels grow under the retina and bleed or leak fluid. This distorts vision.
Prevention and Treatment
While there is no cure for macular degeneration, there is strong evidence that leading a lifestyle that promotes wellness will go a long way toward staving off the advancement of the disease. Not smoking, exercising regularly, eating a healthy diet with plenty of green leafy vegetables, and maintaining normal blood pressure levels, will all go a long way toward overall good health as well as preserving vision.
For intermediate- and late-stage atrophic (dry) macular degeneration, studies have shown that high doses of vitamins C and E, along with zinc and copper, can reduce the disease by up to 25 percent. For the exudative (wet) cases, anti-VEGF treatment (periodic injections in the eye of Avastin or Eylea) allows patients to remain stable instead of getting progressively worse.
The National Eye Institute has more comprehensive information available on the studies.