Age-related macular degeneration (ARMD) is a deterioration or breakdown of the eye’s macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly. The macula makes up only a small part of the retina, yet it is much more sensitive to detail than the rest of the retina (called the peripheral retina). The macula is what allows you to thread a needle, read small print, and read street signs. The peripheral retina gives you side (or peripheral) vision. If someone is standing off to one side of your vision, your peripheral retina helps you know that person is there by allowing you to see their general shape.
Many older people develop macular degeneration as part of the body’s natural aging process. There are different kinds of macular problems, but the most common is age-related macular degeneration.
With macular degeneration, you may have symptoms such as blurriness, dark areas or distortion in your central vision, and perhaps permanent loss of your central vision. It usually does not affect your side, or peripheral vision. For example, with advanced macular degeneration, you could see the outline of a clock, yet may not be able to see the hands of the clock to tell what time it is.
Causes of macular degeneration include the formation of deposits called drusen under the retina, and in some cases, the growth of abnormal blood vessels under the retina. With or without treatment, macular degeneration alone almost never causes total blindness. People with more advanced cases of macular degeneration continue to have useful vision using their side, or peripheral vision. In many cases, macular degeneration’s impact on your vision can be minimal.
When macular degeneration does lead to loss of vision, it usually begins in just one eye, though it may affect the other eye later. Many people are not aware that they have macular degeneration until they have a noticeable vision problem or until it is detected during an eye examination.
Types of Macular Degeneration
Dry Macular Degeneration
Most people who have macular degeneration have the dry form. This condition is caused by aging and thinning of the tissues of the macula. Macular degeneration usually begins when tiny yellow or white pieces of fatty protein called drusen form under the retina. Eventually, the macula may become thinner and stop working properly.
With dry macular degeneration, vision loss is usually gradual. People who develop dry macular degeneration must carefully and constantly monitor their central vision. If you notice any changes in your vision, you should tell your ophthalmologist (Eye M.D.) right away, as the dry form can change into the more damaging form of macular degeneration called wet (exudative) macular degeneration. While there is no medication or treatment for dry macular degeneration, some people may benefit from a vitamin therapy regimen for dry macular degeneration.
Wet Macular Degeneration
Wet macular degeneration occurs when abnormal blood vessels begin to grow underneath the retina. This blood vessel growth is called choroidal neovascularization (CNV) because these vessels grow from the layer under the retina called the choroid. These new blood vessels may leak fluid or blood, blurring, or distorting central vision.
Vision loss from this form of macular degeneration may be faster and more noticeable than that from dry macular degeneration.
The longer these abnormal vessels leak or grow, the more risk you have of losing more of your detailed vision. Also, if abnormal blood vessel growth happens in one eye, there is a risk that it will occur in the other eye. The earlier that wet macular degeneration is diagnosed and treated, the better chance you have of preserving some or much of your central vision.
How is ARMD Diagnosis?
During Eye examination, doctor may ask you to look at an Amsler grid. This grid helps you notice any blurry, distorted or blank spots in our field of vision. Doctor will also examine you your eyes through a special lens. Doctor can see if there are changes in the retina and macula.
Optical Coherenece Tomography (OCT) is another way to look closely at the retina. A Machine scans the retina and provides very detailed images of the retina and macula.
Optical coherence tomography angiography (OCTA) is another way to look closely at the blood vessels in and under the retina. This is like fluorescein angiography but does not use a dye
Treatment for ARMD
Eye-Healthy Foods – Dark leafy greens, fellow fruits and vegetables, fish and a balanced, nutrient rich diet have shown beneficial for people with ARMD.
Nutritional Supplement – Doctor may prescribe you nutritional supplement. The nutritional supplement will have vitamin C and E, Beta caratone, zinc and copper.
Anti –angiogenic drugs – To help wet ARMD, there are medications called anti VEGF drugs. Anti VEGF treatment helps reduce the number of abnormal blood vessels in your retina. It also slows any leaking from blood vessels. This medicine is delivered to your eye through a very slender needle.
Laser therapy – laser surgery may also be used to treat some types of wet ARMD. Surgeon shines a laser light beam on the abnormal blood vessels. This reduces the number of vessels and slows their leaking.