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What is Macular Degeneration (AMD)?
This is a common question from many of our patients. The macula is the part of the retina, inside the eye, that provides us with our central vision. In the middle of the macula is a unique configuration of cones cells called the fovea. It is here that our clearest, most sharp vision or 20/20 vision exists. The photograph to the left depicts a normal macula in which the most central or darkest red area is the fovea. Our central vision expands around the fovea, the macular area, to offer more paracentral vision, extending to the most peripheral part of the retina (less red area) to provide for our most extended peripheral vision. Macular Degeneration occurs when the cells under the macula begin to atrophy, a slow process we call Dry AMD (Fig 2), or if bleeding occurs under the macula, a process we call Wet AMD (Fig 3) . This can significantly blur vision and lead to blindness.
Fig 2. Dry AMD Left eye (note the white spots in macula)
What symptoms does Macular Degeneration Have?
Symptoms may vary as to the severity of the disease from none to severe blurred central vision which may increase over days to weeks. Straight edges or lines will look distorted or wavy, but this could be a symptom of other eye diseases as well. There is no pain in this process.
Can Dry AMD turn into Wet AMD?
Absolutely! In fact with regular examinations your eye doctor often has tools for you to take home to help monitor for early changes. Regular examinations are important to detect subtle changes early on. Also, additional testing may be ordered called an OCT to look at the numerous layer of the retina (see Fig 3. Wet AMD Right eye (note bleeding in macula)
Fig 6. Ocular Coherence Tomography (OCT)
Fig 6). An OCT scan can help your optometrist better study the tissue within the macula and help him or her truly understand what is happening within the retina and to the photoreceptors (rods and cones). An OCT is like taking a cross section of the retina without removing retina from the eye.
Who is at risk for developing AMD?
1. Those over the age of 50
3. Those with a family history of AMD
5. A poor diet: Not eating many fruits and vegetables
6. Being Caucasion
8. Vascular Disease: high blood pressure, high cholesterol, diabetes
Is there anything I can take to prevent AMD?
The Age-Related Eye Disease Study (ARED's) showed that some basic vitamins can help reduce the risk from developing Wet AMD from Dry AMD by about 25%. More longer term studies and in more recent conjunction with the ARED's II study (still ongoing) are showing the effects of antioxidants that are crucial to healthy functioning. Macular pigments found naturally within the macula are Lutein, and another antioxidant/pigment found directly under fovea (area of best vision) is mainly called Zeaxanthin. Studies have shown the positive impact in increasing these nutrients, taking twice as much Zeaxanthin as Lutein may restore some degree of functioning to the fovea and the rest of the macula in early dry macular degeneration. The density of these macular pigments within the macula is very important. Those with less Zeaxanthin and Lutein have higher risks of developing dry and wet AMD. These antioxidants/ macular pigments come naturally in many fruits and vegetables and unless you eat lots of these regularly it is recommended to supplement your diet specifically with these nutrients.