What is Macular Degeneration?

A Personal Note about This Disease
In 2003, my mother (who is now 86 years young) went to a specialist to have cataracts removed. After in depth testing, it was discovered that behind the cataracts she had both wet and dry macular degeneration that even after removal of the cataracts her vision would never be normal again. That was all that was told to us. The only treatment available at the time was a drug called Visudyne. Visudyne is a green liquid that is prepared in a darkened lab room and is used in Photodynamic Therapy or PDT. This stuff glows in the dark like a bright neon green light. This treatment could only be done once a month and for the following three days after the treatment, the patient has to stay out of the sun. This only slows down the progression of macular degeneration for there is no known cure. We were shown a video about the disease, the treatment and various types of equipment that could be acquired to help the patient see better doing day to day chores such as reading a newspaper, recipes, writing checks, etc. That was it. Our family doctor never told us anything else. We basically were left in the dark for years not truly knowing what the disease was, how it occurs in people, what kind of people get it, etc. I was left to my own devices to educate my mother and myself about this disease. My mother now is "legally blind", has difficulty walking due to the distorted images she sees or does not see and can no longer see the thermostat for the furnace or the dial on the oven. She has lost a part of her quality of life and her independence. Now thanks to the information I have obtained for myself, my mother's chances have greatly increased to get back a portion of her sight and alot of her independence.

Now I would like to pass on this information to you my readers in the event yourself, either a relative or a close friend may have this disease.

What Is Macular Degeneration?
AMD or ARMD (age-related macular degeneration) is an incurable eye disease and that it is the leading cause of blindness for those aged 55 and older in the United States, affecting more than 10 million Americans every year.

Macular degeneration is caused by the deterioration of the central portion of the retina, the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain. The retina's central portion, knows as the macular, is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail.

As we, all get older our chances for developing eye diseases increase at a great rate. Specific factors that cause macular degeneration are not completely known and there is insufficient funding to research into this little understood disease.

A recent poll said that Americans dread blindness more than any other disability. By 2025, the population of people over 65 will be six times higher than in 1990 due to "baby boomers" aging and the life expectancy is increasing.

Wet And Dry Forms of Macular Degeneration
Wet Macular Degeneration (neovascular) is the growth of new blood vessels in the area, such as the macula, where they are not supposed to be. This type usually leads to more serious vision loss. In about 10% of cases, dry AMD progresses to a more advanced and damaging form of the eye disease. With wet AMD, new blood vessels grow beneath the retina and leak blood and fluid that cause permanent damage to light-sensitive retinal cells which then die off and cause blind spots in central vision. The underlying process causing wet AMD and abnormal blood vessel growth is the body's way of attempting to crease a new network of blood vessels to supply more nutrients and oxygen to the eye's retina. Misguided as it may be and the process instead creates scarring, leading to sometimes severe central vision loss.

Dry Macular Degeneration (non-neovascular) is the more common type, is an early stage of the disease, and could possibly result from the aging and thinning of macular tissues, depositing of pigment in the macula, or a combination of the two processes.

The diagnosis for dry is when yellowish spots known as drusen accumulate from deposits or debris from deteriorating tissue primarily in the area of the macula.

Symptoms of Macular Degeneration
AMD usually produces a slow or sudden loss of vision. Early signs of vision loss associated with AMD can include seeing shadowy areas in your central vision or experiencing unusually fuzzy or distorted vision.

The use of a chart called the Amsler grid (black lines arranged in a graph pattern) is one way to tell if you are having these vision problems. To learn more about the Amsler chart and its uses, go to www.allaboutvision.com/conditions/amd.htm. In addition, an eye care practitioner often detects early signs of macular degeneration before symptoms occur.

What Causes Macular Degeneration?
Many forms of AMD may be linked to aging and related deterioration of eye tissue. Researchers have noted a strong association between development of the eye disease and of a variant of a gene called CFH (complement factor H). In addition, variants of another gene, called CFB (complement factor B) may be involved.

Who Gets Macular Degeneration?
In addition to older people, it also seems to appear in whites and females in particular. It can also be a side effect of some toxic drugs (anti-malarial drugs, anti-psychotic drugs) and runs in families. High blood pressure, lighter eye color, obesity and smoking can also be risk factors for macular degeneration. In addition, a form can affect young people between the ages of 6 and 20 called Stargardt's macular degeneration. Please go to www.macular.org/disease.html and click on "Stargardt's' to read more about it.

Treatments
While there is no cure for macular degeneration, there are treatments that may delay the progression or even improve vision slightly. This of course depends if the disease is in the early stage (dry form) or the more advanced stage (wet form). The treatments currently available are Macugen and Visudyne used with Photodynamic Therapy or PDT. The FDA in June 2006 has approved Lucentis and Avastin and they are showing promise in reducing vision loss.

To read more about macular degeneration, the treatments available and equipment that can be purchased to improve day-to-day activities, go to www.allaboutvision.com/conditions/amd.htm and www.macular.org/disease.html which is a non-profit, publicly supported organization.

American Macular Degeneration Foundation www.macular.org/disease.html
Macular Degeneration - A Complete Guide from All about Vision www.allaboutvision.com/conditions/and.html