Age-related macular degeneration (AMD)
The leading cause of visual loss in the senior population of the United States is age-related macular degeneration (AMD). This condition causes deterioration—and can cause the eventual loss—of central vision. There are several risk factors for macular degeneration. Some of these risk factors, such as age or genetics (that is, inherited traits), cannot be controlled. Other risk factors, such as smoking, poor diet, and sunlight exposure, can be reduced through changes in behavior.
The most common type of macular degeneration is the “dry” form. In dry macular degeneration, there is progressive thinning (atrophy) and the depositing of waste products (drusen) in the retina. Although vision loss can occur, it is usually minimal and progresses slowly.
The “wet” form of macular degeneration is only responsible for about 10% of macular degeneration cases. With wet AMD, abnormal blood vessels are stimulated to grow beneath the retina. Leakage and bleeding from these abnormal vessels can destroy central vision.
Because the wet form of macular degeneration can be devastating, we have been searching for ways to prevent it from occurring. The Age-Related Eye Disease Study (AREDS) has shown that taking vitamins (vitamin supplementation) is important in slowing the progression of macular degeneration in patients with moderate dry macular degeneration or in patients with more advanced disease in one eye only. The most benefit was derived from a combination of antioxidants and zinc, in the following daily doses:
|Beta Carotene||15 mg|
|Vitamin C||500 mg|
|Vitamin E||400 IU|
|Zinc||80 mg (as zinc oxide)|
|Copper||2 mg (as cupric oxide)|
However, always consult with your physician before taking such supplements.
Metamorphopsia (distortion) is usually the first symptom that appears in a patient when wet macular degeneration begins, so this symptom should be evaluated promptly. Fluorescein or ICG angiography is used to identify the presence and location of any abnormal new blood vessels.
At NJ Retina, we are proud of our leadership in the clinical trials that have led to many of the drugs currently used to treat advanced AMD. We now routinely use drugs called anti-VEGF therapies, which we actively researched such as Lucentis®, Avastin®, and Macugen® in the treatment of AMD. Customizing the use of the drugs, as well as combining these agents with photodynamic therapy and thermal laser treatments, can achieve significant benefits in certain patients. In addition, many patients can achieve excellent results with a treatment schedule of anti-VEGF agents given less frequently. Tailoring the dosing regiment to achieve the best combination of efficacy and safety is key.