Macular Degeneration
What is macular degeneration?
Age Related Macular degeneration (AMD) is an age-related disease that affects central vision. It is a gradual death of patches of the central retina (the macula) responsible for your detailed vision. 90% of cases are known as “dry” or atrophic for which there is currently no effective treatment. 10% of cases are known as “wet” or neovascular. This type causes more rapid and severe vision loss but early treatment can limit the damage.
If you’re concerned about age-related macular degeneration in Calgary, Mission Eye Care can help.
Symptoms of macular degeneration
Symptoms of macular degeneration are specific to the type of AMD that you have. There are 2 types of AMD: Dry Form AMD and Wet Form AMD.
Dry Form AMD Symptoms
- blurry vision with gradual loss of central vision that does not improve with glasses
- late stage AMD can cause complete loss of central vision
Wet Form AMD Symptoms
- rapid vision loss
Wet Form AMD requires urgent referral to a retina specialist for treatment to prevent further vision loss.
Both forms of age-related macular degeneration are very rare under the age of 50 but the incidence increases exponentially with age.
Who is at risk of developing macular degeneration?
Some risks are genetic (non-modifiable) and others are environmental and can be modified.
Non-modifiable AMD risk factors include:
- Being female
- Having fair skin and light eye color
- Having moderate to high myopia (near-sightedness)
- Having an immediate family history
- Advancing age
Environmental AMD factors include:
- Smoking, past or present
- Lifetime UV exposure (especially when young)
- Poor cardiovascular health
- Poor diet and nutrition
These modifiable factors can contribute to progression because they lead to oxidative stress which ultimately damages the sensitive structures in the macula.
Macular Degeneration Treatment
Wet AMD Treatment
Wet AMD treatment involves periodic painless injections done in office at regular intervals from 4 to 12 weeks apart, depending on severity. The goal of treatments is to prevent further vision loss but in some cases, vision can improve slightly following treatment.
Dry AMD Treatment
A healthy lifestyle, diet and vitamin supplements are the only means to slow the progression of dry AMD.
Vitamins for Dry AMD Treatment
The largest study ever conducted on the efficacy of vitamin supplements and AMD is the AREDS (Age Related Eye Disease) study. It is the only evidence-based long-term study to treat dry AMD. Unfortunately, the majority of these vitamins contain high levels of Zinc. Zinc has been implicated in some studies as contributory to a number of health issues, particularly with the genitourinary system. Furthermore, during statistical analysis of the AREDS data, it was noted that AMD progressed faster in some patients who were supplementing with zinc. This lead to speculation that certain people were genetically predisposed to this type of progression and should NOT be taking added Zinc.
There are now in-office genetic tests (MaculaRisk® and VitaRisk®) designed to assess both the risk of disease progression, and what combination of supplements would work best. There are conflicting viewpoints on both the validity and implication of these genetic tests, and the results of such tests need very cautious interpretation. In the absence of testing, it is widely accepted that any supplements taken should NOT contain added Zinc.
We have an in-office nutritional survey you can fill out to see if you are getting adequate intake of these nutrients, and if supplementation may be of benefit. Based on your risk profile, your optometrist can discuss appropriate preventative strategies. If you have AMD, you may be sent home with a nutrition or supplement plan, along with an “Amsler Grid” to monitor for any changes at home. If you have a family history or are concerned about AMD, book an eye exam so we can assess your risks and go over our findings and recommendations.
