Age-related macular degeneration (ARMD) is the leading explanation for blindness in adults over age 60. As its name suggests, this condition primarily affects the macula, the world of the retina answerable for central vision. An individual whose macula is affected by retinal disease could have difficulty with tasks equivalent to reading and driving, but maintain good peripheral vision.
If you could have ARMD, understanding the signs and symptoms, proper monitoring, early detection of advanced disease, and timely treatment are all keys to preserving vision.
Stages of age-related macular degeneration
Depending on the physical changes an ophthalmologist sees during an eye fixed exam, ARMD will be classified as early, intermediate, or advanced. Early ARMD is characterised by the presence of small yellow deposits called drusen within the back layer of the retina. Drusen will be present in healthy eyes as people age, but once they develop into excessive, ARMD will be diagnosed. An individual with early ARMD may not experience any visual symptoms, and is prone to have good visual function when measured using standard methods equivalent to eye charts.
When the number and size of drusen reach a certain threshold, ARMD is classed as intermediate, with a high risk of progression to advanced ARMD and vision loss. People with moderate ARMD may begin to have early symptoms equivalent to a distortion of their central vision or a light lack of visual acuity, although this will not be at all times the case.
A designation of advanced ARMD is made when patients have degenerative lack of photoreceptors (light-sensitive cells within the retina), called atrophy, or abnormal growth of blood vessels, called choroidal atrophy. Called neovascularization (CNV).
There are two primary varieties of advanced ARMD: exudative (wet) ARMD and non-exudative (dry). The presence of CNV confers the designation of wet ARMD. All other types of ARMD, including early, intermediate, and atrophy, are considered dry ARMD. Almost every case of wet ARMD begins as dry ARMD.
When advanced ARMD involves the fovea, the photoreceptor-rich center of the macula, patients can experience profound vision loss. Atrophy often develops slowly over time, resulting in vision loss because it encroaches on the fovea. The effects of CNV, including accumulation of fluid or blood under or throughout the retina, can appear more quickly and cause a sudden lack of vision.
Vision protection in individuals with macular degeneration
A study of age-related eye disease (AREDS And AREDS2) clinical trials found that taking the antioxidants, lutein, and zeaxanthin on the doses studied reduced the chance of developing intermediate- to advanced-stage ARMD by about 25%, thereby increasing the prospect of preserving vision. go
In individuals who develop advanced ARMD, the supply of treatment options depends upon whether or not they have the dry or wet type of the condition. There isn't any FDA-approved treatment for advanced dry ARMD. However, there are several treatments under investigation which will someday slow or possibly reverse the changes that affect vision.
In contrast, wet ARMD has several FDA-approved and off-label agents which have been shown to arrest and reverse the results of CNV within the macula. The current standard of care is to inject anti-vascular endothelial growth factor (anti-VEGF) drugs into the vitreous cavity (the gel-filled space that makes up a lot of the eyeball). Anti-VEGF drugs work by stopping the expansion of abnormal recent blood vessels. There are also several promising treatments within the pipeline for wet ARMD, including long-acting anti-VEGF drugs, combination drugs, surgically implanted drug depots, and gene therapy. There can be hope for eye drops or oral medications, although these treatments have an extended horizon.
Reducing the chance of progression and early detection of advanced ARMD are essential.
If you could have ARMD, the most effective option to preserve vision is to cut back your risk of progressing to more advanced ARMD, and to detect treatable wet forms early. For starters, smoking cessation and a healthy weight loss program can reduce the chance of developing advanced ARMD and stop associated vision loss. Your ophthalmologist will recommend AREDS2 vitamins, which can be found over-the-counter with out a prescription, to cut back the chance of further progression in the event you've been diagnosed with ARMD at an intermediate stage. He will even check recurrently for signs of disease progression.
Be aware of accelerating signs of macular degeneration, including blurred or distorted central vision. And monitor your vision at home with an Amsler grid (a grid of horizontal and vertical lines used to observe the central visual field) or other home monitoring device, as directed by your ophthalmologist. More sophisticated home monitoring systems, including retinal scanning devices, are on the horizon. They can assist detect wet ARMD so it may well be treated before everlasting damage to the retina occurs.
Current treatments can control the disease and preserve vision for years or more, so early detection is vital. Additionally, regular follow-up visits with an ophthalmologist will probably be essential, as he or she's going to check for signs of disease progression that will not be apparent to you. Your ophthalmologist will even be more acquainted with recent and emerging treatments within the rapidly evolving landscape of ARMD therapy.