One of the fastest-growing issues in eye health—and health care in general—is age related macular degeneration. In fact, this disease—also called AMD—has become the most common cause of severe vision loss in people over the age of 65. As we live longer due to the amazing advances in medical care, and the healthy manner in which we take care of ourselves, we expect that this will become even more of an issue in the coming decades.
What is macular degeneration?
There are two distinct types of macular degeneration: a less severe “dry” form, and the more severe and often visually damaging “wet” form. It is a common condition. If you ask your family and friends, you are sure to know someone who is followed for this condition. The majority of people (close to 90 percent of all patients with AMD) have what is called dry AMD. These people have changes in their retina called “drusen,” which present as yellow deposits under the retina.
The wet type of AMD is the one that usually causes visual problems. The term wet is chosen because the disease occurs when new blood vessels form under the retina and bleed, causing vision problems. Patients often notice significant distortion in their reading vision, or loss of the ability to see people’s faces. You cannot develop wet AMD without first having the dry form, which speaks to the importance of early detection and routine monitoring of your eye health.
Who is at risk?
Interestingly enough, many patients who have the dry form of AMD have no idea they even have it until they are informed of it at their routine dilated eye examination. That’s why dilated eye examinations on a routine basis are critical. We suggest annual exams for most patients over the age of 50, not only to examine for AMD, but also to detect other important conditions such as cataract or glaucoma. Your comprehensive eye care specialist can detect if you are at risk for any of these conditions during one of these routine examinations.
How is age-related macular degeneration treated?
There is no treatment for patients with dry AMD to “cure” them; however, the good news is that most patients with dry AMD do not have significant visual symptoms. The real risk is that having dry AMD puts you at risk for developing the more significant “wet” type of AMD. There are very specific eye vitamins that you can take to reduce the risk of this occurring, but the vitamins you should take should be discussed with your eye care provider before starting. It is important to note that not all vitamins are beneficial for the patients with AMD.
Although the presentation of the disease sounds very frightening, fortunately there is a highly effective treatment for wet AMD. If caught soon enough, patients may undergo an inter-office procedure to help maintain their vision. The procedure is an eye injection that must be repeated often (approximately every month or two). While it is a treatment, and not necessarily a cure, it has enjoyed a very high success rate. As long as the eye is treated soon enough, the injection can maintain a patient’s vision approximately 90 percent of the time. Previous to this treatment, wet AMD was often a visually-devastating process.
What does the future of treatment look like?
A great deal of research has been done and continues to be done on this global health issue. We here at the University of Vermont Medical Center’s Ophthalmology division are fortunate to be a major trial center for a number of clinical studies that concentrate specifically on the newest treatments for this condition. Access to one of these trials at our site afforded early access for some of our patients to what is now considered a standard of care treatment for AMD in the rest of the world. New trials continue to open and offer much hope for even better treatment options than we have even now.
As with many other health issues, early detection and education are key in following age-related macular degeneration. If you have not done so recently, please make an appointment with your local eye care provider for a comprehensive dilated eye exam. Doing so will allow you to learn more about what common eye conditions affect you, and help to determine what is the best manner in which to treat you if necessary.
Brian Kim, MD, is Division Chief of Ophthalmology at the University of Vermont Medical Center and Elliot W. Shipman Professor of Ophthalmology at the Larner College of Medicine at UVM. He is also the Director of Clinical Research in Ophthalmology.