Macular degeneration is the leading cause of vision loss, affecting more than 10 million Americans — more than cataracts and glaucoma combined.
According to the American Macular Degeneration Foundation, 1 in every 10 Americans will suffer from macular degeneration by age 80, mostly Caucasian women.
It is frequently referred to as age-related macular degeneration, or AMD.
“The macula is where we get our central vision from,” says Dr. Vivek Chaturvedi of the Illinois Retina Associates and staff member at UChicago Medicine Ingalls Memorial. “It is the central part of the retina and therefore probably our most cherished portion of our vision and sight.”
Chaturvedi explains that there are two main types of macular degeneration: dry and wet.
“In the dry type of AMD, the deterioration of the retina is associated with the formation of small yellow deposits, known as drusen, under the macula,” he said.
“The majority of patients with macular eye disease have the dry condition.” This leads to a thinning and drying out of the macula, causing it to lose its function.
The foundation says 85 to 90% of diagnosed patients have dry macular degeneration. The rest have wet, which involves the growth of new blood vessels under the retina that leak. These new blood vessels cause the macula to bulge or lift from its usually flat position, distorting or destroying central vision. Under these circumstances, vision loss may be rapid and severe.
What are symptoms?
“New distortion in their central vision that does not go away,” Chaturvedi says. “Or a spot in their central vision that makes seeing straight ahead hard.” Patients may seek a dark spot in the center of their vision or wavy lines caused by the lack of smoothness of the macula.
But both types are treatable.
“Treatment for both dry and wet eye diseases include AREDS2 (Age-Related Eye Disease Study 2) vitamins,” Chaturvedi says. These vitamins contain high doses of Vitamin C, E, zinc and copper, along with eye nutrients lutein and zeaxanthin.
“This form of treatment has to be decided after a clinical examination with an ophthalmologist,” Chaturvedi says. “These vitamins are over-the-counter but are not meant for everyone.”
Chaturvedi says injections of anti-vascular endothelial growth factor, or anti-VEGF, medicines inhibit the growth of blood vessels and form a solid defense against wet macular degeneration. He also notes there are no surgical treatments for either type of the disease.
Another way of minimizing the effects of macular degeneration is by increasing dark green, leafy vegetables in the diet. “Spinach and kale are very healthy for the macula,” Chaturvedi says.
He says it's important to stop smoking, which “has been found to substantially increase a person's chances of developing wet macular degeneration."
Seeing an optometrist every one to two years is important to catching, treating and minimizing the effects of AMD.
“A dilated-eye examination with your primary eye care provider should identify whether or not you have macular degeneration,” he says.
“If your optometrist believes there is a possibility you have a macula issue, he or she should refer you to an ophthalmologist.”
There is also hope on the horizon.
“There are a number of clinical trials ongoing to find ways to slow down dry macular degeneration as well as find better drugs to treat wet macular degeneration,” Chaturvedi says.
“The field continues to change and gives promise and hope to patients in the coming years.”
Researchers also are investigating the body’s immune system; inflammation; cardiovascular systems, including the processing of cholesterol; and the various ways cells rebuild themselves and respond to stress from free-radical oxygen. Biological markers show a link between these various pathways or systems and macular degeneration.