Age Related Macular Degeneration

The macula is the center of the retina and is the area of the retina that is responsible for your “20/20” vision. When you read something, or look at someone’s face, you are using the macula. The rest of the retina is used for your peripheral, or side vision. Macular degeneration can cause central vision loss, making it difficult to read, write, drive, use a computer, and watch TV – any activities of daily living.

ARMD is a disease of the macula that causes central vision loss. It is the most common cause of vision loss in Americans older than 65. It is likely that it runs in families, but not everyone with family members that have ARMD go on to develop it themselves. There are other factors which can make ARMD worse, especially smoking tobacco. There are two forms of ARMD; they are called “wet” and “dry.” Patients with dry ARMD may have no symptoms; but the disease can progress to cause blind spots in the central vision. Blood vessels may begin to grow under the macula, which can leak or bleed. This is wet ARMD.
Dry ARMD is the most common type. It usually results in gradual vision loss. Wet ARMD accounts for only 10% of people with the disease. This type of ARMD can progress quickly due to leaking or bleeding blood vessels under the macula. About half of all people who develop wet ARMD in one eye go on to develop wet ARMD in the other eye.

Even before a patient has symptoms, ARMD can be detected with a dilated eye exam. An eye doctor can see “drusen” in the macula, which signifies ARMD. Sometimes, further testing is required to determine if the ARMD is wet or dry. Optical coherence tomography (OCT) and fluorescein angiography (FA) can be used to help make the diagnosis and determine the correct treatment.

Unfortunately, there is no cure for either type of ARMD, however treatment can slow down vision loss significantly. The treatment depends on the type of ARMD and how severe the disease is.
Dry ARMD does not always need specific treatment, and in many cases can be observed. Lifestyle modifications, especially stopping smoking, can help slow down the progression of the disease. Self-testing at home with an Amsler grid can help patients to know if they develop new symptoms which need to be addressed by their eye doctor. More advanced forms of dry ARMD have been shown to progress even more slowly with vitamin/mineral supplements in specific dosages. These are the AREDS2 formulation of supplements.
Wet ARMD can be treated with medications given by an ophthalmologist by an injection performed in the office. The medications used (Avastin, Lucentis, Eylea, Beovu, and steroids) reduce the leakage from the abnormal blood vessels and can cause the blood vessels to go away. A newly FDA approved surgical procedure may also be an option for some patients. Some types of wet ARMD can be treated with lasers. Treatment of wet ARMD has been shown to reduce the amount of vision loss significantly. Treatment for wet ARMD involves frequent office visits for photographs and injections of medication.

Retina specialists, like Dr. Schneider, have extensive training in detecting and treating ARMD. Additionally, retina specialists like those at the Sarasota Retina Institute are often involved in clinical trials of new medications used to treat ARMD. In rare instances, complications from ARMD can require surgery to improve or stabilize vision. Only retina specialists are trained to manage these types of complications. If you have been told that you have ARMD, have family members who have ARMD, or have other concerns regarding the health of your retina, you should see a retina specialist for evaluation.
You can schedule an appointment with Dr. Schneider by calling the Sarasota Retina Institute at 941-921-5335.