Age Related Macular Degeneration (ARMD)

Age related macular degeneration (ARMD) affects the eyesight of up to 15 million Americans, according to the American Macular Degeneration Foundation statistics. ARMD is the leading cause of central vision loss (blindness) in the United States for those over the age of fifty years. The Foundation further reports that macular degeneration, as the leading cause of blindness, affects more Americans than cataracts and glaucoma combined.

Macular degeneration is a medical condition caused by deterioration in the central area of the retina which is the inside back layer of the eye that records images seen and sends them (via the optic nerve) from our eyes to our brain. What happens is that light sensing cells in the macula (The retina’s central portion) malfunction and, over time, cease to work. The macula controls such abilities as reading, driving, recognizing faces or colors, and seeing objects in fine detail.

As the disease progresses, color and central vision areas deteriorate and the gradual destruction of light sensitive cells continues until large areas are totally gone. Peripheral vision will remain, but the individual’s ability to clearly see straight ahead and to see color is lost.

MacularDegeneration

Advanced ARMD is responsible for profound vision loss and has two forms: dry and wet.

The advanced dry form is often referred to as central geographic atrophy; and, causes vision loss through loss of photoreceptors in the central part of the eye. Sadly, there is currently, no treatment is available for this condition.

The advanced wet form is often referred to as neovascular or exudative ARMD; and, causes vision loss due to abnormal blood vessel growth under the macula. These blood vessels bleed, leak, and scar which, if left untreated, eventually cause irreversible damage to the photoreceptors and supporting cells.

The Macular Degeneration Partnership reports the progressive eye condition of ARMD as affecting as many as 15 million Americans, with 200,000 new cases each year. This Partnership provides a simulation video of the deterioration of vision of a person with ARMD.

ARMD Risk Factors:

  • Age: Approximately 10% of patients 66 to 74 years of age will have findings of macular degeneration.
  • Smoking: The only environmental exposure clearly associated with macular degeneration is smoking.
  • Family history: The risk of developing late-stage macular degeneration is 50% for people who have a relative with macular degeneration vs. 12% for people who do not have relatives with macular degeneration, i.e. a fourfold higher risk.
  • Hypertension: High blood pressure.
  • High fat intake is associated with an increased risk of macular degeneration in both women and men.
  • Race Macular degeneration is more likely to be found in whites.
  • Exposure to sunlight

ARMD Symptoms:

  • Blurred vision: Those with dry macular degeneration may by asymptomatic or notice a gradual loss of central vision, whereas those with wet macular degeneration often notice a rapid onset of vision loss.
  • Central vision loss.
  • Distorted vision: A grid of straight lines appears wavy and parts of the grid may appear blank.
  • Slow recovery of vision after exposure to bright light.

ARMD Treatment:

Most of the treatments that are available now and currently being studied are aimed at stopping the neovascular (or wet) form of AMD; and, new, effective treatments have become available in the past few years.

ARMD Prevention:

The Age-Related Eye Disease Study showed that a combination of high-dose vitamins and minerals (beta-carotene, vitamins C and E, and zinc) can reduce the risk of developing advanced AMD by about 25 percent in patients who have earlier but significant forms of the disease. Currently, this is the only intervention proven to decrease the risk of advanced ARMD. There is a follow up study, Age-Related Eye Disease Study 2, currently underway, which is focusing on the potential benefits of fish oil, lutein, and zeaxanthine.

Dr. Singh maintains awareness of the latest proposed theories, research, and trials as well as approved medicines, treatments, and surgeries.