10 Feb Who Gets Macular Degeneration?
Macular degeneration, also known as ARMD, is a retinal disease that typically affects both eyes. It is not a disease that has typical inheritance patterns, yet there is a racial bias for developing the disease. Also, certain habits, such as smoking, seem to increase the risk.
Are you at risk for developing the disease?
Northern European Ancestry
Typically, patients of northern European heritage, aka Caucasians, develop more macular degeneration compared to blacks or Asians. Most of my patients with dry macular degeneration are usually Caucasian. The blacks and Asians that I diagnose with ARMD usually have the wet form. Again, this is in my practice.
Patients with Blue Eyes
Originally, patients with blue eyes were deemed at higher risk. While there may be a statistical association, I think it’s also possible that those individuals with the lightest complexion have blue eyes, too.
Smoking Must be Bad for Your Eyes
There is definitely an association with the wet form of macular degeneration and smoking, especially in Caucasian patients. We don’t know; however, the exact cause (i.e. how does smoking cause the disease?).
Younger Patients Don’t Get the Disease
I hesitate to make the diagnosis of ARMD in patients younger than 55. Patients younger than 55 can get macular disease, but it may behave differently than typical ARMD.
Patients with Drusen
I get questions all the time about drusen and the risk for developing eye disease. Drusen can be normal. Not all drusen constitute the diagnosis of macular degeneration.
Twins and Siblings of Affected Patients?
More than anything, as an observer, I don’t feel that the eye disease runs in families, that is, it doesn’t follow usual inheritance patterns. It is quite possible for you to contract the disease, but your twin does not. Just because your mom or dad had the disease doesn’t mean you’ll get it.
What Does This Mean? Someday we’ll find that “macular degeneration” is actually a collection of diseases that look and behave similarly, but for now we are unable to distinguish between them. Thus, it is difficult to characterize the disease.
There does seem to be certain risk factors that make us more susceptible to developing ARMD. Certainly if smoking were the only risk factor, the disease would be more evenly dispersed amoung races, that is, the disease would be similar to the prevalence of smoking in a particular race. Clearly, this is not the case, so there must be a risk factor for developing the disease if we smoke.
There must also be, but yet to be proven, a protective effect of diet. We’ll see with AREDS II.
For now, we think we’ve identified those attributes that increase our risk for macular degeneration. Until we can predict who will develop the disease, get regular dilated eye exams if you are concerned.
The disease may not be truly inherited, but the risk factors might be.
NeilPosted at 09:24h, 10 February
I really find your blog postings informative. Please keep sharing the good information.
Randall V. Wong, M.D.Posted at 17:34h, 11 February
Thanks again for following and the great comments.
MarionPosted at 13:25h, 12 February
I HAVE BEEN ON BOTH SHOT FOR OVER A YEAR..IT SEEMS TO HAVE STOPPED THE LEAKING OF FLUID AS WELL HAS TAKEN THE SWELLING DOWN SOME…THE ONLY THING IT HASNT HELP IS MY EYE SITE…IS THERE ANYTHING ELSE TO BE DONE…MY RETINA DR. SAID I HAVE WET AND SOME MAGULAR……I DONT KNOW WHERE TO TURN FROM HERE…PLEASE HELP ME.
Randall V. Wong, M.D.Posted at 19:22h, 19 February
If no more shots are indicated at this time, it doesn’t sound as if there can be much improvement of your vision, but I’d make sure you ask your doctor directly.
MarionPosted at 13:26h, 12 February
BY THE WAY …I AM LITE SKINED, HAVE BLUE EYES AND WAS A SMOKER FOR MANY YEARS…I GUESS I HAVE ALL OF IT.
Randall V. Wong, M.D.Posted at 19:23h, 19 February
Hang in there. Let me know if I can help further.
richardPosted at 18:21h, 17 February
Any opinion on alternating Lucentis and Avastin on a two week basis? I have received about 8 shots of Lucentis with about a 4 line improvement, but the OCT is staying about the same…And why has the vision improved if the fluid still leaks-area seems to be about the same size… Thank you for taking time to answer questions, very, very few people will do that.
Randall V. Wong, M.D.Posted at 19:53h, 19 February
Never tried injections that frequently. Never had the opportunity. I’m a bit confused, but, hell, take the improvement in vision even if you can’t explain everything!
Good for you,
JudyPosted at 00:56h, 07 April
I was diagnosed with posterior subcapsular cataracts in both eyes around August, 2009 at age 43. The cataract in the right eye was fairly advanced, the left was very small and way off to the side. I had no insurance (and still don’t) primarily because I was unable to work for about five years because I was acting as full-time caretaker for my AD/PD mother who since passed away just a few months ago. The cataract in my left eye has not progressed that much, but I am completely blind in my right eye and have been for around nine months. I can see light, but nothing else. My right pupil is milky white and has been for many months. I have just very recently noticed an uncomortable feeling in my right eye and am fearing detached retina. It seems like I can feel film around my right eye coupled with slight pressure. I am at a loss at what to do.
Randall V. Wong, M.D.Posted at 07:57h, 07 April
My suspicion is that you might have a really advanced cataract. It would be impossible for you to tell without an examination. I can’t tell either, but would recommend you get a dilated examination soon just in case there is a retinal detachment.