14 Jul Top 10 Comments About Macular Degeneration
Macular degeneration, or ARMD, is one of the more common diseases seen by a retina specialist. It is usually a disease of the elderly, and with the “baby-boomers” aging, the prevalence continues to rise. There is a lot of “misinformation” regarding macular degeneration. So, here goes;
1. There are two types; so called “wet” and “dry.”
Wet, or exudative macular degeneration, is less common, advances more rapidly than dry. While there is treatment for the “wet,” the prognosis is better for the dry.
2. Vitamins HAVE NOT BEEN PROVEN to be effective for most cases of macular degeneration.
While the AREDS study did indicate that a certain formulation was effective, it was only effective in 25% of those patients that had high-risk characteristics. Most of the information about free radicals and luteins, etc. have yet to be proven. AREDS II will be more informative. It is ongoing and scheduled to finish in December 2012.
3. Macular degeneration is NOT inherited.
Macular degeneration is really a “waste basket” term. There are probably lots of types of macular degeneration, only a few of which seem to run in families. For the most part, age-related macular degeneration does not run in families. While there have been a few genetic studies indicating that a similar disease may run in families. It’s too early to really know.
On the other hand, there are certain characteristics that seem to be risk factors; persons of northern European descent, blue eyes and smoking to name a few.
4. Macular degeneration will not blind you.
Macular degeneration is a disease of the macula. The macula is the most sensitive portion of the retina and gives us our straight ahead vision and our ability to see 20/20. Diseases of the macula affect central vision only. While one with significant vision loss from ARMD may not read, they will have preserved side, or peripheral, vision.
5. Macular degeneration usually does not affect those below age 55.
While there are many macular diseases affecting patients of any age, “macular degeneration” typically is diagnosed in patients over 55.
6. Routine checkups are not as useful as self-monitoring with an Amsler grid.
An Amsler Grid is basically a piece of graph paper with a big dot in the center for fixation. The grid lines are useful for determining any NEW distortion that may develop in the vision. The most common symptoms of progressive macular degeneration are new, persistent decrease vision and new distortion. A grid is an easy way to monitor.
7. Intraocular injections do NOT hurt.
Intraocular injections of anti-VEGF inhibitors are very common and have become the mainstay of treatment. Most patients are extremely relieved, yet surprised, that the injections are painless. Before the injection, topical anesthesia is applied for 10-20 minutes allowing the injection to proceed with discomfort!
8. Sunglasses probably do NOT prevent macular degeneration.
For many of the reasons stated in #3 (macular degeneration is not inherited), there are environmental factors that must lead to macular degeneration, but only in those with certain risk factors. There is a racial predisposition for developing macular degeneration; those from northern European descent; however, there are many more that are exposed to the sun or that smoke.
9. There is no cure for macular degeneration.
Despite new treatments on the horizon, there is no cure for macular degeneration. Present treatments include anti-VEGF therapies for development of the wet, or exudative, macular degeneration. While vision is improved, these tend to be chronic treatments for recurrent disease and not a “cure.” There is presently no proven therapy for the dry, nonexudative, form of macular degeneration.
10. Changing your diet, eating fish or other supplements may improve your macular degeneration.
Studies are underway and, as yet, there is no definitive proof that any supplements are beneficial.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist