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Age Related Macular Degeneration

The Difference Between Wet vs. Dry AMD

Elderly man with maginfier who has age related macular degeration 

 

Macular degeneration is an extremely common reason for vision loss among the elderly. The macula is a sensitive area of the eye located in the center of the retina, which helps people see clearly when looking straight ahead.

During macular degeneration, this part of the eye deteriorates, resulting in symptoms such as blank or blurred areas in your field of sight when looking straight ahead. Macular degeneration may occur slowly or quickly, and in one or both eyes.

Macular degeneration does not cause complete blindness by itself.
It can, however, interfere with daily activities such as driving, writing, reading, cooking, or even recognizing faces. It can be debilitating, and there is no cure—although there are treatments that can mitigate the effect.


The Difference Between Wet vs. Dry

Dry macular degeneration is the most common
, and is usually how the disease starts. Approximately 80-90% of cases are dry. In this type of degeneration, white and yellow deposits or “drusen” are found on the retina under the macula, causing damage over time. In the most severe cases, dry macular degeneration causes a thinning in the macula’s normal, healthy cell layers, resulting in atrophy that can cause blind spots in the patient’s central field of vision.

Wet macular degeneration is more serious.
While it affects only about 10-15% of cases, it is also the culprit in about 90% of the most severe cases of vision loss from macular degeneration overall. It occurs when abnormal blood vessels grow in the area of the macula. The blood vessels leak, break, and bleed frequently, causing serious damage to the macula that eventually separates it from the rest of the eye.

It is possible to have the wet form of the disease in one eye, and the dry form in the other. Those who are most at risk for developing macular degeneration are the elderly. Most cases appear in patients age 60 years or older. It is possible to contract it at a younger age, however.


Those most at risk, aside from the elderly, are:

Smokers
. According to research, smoking doubles the risk of contracting macular degeneration.

Caucasians.
Caucasians are more likely to get the disease than African Americans or people from Latin American countries.

Those with macular degeneration in the family.
The disease is passed on in the genes, and if you have a history of it in the family, you are at higher risk of contracting it yourself. There are approximately 20 genes that contribute to developing macular degeneration, so it is difficult to test for.

Although there's no cure there are treatments which include:

Medications.
The most common are the anti-angiogenesis drugs that stop new blood vessels from forming under the macula, and help prevent abnormal vessels already there from leaking. These drugs are a major leap forward for treatment of wet macular degeneration, and they can even cause vision to return in some cases. These drugs are often administered via injection, on a monthly or six-week basis, or on a different timeline depending on the patient’s needs.

Vitamins can also be helpful. Vitamins C, E, copper, zinc, and beta-carotene have all been shown to help slow the progress of dry macular degeneration.

Laser treatment. Laser light therapy can destroy abnormal blood vessels under the macula, stopping them from growing and damaging the tissue.

A joint medication and laser light therapy technique called photodynamic laser therapy has also been shown to be effective. With this treatment, a light-sensitive drug is injected into the patient’s bloodstream, where it enters the blood vessels under the macula. Afterward, the doctor shines a laser into the eye, activating the drug and destroying abnormal blood vessels.

Vision aid devices. Some devices with specially designed lenses or electronic features that show magnified images of nearby objects have also been shown to help patients with this type of degeneration see better.

There are other types of treatment as well, which are considered to be more experimental. These include submacular surgery and retinal translocation to eradicate abnormal blood vessels. Patients do not go blind from macular degeneration, and although the disease can cause impairment, it is also possible to live a normal life with it—especially with the assistance of vision aids and treatment.

While there is no cure, several different types of treatments have been shown to help slow the progress of the disease and even improve the patient’s vision.

 

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