The newsLINK Group - Macular Degeneration

Editorial Library Category: Health Topics: Macular Degeneration Title: Macular Degeneration Author: newsLINK Staff Synopsis: Age-related macular degeneration (AMD) has two forms, atrophic (dry) and exudative (wet). Editorial: Macular Degeneration 4064 South Highland Drive, Millcreek, Utah 84124 │ │ (v) 801.676.9722 │ (tf) 855.747.4003 │ (f) 801.742.5803 Editorial Library | © The newsLINK Group LLC 1 A Brief Review Age-related macular degeneration (AMD) has two forms, atrophic (dry) and exudative (wet): Dry AMD consists of three stages: early, intermediate, and advanced. It can occur in one or both eyes, and is less likely to cause vision loss. Patients with advanced dry AMD experience a breakdown of supporting tissue and light-sensitive cells in the middle of the retina. Progression of the disease is usually a slow one. For reasons that are not yet clear, sometimes dry AMD can develop, at any stage, into wet AMD. Wet AMD is also called advanced AMD, and it develops when fragile, abnormal blood vessels that can often leak both blood and fluid begin growing under the macula and behind the retina. Vision loss occurs as a direct result of these blood vessels moving the macula out of position, damaging it as it moves. This can happen quickly. Approximately 85 to 90 percent of patients who are diagnosed with intermediate and AMD have the dry version. For those who are diagnosed with advanced AMD, about 66 percent have the wet form. Wet AMD causes severe vision loss in 80 to 90 percent of the cases where vision loss occurs. A person with advanced AMD in one eye is at increased risk for developing it in the other eye as well. The pathophysiology of AMD is unclear, including the exact location of the disease. Although some researchers believe it is in the rods and cones of the neural retina, others are studying the retinal pigment epithelium that nourishes the rods and cones. The Benefits of Screening for AMD Although AMD is painless, it affects the macula and therefore affects a patient’s central vision. It is a major cause of vision loss in people whose age is 60 years or older; those who are middle-aged have only a two-percent risk of developing AMD, but for those who are over the age of 75, the risk increases to almost 30 percent. Does an AMD diagnosis matter? Yes. Since AMD affects the ability to see detail, it can affect an individual’s ability to read, watch a screen, or drive, and it can contribute directly to a significantly diminished quality of life. In addition, it places patients at greater risk for depression, falls, and fractures. Diagnosis is complicated by the fact that dry AMD can develop gradually in only one eye, making it possible for the other eye to compensate for any vision lost. When this happens, a patient may be completely unaware that any problem exists at all, which in turn makes it unlikely that the patient will seek medical care. This is why screening becomes critically important. To screen for AMD, primary-care physicians can perform an ophthalmoscopic eye exam. The purpose of this screening can be finding drusen deposits. Early screening for drusen has the following benefits: Early detection means early intervention, especially of neovascular AMD. When AMD is detected early enough, it may be possible to mitigate or avoid the worst effects of the disease. Primary-care physicians can teach patients how to examine themselves for choroidal neovascularization, or can refer patients to a specialist who can provide this instruction. Since nutrition has a role in the development of AMD, a primary-care physician can provide advice and direction on nutrition. By detecting AMD and referring patients who are at increased risk for losing their vision to an ophthalmologist, primary-care physicians can perform an invaluable service for their patients. The ophthalmologist can then provide any necessary care for choroidal neovascularization. The most common indicator for AMD is the appearance of drusen. These occur in the Bruchs membrane layer of the retina and consist of tiny lipid deposits that are either white or yellow. Researchers believe that drusen occurs as a result of dysfunction in the retinal pigment epithelium.