Macular Degeneration is a common diagnosis describing a large amount of patients; it has many different forms with widely varying severity. For some people the disease causes only slight distortion, but in the worst cases, it can lead to a complete loss of central vision, making reading or driving impossible. It usually affects older patients – retirement age and above. Initial signs of macular degeneration may be picked up earlier, in the 40’s and 50’s. This is important since there is evidence that intervention with nutritional supplements and life-style changes may reduce the development of the blinding disease.

There are two forms of macular degeneration – dry and wet. The dry form results from degeneration of the outer layers of the retina – the light absorbing photoreceptors and the retinal pigment epithelium (RPE). The RPE forms the blood retinal barrier between the outer retinal circulation (choriocapillaris) and the outer retina (photoreceptors). With age, the waste products of vision accumulate beneath the RPE in little mounds called drusen. These proteinaceous and fatty-like deposits impede the flow of oxygen and nutrients and result in degeneration of both the RPE cells as well as the visual cells (photoreceptors).

In the wet form of macular degeneration, abnormal blood vessels grow from the outer retinal circulation (choroid) beneath the retinal pigment epithelium (RPE) and sometimes into the retina itself. These blood vessels can leak fluid and protein and eventually form a scar. With early diagnosis of these blood vessels, laser surgery may be used to close the blood vessels and prevent further vision loss. Fluorescein angiography and indocyanine green angiography may be used to image the abnormal blood vessels and guide laser treatment.

Many patients with wet macular degeneration receive treatment with anti VEGF medicines (anti-vascular endothelial growth factor). These are fairly new drugs and are injected into the eye and work by blocking an essential signal that causes abnormal blood vessels to grow and leak. Some of these drugs include LUCENTIS™, AVASTIN, and/or MACUGEN. Another treatment option is Photodynamic Therapy. This involves using the light activated drug VISUDYNE combined with a laser to stop abnormal blood vessel growth in some patients with web AMD. Talk to your physician at LoBue Laser and Eye Medical Center today about whether this is an option for you.

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