What You Should Know About Wet Macular Degeneration
What are the causes of Wet Macular Degeneration?….and more importantly – What can you do to limit it. Read the article below to learn all about Wet Macular Degeneration.
According to the Macular Degeneration Association, the disease is a leading cause of vision loss in adults over fifty five years of age.
There are two forms of Macular degeneration, wet and dry. Dry macular degeneration occurs gradually, as the result of degenerating cells in the retina, leading to gradual loss of central vision.
Wet macular degeneration occurs less frequently, but often results in rapid loss of vision.
What is Wet Macular Degeneration?
Abnormal blood vessels grow beneath or behind the retina, which can leak fluid onto the retina and cause scarring. The following are the Symptoms of Macular Degeneration
Symptoms of Wet Macular Degeneration:
– dark or blurry spots in the center of the visual field, or white spots in the same area.
– floaters (dark floating spots in the field of vision).
– straight lines may look crooked and color perception may change.
– objects can appear farther away than they are.
– difficulty reading, writing, or recognizing familiar faces of friends and relatives.
If you have experienced any of the symptoms, call The Sight Clinic to make an appointment for evaluation and a thorough eye exam. Our eye care professionals are experienced in treating cases of wet macular degeneration.
Treatments for Macular Degeneration (as reviewed by the Macular Degeneration Association, 2017).
– nutritional therapy including antioxidants,
– injections to slow the development of new blood vessels.
– medication therapy: common medications include Eylea, Lucentis, and Avastin.
– laser treatment to target abnormal blood vessels
– photodynamic therapy: more popular than laser therapy. A cold lase is used to close off blood vessels, after a light reactive drug is given by IV.
More details about macular degeneration
Macular degeneration is a progressive deterioration of the cells of the retina, specifically, the central portion of the retina known as the macula.
This is the portion of the retina responsible for central vision, or what a person can see directly in front.
While the dry form of the disease is more common, wet macular degeneration is more severe and tends to progress more quickly. In dry macular degeneration, yellowish, round spots and the outer most layer of the retina, known as drusens, are formed.
This is when affected individuals may begin to notice floaters or dark spots in the central visual field.
In wet macular degeneration, the abnormal blood vessels grow behind the center of the retina. Leaking fluid and blood cause scarring on this portion of the retina. this is why wet macular degeneration symptoms can progress so rapidly.
Facts about the occurrence of macular degeneration
– Macular degeneration can occur at any age, but typically symptoms appear in adults over aged 55.
– 11 million people in the U.S. are affected by macular degeneration annually.
– only 15% of people with the disease have Wet macular degeneration.
– dry macular degeneration affects roughly 85-90% of those with the disease. Symptoms can begin to appear at age 30, though this is less common.
– floaters or dark spots can occur years before any vision loss or visual changes are noticed.
– about 250,000 new cases of wet macular degeneration occur yearly in the U.S.
Symptoms of macular degeneration
– gradual or rapid loss of central vision
– blurred vision, dark spots, or floaters
– blind spots or missing areas of the visual field
– grids or straight lines look wavy or irregular
– difficult discerning dark colors and/or light colors
– vision is slow to recover after bright light exposure
– loss of discernment in contrast
When to Seek Medical Attention from The Sight Clinic
– When central vision changes occur rapidly
– when something seems “not quite right” about the visual fields
– if black spots or floaters have occurred on more than one occasion
The best professional to diagnose and treat wet macular degeneration is an ophthalmologist. However, there are instances that can be considered an emergency. Sudden loss of central vision in one or both eyes is always a concern.
It should always be addressed as soon as possible.
While this symptom could be a sign of another eye disease or another condition, it may be best to go to the emergency room, especially if no ophthalmologist is available to do a complete vision screening.
Immediate treatment of wet macular degeneration can prevent further vision loss and can help you maintain a certain quality of life.
What are Some of the Risk Factors for Wet Macular Degeneration
– age 50 or older
– family history of macular degeneration
– genetic mutation
– female gender
– Caucasian race (affected more than other races)
– obesity (increases the chances of early disease process)
– cigarette smoking
– nutritional deficits, particularly a diet low in vitamin A, C, and E.
– high blood pressure
– elevated cholesterol
Prevention of wet macular degeneration
As of now, there are not proven prevention methods. However, eating a healthy diet of green vegetables and plenty of omega 3 fish can help maintain general eye health. Additional supplementation with zinc may also help.
Regular eye exams after age 45 can help detect early disease processes.
The sooner a treatment plan is developed, the easier it may be to prevent further deterioration of the macula portion of the retina. The Sight clinic can provide thorough screening and exams for macular degeneration.
There is a genetic test to detect DNA responsible for progressive macular degeneration. This is usually used only if an individual is already diagnosed in the early stages, has a strong family history, or is suspected of having macular degeneration.
Monitoring vision on a daily basis is a good idea for anyone diagnosed with the progressive disease. There are grids available that people can attach to a refrigeration, wall, mirror, or any flat surface at eye level.
There are grids available online that can also help determine if any changes in the central visual field are noticed.
Any changes should be reported to the ophthalmologist right away, so a plan for treatment can begin, to prevent further vision loss.
Screening for Wet Macular Degeneration
Screening for all types of vision loss and visual or optical disease should become routine after age 45. For most people, screening every 2 years is sufficient. An exam will begin with the optometrist or ophthalmologist examining the eyes for drusen or abnormal pigments in the macula.
The exam will usually include a simple exam to test central vision, possibly using the Amsler grid will ask about any breaks in the grid, to determine if and where degeneration is present.
The eye care specialists at The Sight Clinic can provide an exam using the modern tools and methods available in the eye care industry.
Usually, if an optometrist suspects any type of progressive vision or eye disease, a referral will be made to an ophthalmologist, for further evaluation. This evaluation may include another physical exam, an angiography using dye to look at the blood vessels at the back of the retinas, and possibly genetic testing.
Additional tests for the eye disease may include the Optomap Retinal exam. This test provides a visual map of the retinas. An OTC scan is used to look for any areas of thicker or thinner retina. The OTC scan can also detect any abnormal fluid behind or near the retina.
There are tele-medicine home monitoring systems available, for those who have been diagnosed with the disease.
Telemedicine is a growing field and is being adopted in many medical specialties, including the eye care profession.
There are new technologies and procedures being developed all the time, to detect wet macular degeneration and other degenerative eye disease. Asking questions and researching the disease can help you prepare for the next visit to an eye care professional.
Any symptoms such as loss of vision in a particular area of the visual field, dark spots, blank areas of vision, recent difficulties with color discernment, and difficulty recognizing familiar faces, should be addressed as soon as possible. Putting off seeing an eye care specialist is not helpful in preventing disease progression.
Only an eye care professional can know for sure whether you’re suffering from wet macular degeneration, dry macular degeneration, or some other eye disease that causes visual disturbances.
Current Treatment for Wet Macular Degeneration
– Nutrition, particularly antioxidants, including vitamins A, C, and E, zinc, and omega 3 fatty acids (found in fish, flax, and other omega 3 rich plants). Eating a balanced diet and reducing elevated cholesterol can also help.
– Reducing high blood pressure. Increased exercise will help reduce blood pressure, as well as increase self confidence at what may be a difficult time, when visual disturbances require an adjustment period.
– injections into the eyes consist of anti-VEFD, which blocks the growth factor secreted by the eyes, responsible for the increased development of abnormal blood vessels. Injections may be required on a regular basis.
They only concern for most people, is the thought of having a needle inserted into the eyes. It is far less traumatic than most people imagine.
– Medications. Lucentis and Avastin are some of the newest medications available for treatment of macular degeneration. Lucentis is thought to not only slow progression of the disease, but improve vision as well.
Avastin requires injection into the eyes and is less expensive than others. Eylea is injected into the eyes and is less costly than others.
It can also be given every two months, rather than monthly, making it a more sensible option for many patients with macular degeneration.
Photodynamic therapy is quickly replacing laser surgery, though in some cases later treatment may be the best option. Photodynamic treatment involves giving a drug by IV, which is light sensitive. A cold laser is then used to visualize and close up the blood vessels. This treatment is highly effective, but may require several sessions over a period of a couple years. The only precaution with this treatment, is avoiding sunlight exposure for several days after the procedure.
Laser surgery treatment
This treatment involves using the laser to destroy the abnormal blood vessels. It is often used when abnormal blood vessel growth occurs farther away from the macula, or center of the retina. For the most part, it has been replaced with photodynamic treatment.
Research on Wet Macular Degeneration
– Reducing the ability to sense light helps keep the eyes and the retinas from being overworked. The thought is that by limited the capacity to sense light, the free radicals produced in the processes of the eyes is reduced, to further reduce the risk of abnormal blood vessel development.
A side effect of using the medication to limit light sensing is difficulty seeing in low light or night blindness.
Implants are placed in the eyes, to slowly release drugs that protect the eyes. This treatment is also being used to reduce increased eye pressure often associated with glaucoma.
This treatment requires injecting certain cells associated with the retina, behind the retina. It is thought to reduce the loss of cells responsible for central vision. It is also thought to be a safe procedure, with few side effects.
Certain drugs, when used as eye drops, can increase blood circulation to the retina and reduce the free radicals produced in the retina.
– Dietary control of blood lipids/statin drugs
Just as elevated lipids, or LDL cholesterol can cause hardening of the arteries, it can also have the same effect in the retinas.
Therefore, a diet and measures to reduce LDL cholesterol can have a positive effect on macular degeneration.
In conjunction with a diet high in green, leafy vegetables and antioxidants, it can be used with other therapies, to improve overall health and function of the retinas.
Statin drugs are often prescribed for those with moderately to highly elevated LDL cholesterol levels.
While these drugs are effective in reducing LDL cholesterol, they show promise in reducing the effects of dry macular degeneration. It is not known whether statin drugs can help in treating the wet form of the disease.
There are currently no drugs known to prevent wet macular degeneration. However, some preventive measures involving lifestyle changes may help. Stopping smoking, reducing LDL cholesterol levels, eating a healthy diet rich in antioxidants and green, leafy vegetables, and protecting the eyes from harsh conditions can help.
Wearing sunglasses also helps reduce the strain and work of sensing light. All of these lifestyle changes are inexpensive or free, so anyone who is concerned can reduce the risk of macular degeneration.
These measures may be particularly important for those with a family or genetic history of the disease, to reduce risk.
If you’ve been diagnosed with wet macular degeneration or it is suspected, you will likely experience emotional strain and will need to make adjustments in daily tasks. You may even have to stop driving.
Seeking support and maintaining open communications with the eye care professional are important in understanding and making decisions about treatment.
Additional considerations for those with macular degeneration
– Call The Sight Clinic for more information about treatment options
– address issues of depression related to vision loss
– support adaptive strategies
– discussion treatment options with the eye care specialist openly and voice preferences in treatment
– Let friends and family members know how they can help, if they offer
– develop a long range plan on how you will get around if driving becomes impossible
– educate yourself on the treatments, symptoms, and research on the disease, for greater understanding