Macular Degeneration

Age-related macular degeneration (AMD) is a disease associated with aging that gradually destroys sharp, central vision. Central vision is needed for seeing objects clearly and for common daily tasks such as reading and driving.
AMD affects the macula, the part of the eye that allows you to see fine detail. AMD causes no pain.
In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. AMD is a leading cause of vision loss in Americans 60 years of age and older. AMD occurs in two forms: wet and dry.

Dry macular degeneration is a chronic eye disease that causes vision loss in the center of your field of vision.The vast majority of cases of macular degeneration are the dry type, in which there is thinning or deterioration of the tissues of the macula or the formation of abnormal yellow deposits called drusen. Progression of dry macular degeneration occurs very slowly and does not always affect both eyes equally.

Dry macular degeneration is one of two types of age-related macular degeneration. The other type, wet macular degeneration occurs when abnormal or leaking blood vessels grow underneath the retina in the area of the macula. These changes can lead to distorted or blurred vision and, in some cases, a rapid and severe loss of straight ahead vision.

​Macular degeneration can cause loss of  central vision, but by itself will not lead to total blindness.

Dr. Kessler can diagnose macular degeneration by identifying changes of the macula by looking into your eyes during your complete eye examination. A chart that you can use at home, known as an Amsler Grid, can be used to pick up subtle changes in your vision.

The best way to diagnose wet AMD is with Optical coherence tomography (OCT). This noninvasive imaging test displays detailed cross-sectional images of the retina. The test identifies areas of retina thinning, thickening or swelling. These are caused by fluid accumulations from leaking blood vessels in and under your retina. In addition to its value in an initial evaluation, OCT is also often used to help monitor the response of the retina to macular degeneration treatments.

Treatment can’t reverse dry macular degeneration. But this doesn’t mean you’ll eventually lose all of your sight. Dry macular degeneration usually progresses slowly, and many people with the condition can live normal, productive lives, especially if only one eye is affected.
Taking a high-dose formulation of antioxidant vitamins and zinc may reduce the progression of dry macular degeneration to vision loss, according to research by the National Eye Institute (NEI). These are the [AREDS study vitamins].

​Wet macular degeneration can’t be cured. If diagnosed early, treatment may help slow progress of wet macular degeneration and reduce the amount of vision lost.Medications may help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels. These drugs are considered the first-line treatment for all stages of wet macular degeneration.

Dry macular degeneration symptoms usually develop gradually. You may notice these vision changes:

  • The need for brighter light when reading or doing close work
  • Increasing difficulty adapting to low light levels, such as when entering a dimly lit restaurant
  • Increasing blurriness of printed words
  • A decrease in the intensity or brightness of colors
  • Difficulty recognizing faces
  • A gradual increase in the haziness of your central or overall vision
  • Crooked central vision
  • A blurred or blind spot in the center of your field of vision
  • Hallucinations of geometric shapes or people, in case of advanced macular degeneration

Dry macular degeneration may affect one or both eyes. If only one eye is affected, you may not notice any changes in your vision because your good eye may compensate for the weak eye.

Age-Related Eye Disease Study (AREDS)

The Age-Related Eye Disease Study, called “AREDS” for short, was a major landmark medical study sponsored by the National Eye Institute, one of the federal government’s National Institutes of Health. It closely followed about 3,600 participants with varying stages of AMD to see if taking high levels of antioxidant vitamins and zinc over a long period could reduce the risk of developing advanced AMD.
The landmark AREDS study showed that patients diagnosed with moderate to advanced AMD who are most at risk for progression to advanced disease decreased that risk by 25% and reduced the risk of AMD-associated vision loss by 19% by taking a high-potency antioxidant and mineral supplement every day.

Age-Related Eye Disease Study 2 (AREDS 2)

Emerging scientific research suggests that there may be other nutrients that may also have a protective effect in AMD. These new nutrients are lutein, zeaxanthin, and omega-3 fatty acids. When AREDS was started, lutein and zeaxanthin were not readily available, so they were not tested in the study. Now, many researchers believe that lutein and zeaxanthin may be more significant for macular health.

A second nationwide study is currently underway called AREDS2. This is being conducted to determine whether these new nutrients – taken in combination with the antioxidants and minerals tested in the original AREDS study – can further slow the progression of AMD and the associated vision loss

AREDS 1 formula

500 mg vitamin C
400 (IU) vitamin E
15 mg of beta carotene
80 mg of zinc
2 mg of copper

AREDS 2 formula

500 mg vitamin C
400 (IU) vitamin E
25 mg of zinc
2 mg of copper
10 mg lutein
2 mg zeaxanthin
350 mg DHA
650 mg EPA