What is age related macular degeneration?
Age related macular degeneration (ARMD) or macular degeneration is the leading cause of significant vision loss in people over the age of 55. The macula is the central area of the retina responsible for fine detailed vision. As we age, the macula becomes thinned and deposits called drusen are formed. This is the early form of age related macular degeneration.
There are three forms of age related macular degeneration. All three forms can cause vision loss. However, they do so at different rates. Dry or atrophic macular degeneration is a slow degenerative process with gradual vision loss over many years. It may lead to severe central vision loss, but peripheral vision is not affected.
The "wet" form of macular degeneration or choroidal neovascularization (CNV) usually occurs suddenly. Symptoms include blurry or fuzzy vision, straight lines such as sentences on a page or telephone poles appear wavy, distorted and dark or blank areas appear in the center of vision. Abnormal blood vessel growth (choroidal neovascularization) from underneath the retina causes this type of severe vision loss. A small percentage of these cases fall into the strict guidelines required for laser treatment to be effective. If left untreated, bleeding and scarring will lead to a profound permanent loss of central vision.
In many cases if the choroidal neovascular membrane (CNV) is discovered early enough and the membrane falls within treatment guidelines, prompt laser treatment can be used to seal off the leaking blood vessels and prevent further vision loss. Fluorescein and indocyanine green angiography are tests used to identify the leaking CNV and help guide laser treatment.
A third stage of ARMD is "Pigment Epithelial Detachment." A blister-like macular lesion called "PED" characterizes this form. The lesion may be stable for years or may change at any time to a blood filled blister with CNV. ICG is especially useful in PED because the dye can demonstrate the CNV through the fluid or blood in the PED. Laser treatment is useful in certain cases of PED when the strict guidelines are met.
After treatment, periodic exams and fluorescein angiography are important since recurrence of CNV can occur in as much as 40 percent in some eyes. You will be given an Amsler grid and instructed on how to use it. This home test is important because it may help you recognize an occurrence of new CNV. If you notice any changes in the grid, you should contact your doctor immediately for a complete retina examination.
John D. Matthews, MD and John T. Harriott, MD of Southeastern Eye Center are both fellowship trained retina specialists and Board Certified by the American Academy of Ophthalmology.
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