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~ Macular Degeneration ~


~ Macular Degeneration ~

What is Macular Degeneration?

Macular degeneration is a disorder that affects the macula (the central part of the retina) causing decreased visual acuity and the possible loss of central vision.
Macular degeneration is also referred to as:
Age-related macular degeneration (ARMD or AMD); Senile macular degeneration (SMD)
The macula is the part of the retina that allows the eye to see fine details at the center of the field of vision. Degeneration results from a partial breakdown of the retinal pigment epithelium (RPE).
The RPE is the layer of blood vessels behind the retina, It is the insulating layer between the retina and the choroid. The RPE is a very selective filter, it determines what nutrients reach the retina from the choroid. Many components of blood are very harmful to the retina and are kept away from the retina by normal RPE.
When the RPE breaks down this interferes with the metabolism of the retina, causing thinning of the retina, this is the "dry" phase of macular degeneration, and may allow these harmful elements from the blood to damage and scar the retina, the "wet" phase of macular degeneration.
The results are the loss of central vision only the peripheral fields are always maintained. The loss of reading and driving may occur, complete blindness never occurs from this disease.
This increases with each decade over age 50 to almost 15% by the age of 75.
Other risks are family history, cigarette smoking, and being Caucasian.
There is no known prevention. If someone in your family has a history of macular degeneration, if you smoke, stop.
The symptoms include blurred, distorted, dim, or absent central vision.
To evaluate the retina these tests may include:
Visual acuity
Refraction test
Pupillary reflex response
Slit lamp examination
Retinal examination by various techniques
Retinal photography
Fluorescein angiography, and sometimes indocyanine green angiography
Amsler grid
Most with mild dry macular degeneration never have disabling central vision loss. There is no way to tell who will progress to more severe central vision loss. The results are the loss of central vision only, peripheral vision is never lost from macular degeneration.
The loss of central vision may interfere with many parts of our daily life. With reading you may require a magnifing glass or become impossible. The ability to drive is more likely to be lost.
If you notice any dim or distorted areas in your vision call your health care provider.
There is no specific treatment for macular degeneration, but zinc supplements may slow it down. Laser surgery to coagulate leaking choroidal blood vessels of the eye may be useful in the early stages of the disease. Some patients benefit from photodynamic therapy, which is laser treatment after injecting a dye to sensitize the leaking vessels to the laser light. Laser therapy is not a cure, but has been successful in managing an area that has leakage from the choroid through the RPE.
An Amsler grid, used at home to discover possible new leaks before scarring occurs, may be recommended.
In any case regarding your health, get things checked out, finding the right treatment is far better than the results with no treatment.

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