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Age Related Macular Degeneration

Age Related Macular Degeneration (ARMD or AMD) is a painless deterioration of the part of the retina that is used for central, fine vision, called the macula. There is a familial tendency, and it is much more common in smokers.

I tell my patents, "you will never go completely blind. You will always see well enough to take care of yourself. But gradually your reading vision will leave you."

There are two forms of AMD. In the dry form the macula atrophies and slowly dies. In the wet form there is leakage in the macula. This leakage causes a sudden decline in central vision and metamorphopsia. (Things look distorted).

Tremendous advances have been made in the understanding and treatment of both dry and wet macular degeneration.

The landmark study, "Age Related Eye Disease Study" (AREDS) showed that about 30% of the patients with dry macular degeneration had

a slowing of the progression of their macular degeneration when they took a special vitamin supplement. This supplement had ... This study confirmed

the association of macular generation and smoking. And surprisingly showed that smokers who took the supplement had a

higher rate of lung cancer. Because of this we now recommend that smokers avoid the original AREDS formula, and instead

take vitamins with Leutein and Zeoxanthin replacing the beta carotene.

Many questions remain concerning vitamin supplements for dry ARMD. Does the AREDS treatment PREVENT the development of

macular degeneration? What is the best concentration of these vitamins? And are there other supplements that may help as well, such as fish or

flax seed oil?

The other form of macular degeneration is the wet form. In this new vessels grow under the macula, and cause a rather rapid, catastrophic

visual loss.

My opinion is that the recent changes in the treatment of wet macular degeration will be considered one of the great advances of medicine.

Whereas the was previously no real good treatment for wet macular degeneration, now days we use an injection of a chemotherapeutic

drug INTO the eye. The most common drug is bevacizumaub or Avastin.

Prior to the development of intraocular injections patients would become legally blind very quickly after they developed their wet macular degeneration.

Now 40% of patients with wet macular degeneration who received the avastin injections GAINED vision, and nearly all patients receiving the avastin injections

had stabilization of their vision.

The catch is that the proper frequency of these injections is not known at this time. The original studies involved monthly injections for at least two years.

More recent protocols have tried to lessen the frequency of these injections. Excellent studies are going on to try to determine the best treatment frequency.

At the present time we fell that three priming injections are necessary, then aren't really sure what is the best protocol to follow. We anxiously await the results of

ongoing studies to answer some of these questions.

One of the big drawbacks to this treatment is that patients must be seen on a regular basis, and get shots in to their eyes on a pretty regular basis. Yet with this

treatment the results have been truly amazing.

To determine if you have the wet for of macular degeneration watch for distortion of your vision. We furnish a grid to help you monitor your vision.