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Last Update: April,
2011 12:06 PM
Macula Degeneration
Age Related Macular Degeneration 2011
The problem
The central vision is decreased due to age related changes at the central retina or macula. This is the most common cause of legal blindness in Australia.
The Cause
Deposits in the layer under the retina can build up with time. This can lead to thinning of the central retina (‘dry’ macular degeneration) and a slow deterioration of central vision. A second, less common complication of age related macular degeneration involves the growth of abnormal blood vessels under the macula. This can lead to fluid or blood under the retina (‘wet’ macular degeneration) and a rapid decrease in central vision.
Treatment
1/ Prevention is better than cure. Vitamins, antioxidants and zinc supplements (see next page) may slow the progression of this disease. Ceasing smoking is of great benefit.
2/ Intravitreal injections of Vascular Growth factor inhibitors of AVASTIN or LUCENTIS are use for ‘wet’ AMD. They are very successful and 95% of eyes do not lose vision (lose more than 3 lines on the chart) but repeated injections over 2 or more years are needed. An average of 6 injections per year is needed.
Laser treatment is only used occasionally for the ‘wet’ form of age related macular degeneration. However only about 5% of ‘wet’ macular degeneration is treatable either with Argon laser or Visudyne Photodynamic therapy in conjunction with injections.
3/ Low vision aids. Optimum lighting, glasses and sometimes magnifying devices are helpful in this condition.
4/ Blind registration and pensions with Centrelink and taxi subsidies are available only if legally blind in both eyes.
Prognosis
This condition never causes complete blindness, although it may decrease central (reading) vision. The peripheral (side) vision is retained. Thus a patient with severe macular degeneration will still be able to get around independently.
Often the condition presents in one eye only and the other eye retains normal vision. The risk of loss in the second eye, however, is about 10% every year so it is important to monitor the other eye regularly. This is done by looking at a grid every week to check for increasing distortions or missing vision. If any changes are noted please make an appointment to see the eye doctor.
Prevention of Age Related Macular Degeneration (ARMD) 2011
ARMD is age related and the increase in numbers of cases of this blinding disease is because the general population is getting older. The relative risk odds ratio for ARMD in Australians was estimated at 119 times greater for people over the age of 80 years compared to the reference age group aged 40 to 69.
Prevention suggestions:
1. DO NOT SMOKE. Smoking is linked to ARMD with a small odds ratio of 2, but it is a modifiable risk.
2. A diet of fresh fruit and vegetables (especially corn, orange juice)
3. Fish especially SALMON and TUNA 3 times per week.
4. EGGS are good.
5. Low G.I. (Glycaemic index) diet.
6. Luteinvision (Blackmore’s) or similar Lutein and Zeaxanthin supplements AND high dose vitamins and zinc MACUVISION OR combination tablet ULTRAVISION (MACUVISION and LUTEIN).
Recommended supplements:
* ULTRAVISION – available at most optometrist and some chemists
* MACUTEC – is available in Australia, for more information please phone 1800 6228832 free call. This has vitamins and Lutein like Ultravision and fish oil.