What Is Age-Related Macular Degeneration

Age-related macular degeneration (ARMD) refers to a state of decreased vision or sight more commonly found in the United Kingdom. This medical condition leads to noteworthy reduction in sight, but never becomes the reason for loss of vision (blindness). This is because in this condition, only the middle area of the vision (retina) is affected, leaving the side portions undamaged.

The main function of the retina that is located behind the eye is to send the images observed by us to the brain. This is possible because of the two parts of the retina namely, the macula and the peripheral retina. The macula makes it possible to view fine aspects such as reading, observing facial characteristics, and identifying various colors. Age-related macular degeneration actually affects the macula part of the retina, instead of affecting the whole retina that can cause blindness.

This medical condition is mostly found in people of older age, nearly 60 years and above. However, a few young people might be vulnerable to this condition. This also involves people who are shortsighted. As compared to men, women are more susceptible to this disorder because they have good span of life.

According to some people belief, this disorder can be even in genetic in nature; but there is no evidence or complete research done on the same.

Types

ARMD is divided into two categories. These are named as dry and wet.

Dry ARMD

It is comparatively the common type of ARMD wherein both the eyes are equally influenced. The start of this type of ARMD is usually gradual and thereby, its effects, too, are slowly known. According to a research, it affects approximately 80 percent of the victims.

Wet ARMD

This is not that common as dry ARMD wherein it first affects only a single eye. This type of ARMD quickly and severely affects the central region of the vision. Here, the blood vessels, originating from a layer behind the eye, develop abnormally into the macular region. These vessels might leak or bleed. Due to this leakage, there is a fast and noteworthy decline in the central vision.

After affecting an eye, wet ARMD can also affect the other eye in the same manner in the upcoming months.

Causes of ARMD

ARMD is a condition that comes with age in the retina. So, its cause is nothing but the ‘wear and tear’ mutations (changes) that take place in the macular region. This means that the waste materials in this region of the eye that get accumulated due to malfunctioning of the removal mechanisms causes damage to the cells as the time passes by.

Symptoms of ARMD

Listed below are the symptoms according to the types of ARMD.

• Dry ARMD:
  Low central vision that influences the capability of reading and viewing fine aspects such as facial characteristics; leaving the distance vision unaffected.
• Wet ARMD:
  Distortion of vision (known as metamorphopsia – initial symptoms) wherein the straight lines do not appear as straight, but as curved or tilted. Next, the vision worsens that eventually results in complete loss of the central vision leaving the area dark, which is known as central scotoma.

Treatment of ARMD

Until today, medical experts are researching on the treatment of age-related macular degeneration. However, there is no single treatment that is globally effective. Further, there are no tablets or drops that can be effective in treating this condition.

Dry ARMD

In this type ARMD, the vision deteriorates slowly, which is mostly not severe. Listed below are suggested treatments to deal with this condition.

• Wearing the best spectacles
• Utilizing bright lights such as halogen lights to aid in viewing things comparatively clearly
• Utilizing books of large font size
• Utilizing a magnifying glass (mandatory prescription)

Wet ARMD

The first step is to determine whether a patient is suitable for the treatment. This is done by further evaluation through visual assessment with special letter charts and imaging of the retina.

In imaging the retina, a fluorescein angiogram and a scan of the retina using an Optical Coherence Tomography (OCT) machine is done. During the fluorescein angiogram, a dye is injected into the arm’s vein and then many photographs are taken of the retina. The aim of the OCT scan is to detect macular degeneration under the retina within just a few minutes.

The treatment is started immediately on an urgent basis once the patient is diagnosed having wet ARMD. At present, there are two types of treatments for this type of ARMD, which are listed below.

• Injection of a Medicine into the Retina:
  Based on the vision’s level and retinal imaging, some cases of wet ARMD can be considered appropriate for injecting a drug called ranibizumab (Lucentis) into the retina. Lucentis actually dehydrates the leakage of the existing abnormal blood vessels and prevents the development of new such blood vessels at the back of the eye. This means that Lucentis does a two-way job of correcting the present damage and preventing the new one.
• Laser Treatment:
  Here, laser is applied to prevent further damage by dealing with the new abnormal blood vessels. Additionally, Photo Dynamic Therapy (PDT) is also sometimes implemented that makes use of a light-sensitive dye named verteporfin (Visudyne) along with the laser treatment. The dye is first injected into the body and then the laser is applied to trigger the dye to start functioning that shuts down the new abnormal blood vessels to avoid further damage.

Lucentis is not appropriate for all patients of wet ARMD despite of it being the most effective drug. It is only successful in early stages when injury to the central vision is not huge and severe. Therefore, opticians, general practioners, or other health workers can quickly refer the patients with wet ARMD to the local ophthalmologists for quick examination and treatment. The patient is also suggested to visit an eye clinic if the condition occurs again or is about to affect the other eye. Generally, the injection of Lucentis is taken only once a month for first three months with the subsequent number of injections being increased due to disease recurrence.

Precautions than Cure

Many experts are of the opinion that the high dose of certain vitamins can prevent this ARMD, but there is no scientific evidence to support it or to contradict it.

The best ideal is to opt for regular check-ups of the eyes. A patient suffering from wet ARMD only in a single eye should regularly visit the concerned specialist for a check-up of another eye’s vision. This can result in early detection of distortion. The detection of wet ARMD in another eye can be done by viewing picture frames or by using an Amsler Chart that can be taken from an ophthalmologist.

Wrong Belief of Total Blindness

In the U.K, ARMD is commonly known as the disorder of partial sight. If any person in the U.K. tends to suffer from age-related macular degeneration, the ophthamologist always registers him/her as blind. However, this does not infer that the person is blind or can become blind. It simply implies that the central vision has been affected and it has made it difficult to view things properly, which needs recognition.

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