Atrophic (Dry) Macular Degeneration
Dry macular degeneration is generally characterized by a slow but progressive visual loss over the years. Often people will notes spots of blurred vision or distortion but this is generally not too bothersome unless it involves the center of the retina. Clinically this is characterized by yellow spots under the retina, called drusen, which are accumulations of metabolic waste products that indicate the overlying cells are not perfectly healthy. Areas of pigment clumping and atrophy (retinal thinning) are also found. Over time, large areas of thinning called geographic atrophy can cause severe visual loss.
Treatment
There is no effective treatment for atrophic macular degeneration. Once this degeneration has occurred, visual loss in that area is permanent. The Age-Related Eye Disease Study (AREDS) was released in 2001, and it showed that antioxidants, including beta-carotene, vitamin C, E, plus zinc slowed the rate of visual loss in patients who took them over a placebo. Patients with no degeneration or minimal degeneration did not benefit over the course of the study but this is likely due to the fact that their rate of visual loss with no or minimal disease over the course of the study was extremely small. It is generally our recommendation that, because the risks of antioxidant vitamins are small, patients with early signs of degeneration, especially those with a family history of the disease, take the vitamins anyway.
Examinations
It is recommended that in addition to the vitamins, you monitor your vision daily with an Amsler grid. Patients should look at the grid with one eye at a time at a reading distance with your best reading correction. They should look at the central dot and make sure that all the lines appear straight and that all of the corners are visible while. Patients with some degeneration will have some abnormalities or areas where the line is distorted or even absent. Sudden changes from a baseline status could indicate bleeding or fluid leakage and require a dilated exam. General follow-up with dilated exam is recommended approximately twice a year depending on any other existing problems.
| |
