Macular Degeneration

Macular degeneration is the leading cause of blindness in the United States. Macula is central part of the retina that provides the sharp central vision, which we rely on for driving automobiles, watching television, working on the computer, reading newspaper, writing checks, etc. In macular degeneration, as the name implies, the macula breaks down, leading to loss of central vision.

At times, glaucoma and macular degeneration are confused. Both glaucoma and macular degeneration becomes more prevalent with age. However, in contrast to glaucoma, which primarily causes of loss of side vision, macular degeneration affects the central vision

Macular degeneration comes in two types: dry and wet. In dry macular degeneration, the cells of the macula die off and leave behind bare areas in the macula, whereas in wet macular degeneration, the macula is damaged due to growth of abnormal vessels, which eventually bleed and lead to scar formation. The progression of dry macular degeneration is typically slow and may take years for patient to develop significant visual loss. On the other hand, wet macular degeneration tends to lead to more rapid visual loss, which can occur in days to weeks.

With macular degeneration, whether dry or wet, the loss of macular function or central vision can have devastating effects patient’s lifestyle and psyche. At DuPage Ophthalmology, we have the clinical expertise and most up-to-date tools to detect macular degeneration. We have one the best digital imaging systems for the retina. By taking serial digital retinal images with the fundus camera, we can detect early changes indicative of macular degeneration.

We also use RTVue to image the eyes in patients with macular degeneration and those suspected as having macular degeneration. RTVue, a high-definition ocular coherent tomography machine, is considered the state of art in retinal imaging. It gives a cross-sectional view of the macula at a resolution of 1/200 mm, which is equivalent to the resolution of a good light compound microscope. With the aid of its computer, RTVue can also perform comparison, through sophisticated statistical analysis, on serial images taken of the macula over time. RTVue can detect the earliest changes from macular degeneration, which could be difficulty to detect even with the most careful clinical examination.

With early detection of macular degeneration, we can counsel the patient on the proper course of therapy. For patients with early dry macular degeneration, daily intake of a special preparation of vitamins (also known as the AREDS formulation) is recommended, along with daily monitoring of the central vision with a grid (known as the Amsler grid). The AREDS vitamins have been shown to significantly retard the progression of dry macular degeneration. Amsler grid is a sensitive method of checking the status of the macula and should be performed regularly by the patient.

In cases of wet macular degeneration, timely referral is made to our extensive network of retinal specialists. The treatment of wet macular degeneration has improved much over the past few years, and wet macular degeneration is no longer a cause of blindness, for which little can be done. In the past, wet macular degeneration has been treated with laser and surgery. The latest therapy involves injection of medication into the eye with wet macular degeneration in order to arrest the growth of abnormal vessels in the macula. Eye injections might sound unappealing to the uninitiated, but this newest treatment modality has saved the eyesight in countless patients with wet macular degeneration. The discomfort associated with the eye injections is usually insignificant.

Risk factors in the developing macular degeneration include:

• Age: With age, we are more likely to develop macular degeneration.
• Family history: Positive family history makes one more prone to develop macular degeneration.
• Gender: Women are more prone to develop macular degeneration.
• Eye color: patients with light eye color are more likely to develop macular degeneration.
• Medical conditions: cigarette smoking, high blood pressure, high cholesterol, and cardiovascular disease contribute to the development of macular degeneration.

Low vision consultation and rehabilitation is often very helpful in macular degeneration patients with significant visual loss. At DuPage Ophthalmology, Dr. Manastersky is our low vision specialist, who has extensive experience and expertise in solving the visual challenges and lifestyle issues that confront patients with macular degeneration daily.