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Age Related Macular Degeneration

This page aims to give you some information about the condition of Age Related Macular Degeneration or AMD for short. It is one of the commonest causes of poor vision amongst retired people with almost 50% of those over 75yrs having a degree of AMD.

The Retina

The retina is situated at the back of the eye and acts like the film in a camera. It is the part of the eye that converts light into electrical impulses which are then passed along the optic nerve to the brain and form the image you see.

The Macular area

This area of the retina is responsible for most of our central vision.
Unfortunately this is the part of the retina which Macular Degeneration affects. It does not affect the retina outside this area, which means that your peripheral vision will never be affected by this condition. It is only the central vision which is affected causing difficulty in reading but NOT total blindness.


Types of Macular Degeneration:

Fluorescein angiogram of "wet" ARMD

Disciform scar

 

 

 

 

 

 

 

Is there any treatment?

Most people have the dry form for which there is no specific treatment other than dietary supplements - see below. Although the condition may slowly progress, it will NEVER make you go completely blind, as it never affects the peripheral vision.

Some people have the wet form. Treatment is now possible in most forms of wet disease due to the introduction of anti growth factor injections such as Lucentis and Macugen. These drugs are still very new and unfortunately not yet funded by the NHS but offer the potential for visual improvement in up to 40% of cases. Other treatment options include Photodynamic Therapy using Visudyne, possibly combined with intravitreal Triamcinolone steroid injections."

Can glasses help?

You should ensure that you have an up to date pair of glasses. Full frame reading glasses are better than Bifocals of Varifocals. If you are having difficulty reading, please ask to be referred to the Low Vision Aid Clinic for advise on magnifying aids. Remember extra lighting can help with reading.

Can I do anything to prevent it happening?

Good advice for everyone young and old is to wear a pair of UV blocking sun glasses together with a brimmed hat when outside in the sun.

Stop Smoking

If you are a smoker, research has shown that smokers have a higher instance of Age Related Macular Degeneration and I would encourage you to stop smoking to help decrease your overall risk as well as avoiding other medical problems.


What about dietary supplements?

Results from the AREDS study, published in the Archives of Ophthalmology (2001) show that taking supplements containing high levels of antioxidants and zinc, significantly reduced the risk of advanced age-related macular degeneration (AMD).

People at high risk for developing advanced stages of AMD lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc.

The supplements benefitted patients with both the wet and dry forms of AMD. Supplements did not provide benefit for those with either early AMD or no AMD. Previous studies have suggested that people who have diets rich in green, leafy vegetables have a lower risk for developing AMD. However, the high levels of dietary supplements that were evaluated in this study are difficult to achieve from diet alone.

Five year follow up of patients who are taking the high dose preparations has shown no significant side effects other than a mild increase of non specific genito-urinary tract problems which is of questionable significance. Other researchers feel that high levels of Lutein and Zeoxanthine may also be of benefit in reducing the risk of progression of ARMD and there are several animal studies to support this. I would therefore recommend that you use a combination tablet containing not only the high dose multivitamins and antioxidants as used in the AREDS trial but additional Lutein supplements as well.

The best combination I have found to provide all of these ingredients is the preparation known as "VitEyes". These tablets will provide the appropriate levels of supplements when used twice a day and are obtainable in three month supplies from my offices via Jacquie, my personal assistant, on 01189 553457


Smokers

In smokers a slightly different formulation is recommended which my secretary will be happy to discuss with you.

General Advice

 

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