By Deborah Jeanne Sergeant
Macular degeneration is one of the nation’s leading causes of blindness and low vision, affecting 1.8 million Americans, according to the Centers for Disease Control and Prevention.
Age-related macular degeneration or “dry” macular degeneration is more commonplace, 70%-90% of cases, than wet macular degeneration.
Either type of macular degeneration affects the central vision, which is important for reading, filling out paperwork and driving. Patients may see fine in their peripheral vision, but not in the center. For example, they may see a person’s clothing and hair, but not the face.
WMD occurs when blood vessels grow abnormally under the macular and leak blood and fluid. This vision loss is rapid, and typically presents with straight lines appearing wavy. AMD is a slower process as the macula thins, which eventually blurs vision. Patients have a 10% chance of progressing into WMD.
Although there is no cure for AMD, doctors can treat WMD to reduce its effects with anti-VEGF injections to decrease the bleeding in the back of the eye and photodynamic therapy, a less common treatment sometimes used with anti-VEGF injections.
The injections “are generally very effective,” said Luca Zatreanu, ophthalmologist with Reed Eye Associates in Pittsford and Irondequoit. Reed Eye also operates an office in Newark.
“Patients need to realize that these are treatments, not cures.”
They will need to return to the office for injections to prevent further damage. Even a week’s delay can negatively affect vision. With effective treatment, WMD can be managed for years—even decades—thanks to current protocols with a much lower risk of losing vision.
Photodynamic therapy uses a cold laser to target a light sensitive medication in the eye to break down blood vessels that cause the vision loss. Patients may need repeated treatments to maintain the effect.
Zatreanu tells adult children of someone with macular degeneration to regularly undergo a dilated eye exam of the back of the eye “even if they don’t have problems with their vision,” he said.
He also advises patients in lifestyle modifications for those with macular degeneration that can reduce their risk for further vision loss, including avoiding exposure to smoking and other sources of carbon monoxide, such as a woodburning stove.
“That can potentially accelerate the condition,” he said. “If you’re outdoors, even in winter, put on sunglasses as UV exposure can accelerate.”
Supplements can also help, including brands such as Preservision and Ocuvite.
Early diagnosis can help patients make lifestyle changes that can slow macular degeneration progress. In addition to smoking, the greatest risk factors for macular degeneration include age, family history, gender (women are more prone), high blood pressure, high cholesterol and poor diet.
Mary Jo Parker, registered dietitian nutritionist in private practice in Williamsville, recommends improving the diet by including more healthful foods to prevent further degradation for eye health and in general to promote eye health and reduce the risk of eye issues. She recommends improving intake of vitamins C and E. Phytochemicals lutein and zeaxanthin can also promote eye health.
“It’s been studied pretty extensively,” Parker said. “The recommendations now are dark green leafy vegetables and other dark green vegetables like broccoli and peppers, red and orange, and citrus can help.
“Eat a plant-based diet with healthful oils and fatty fish two to three times a week as well. Age related eye disease studies provided good results saying people will do better if they eat more like a traditional Mediterranean diet and avoid foods high in sugars, refined starches and alcohol.”
Nuts are good sources of healthful fats. For people watching their sodium intake, shopping for walnuts in the baking aisle can make it easy to avoid added salt since these nuts are typically sold plain.