Ask anyone and they probably know of a friend or a family member that has been diagnosed or is being treated for Age-Related Macular Degeneration (AMD). The macula is the central part of the retina measuring only 6mm in diameter and providing the central 20 degrees of our vision. Age-related changes of the macula occur in each and every one of us. What factors cause some of us to develop this pathological condition of an otherwise normally occurring aging process? The challenge as an eye doctor is to predict which of our patients are more at risk and to diagnose AMD before it progresses and causes vision loss.
The good news is that we have identified several factors that can reduce our risk as we age: not smoking, a diet rich in the leafy greens, use of nutritional supplements containing Omega 3, other lifestyle health changes, and using sun and UV protection. Current research is focusing on identifying certain genetic factors that put more of us at risk. New technology and retinal digital imaging systems to view retinal structure are constantly being updated and improved. On the treatment front, the use of injectable drugs to stabilize the “wet” form of AMD has proved beneficial to many patients. Newer drug formulations have been able to reduce and extend the number of injections required.
The bad and ugly news is that as the US population is aging the number of people with AMD is increasing. The sight-threatening “wet” form is projected to affect 3 million people this year. The grim statistics predict that up to 78% of AMD patients will have significant, irreversible vision loss in at least one eye before receiving treatment. (1) This presents a clinical challenge to us as eye care providers to identify subclinical findings that occur at a cellular level. Unfortunately, subclinical macular disease has no or minimally recognizable features. New dark adaptation studies identify that subclinical macular disease can occur 3 years before it can be seen with our current use of retinal photography or OCT imaging. We as doctors anxiously await new technology and are committed to combat this disease to improve the quality of life of our aging families, friends, and patients.
Rick L. Hartman OD, FAAO
1. Pizzimenti,JJ, Pinnacles of Awareness in AMD, Review of Optometry, 2019 Sept.,84-89.
