Americans fear blindness more than deafness, memory loss or speech loss, ranking the loss of sight among the four “worst things that could happen to you”. Age-Related Macular Degeneration (AMD) is one of the leading causes of vision loss among people age 50 and older.
It is currently estimated that as many as 11 million people in the US alone have some form of macular degeneration, and this population is expected to double by 2050. Due to discussions around AMD gaining so much momentum in recent years, February has been designated as AMD Awareness Month.
RISK FACTORS FOR AMD
Non-modifiable risk factors:
Modifiable risk factors:
AMD has few symptoms in the early stages, so it is important to examine your patients’ eyes regularly. If patients fall under any of the previously mentioned risk factors, you should not wait for them to experience changes in vision before checking them for AMD.
Stages of Age-Related Macular Degeneration
Early AMD, the first stage, is diagnosed by the presence of medium-sized drusen, or yellow deposits under the retina, and usually does not include vision loss. Those with intermediate AMD typically have large drusen and/or pigment changes in the retina. These are changes that can only be detected during an eye exam. In this stage of AMD, individuals may notice vision loss to some degree, but most will not experience any symptoms. In addition to drusen, people with late AMD have vision loss from damage to the macula. The two types of late AMD include:
- Geographic atrophy (Dry AMD): accounts for 90% of diagnosed cases
- Neovascular AMD (Wet AMD): accounts for about 10% of diagnosed cases and 90% of legal blindness.
Note: There is a possibility for dry AMD to advance and cause loss of vision without turning into the wet form of the disease, but it is also possible for early-stage dry AMD to suddenly progress into the wet AMD.
While macular degeneration itself does not cause total blindness, the loss of central vision can impede simple abilities like seeing faces, driving, reading, writing, cooking or fixing things around the house. These potential lifestyle complications further emphasize early detection as a critical first step.
What Can Be Done
The following tests can be used to detect AMD:
- Visual acuity test
- Dilated eye exam
- Amsler grid
- Fluorescein angiogram
- Optical coherence tomography
Lifestyle changes can be made to reduce the risk of AMD, or even slow its progression once diagnosed, such as:
- Avoiding smoking
- Exercising regularly
- Maintaining normal blood pressure and cholesterol levels
- Eating a healthy diet rich in green, leafy vegetables and fish
Current AMD Research
Nutritional supplementation has proved to be effective in reducing risk and slowing progression of AMD. In a new study published in Advances in Ophthalmology & Visual System, John P. Herman studied subjects with varying degrees of risk factors and symptoms as they supplemented with a macular health supplement designed to increase macular pigment optical density (MPOD). The two-year study was completed in a clinical setting and investigated the visual, retinal and MPOD changes of the participants.
Follow-ups were scheduled in six-month intervals, and improvements were recorded in macular pigment density, visual functions, macular appearance and metamorphopsia. Herman’s conclusion is that supplementing with a macular health supplement improved visual functions and retinal condition documented by SD-OCT and fundus photography. Herman states, “The results of this clinical case study demonstrate improvements in retinal changes from the early to moderate stages of dry AMD,” and stresses that “addressing this disease process in the earliest stages may have the greatest benefit.”