Diagnosis of Macular Degeneration
Dry macular degeneration is diagnosed by an examination of the retina. Fluorescein angiography is used for identifying and localizing abnormal vessels. Optical coherence tomography (OCT) is used for diagnosis and for follow up evaluation of treatment.
Vision Loss with Macular Degeneration
Vision loss caused by macular degeneration will not lead to total blindness. There can be significant loss of central reading vision but the peripheral vision remains. People lose the ability to read, drive a car, and unable to recognize people’s faces. It can progress where they are legally blind due to the loss of central vision. Legally blind is vision of 20/200 or worse.
Management and Screening
Studies have shown that supplements with high levels cartenoids, zeaxanthin, luteins, and other antioxidants may help slow the progression of macular degeneration. Omega-3 fatty acids have been shown to decrease the rate of progression of macular degeneration.
Amsler Grid Test
This is an effective and simple test for monitoring macular degeneration. The grid is a pattern of intersecting lines with a central fixation dot. In normal eye the lines are straight and no one are missing. With macular degeneration these lines can appear distorted, wavy, or missing. Any changes in the grid should be immediately reported to the doctor.
There are magnifying lenses, special telescopic lenses, and magnifying scanners for computers. JAWS for Windows which reads computer screens allows for use of computers. Large print materials are available.
Treatment for Wet Macular Degeneration
Wet macular degeneration can be treated by laser treatment, photodynamic treatment, and injections of medications into the eye.
Laser treatment is not used very often anymore due to the better results from injections of medications. The laser is aimed at the abnormal vessels to destroy them. The laser treatment also can destroy surrounding normal retinal tissue.
A drug called verteporfin is injected into the vein in your arm. This drug tends to stick to the surface of new blood vessels. A light is shined into your eye for about one and half minutes. The light activates the drug. The activated drug destroys the new blood vessels. Unlike laser surgery, this does not destroy surrounding normal retinal tissues. Because the drug is activated by light, you must avoid exposing your skin and eyes to direct sunlight or bright indoor light for five days. It may take several treatments to be effective.
Eye Injections of Anti-VEGF Medications
Wet macular degeneration is most often treated now with new drugs called anti-VEGF.