Age-Related Macular Degeneration (ARMD)
Age-related macular degeneration (ARMD) or age-related maculopathy (ARM)
is the most common cause of legal blindness above the age of fifty-five
(55) in the United States. It commonly affects patients in their
retirement years. This disease affects the central vision leading to
difficulty in driving and reading as well as other near vision tasks.
Age-related macular degeneration is a disease that affects the macular
area of the retina. The retina lines the back two-thirds of the eye and
is much like the film of a camera. It takes the ‘picture’ for the eye.
This ‘picture’ is then transmitted back to the brain via the optic
nerve. In the brain this image is processed resulting in what we call
sight. The central area of the retina is called the macula. This area
is responsible for the detailed vision that enables us to read this
paragraph. In ARMD the layers of the retina are damaged.
Cause of ARMD
At this time, no one knows the cause. Many ideas have been proposed and
none proven. There appears to be some families in which ARMD occurs
later in life.
Types of Age-Related Macular Degeneration
ARMD is divided into two categories: dry and wet. The dry type is
caused by a generalized degeneration of the macular area and not
associated with growth of new blood vessels and/or bleeding. This type
of degeneration usually leads to a slow, gradual loss of central vision
over many years. The dry type may advance to the wet type.
The wet type of macular degeneration usually involves rather rapid loss
of vision. The wet type of macular degeneration is associated with
abnormal vessels that have grown underneath the retina. This growth
leads to bleeding and scarring which destroys the overlying retina.
This destructive process can lead to distortion of central vision as
well as loss of central vision.
Symptoms of Macular Degeneration
The most common symptoms of macular degeneration are loss of vision and
blurriness. Since the visual loss can affect one eye at a time, it is
important to check each eye individually. Other symptoms include
distortion of straight lines and objects. Color vision may seem to be
washed out or dimmed.
Detection and Diagnosis
The diagnosis of macular degeneration is made by a dilated examination
by a qualified professional. Early detection is important, if there is
growth of abnormal blood vessels this can be detected and treated at the
earliest possible time. This may help decrease the chance of profound
visual loss. Additional tests may be utilized to determine whether
macular degeneration is dry or wet. These tests may include fluorescein
angiography. There is no clear evidence (in 1999) that the addition of
a indocyanine green angiogram (ICG) allows patients to have a better
final visual outcome.
There is some evidence but no proof that vitamins, minerals, and other
dietary supplements may be beneficial in patients with macular
degeneration. There are some significant studies that show patients may
benefit from eating dark, green, leafy vegetables.
Although there is no ‘true cure’ for macular degeneration, we are able
to help some people with laser photocoagulation. Laser photocoagulation
can be used to stabilize the wet type of macular degeneration by
destroying the abnormal blood vessels that are noted on examination.
Unfortunately, even with laser photocoagulation, there is no guarantee
of maintaining central vision. Other treatments are experimental,
including surgical macular translocation and photodynamic dye
Age-related macular degeneration involves the deterioration or
degeneration of the macular area of the retina. This disease is quite
common in the retired age population. Full, careful, retinal
examination is indicated as well as possible fluorescein angiography to
best follow and treat this disease. We recommend patients eat dark
green, leafy vegetables at least four times a week, take a daily
multi-vitamin with minerals, and observe an Amsler grid daily.