Macular Degeneration

Macular degeneration is the deterioration of the macula, the small, central area in the retina which creates fine detail in the central vision.  The most common form is age related.  There are two types of macular degeneration, wet & dry.  In wet macular degeneration, the tiny blood vessels that supply the retina degenerate.  New blood vessels grow, but are fragile and leak fluid into the retina, damaging the photoreceptors (light sensitive rods and cones).  Vision loss occurs very rapidly.  Early symptoms include distorted vision where lines appear wavy or crooked and objects appearing closer or further away than they should.  There is currently no cure, and treatments help slow or stop vision loss.  Laser surgery may slow or stop the blood vessels that are damaging the macula.  Photodynamic therapy, in which a cold laser is used with a drug called verteporfin to seal off leaky blood vessels is another option.  New treatments include anti VEGF (vascular endothelial growth factor) therapy, in which anti-protein drugs are injected into the eye, and angiostatic therapy, which injects a steroid into the back of the eye.  In dry macular degeneration, which accounts for 85% of cases, yellowish white deposits form in the retina in the retinal pigment epithelial layer under the macula.  Macular degeneration causes the central vision to become blurred or distorted, with progressive difficulty seeing detail.  Patients feel a need for greater light.  A blind spot may begin to develop in the center of their vision. Peripheral areas of the visual field are not affected.  There are currently no treatments to reverse dry AMD.