Your Age and Low Vision

By Sadiq N. Syed, MD

A common condition we hear about in relation to the retina is age-related macular degeneration, also known as AMD. AMD is a common eye condition and a leading cause of vision loss among people age 50 and older. It causes damage to the macula, a small spot near the center of the retina.
To break down the word macular degeneration, the macula refers to a special part of the retina that provides our clear 20/20 vision, which is necessary for reading, driving, and other important daily activities.
Degeneration refers to a slowly progressive deterioration of the macula, which happens at a different rate in each affected person, and for the most part it tends to be a very slow process.
The degeneration of the macula starts with yellowish deposits in the retina called drusen. Most people develop some very small drusen as a normal part of aging.
Individuals with drusen may not have any significant effect on their vision, but the presence of medium-to-large drusen may be enough to establish an early diagnosis of dry macular degeneration for which a routine follow up every six months is necessary to monitor the progression of the disease.
Over a period of years, many patients with drusen of the macula will develop atrophy (thinning) of the macula. Macular atrophy then causes vision deterioration affecting one's ability to read and see clearly at a distance. Taking daily vitamins that have been formulated for individuals with dry macular degeneration can slow the process of macular thinning. Specifically, the AREDS Formula vitamins (and more recently AREDS-2 Formula) have proven benefits in decreasing a patient's risk for vision loss from macular degeneration.
About 10% of patients with dry macular degeneration will develop wet macular degeneration, or growth of blood vessels under the macula resulting in macular blood and fluid. The leakage of blood and fluid in the macula can cause rapid loss of vision potentially leading to legal blindness. If detected early, excellent treatments have become available which reduce vision loss in up to 90% of cases of wet macular degeneration. The most common treatment for wet macular degeneration is intravitreal (eye) injection of anti-vascular endothelial growth factor (anti-VEGF) agents. The anti-VEGF agents that are prescribed most commonly are avastin (bevacizumab), lucentis (ranibizumab), and eylea (aflibercept).
All of these treatments are known to be safe and effective for the treatment of wet macular degeneration. Eye injection of anti-VEGF agents is a well-tolerated procedure that is performed in the office by a retina specialist.