Irene Rusu, MD
Macular Degeneration Specialist
Age-Related Macular Degeneration is a serious condition affecting elderly patients, resulting in progressive loss of central vision. With age, the central retina (macula) can develop degeneration of the bottom layer of the retina (retinal pigment epithelium or RPE). Waste products can accumulate in the retina and form deposits called drusen. The presence of a few drusen usually will not cause vision loss. However, as drusen increase in number and the RPE thins, the central vision becomes blurry and distorted. This type of disease is called dry macular degeneration. When enough damage to the tissue layers under the retina occurs, new blood vessels can form underneath the retina, called choroidal neovascularization (CNV). Neovascularization is a bad development because it causes bleeding underneath the retina that results in a rapid decrease in central vision and permanent scarring. This type of disease is called wet macular degeneration. Vision loss is usually progressive, but may suddenly deteriorate if new retinal bleeding occurs. Unfortunately, vision loss from dry macular degeneration is irreversible, but with macular degeneration treatment, vision loss from wet macular degeneration can by improved in some cases.
Dry macular degeneration
Symptoms of macular degeneration include progressive blurred central vision affecting reading and driving, and occasional sudden vision loss if bleeding occurs. The most important risk factors are age, family history, and smoking.
Wet macular degeneration
To screen for macular degeneration, the central vision will be tested. An Amsler grid test test may be used to determine if there is distortion of the central vision. A thorough retinal exam performed by our retinal specialist will determine the extent of retinal changes associated with macular degeneration. Finally, two special tests, called a Fluorescein Angiogram and an Ocular Coherence Tomogram, may be performed at our clinic for macular degeneration to determine if the disease is of the wet or dry variety, and will guide us in the appropriate treatment.
There is no dry macular degeneration treatment available. However, a major study (Age Related Eye Disease Study – AREDS) concluded that a combination supplement of antioxidant vitamins and zinc can reduce the risk of progression of dry macular degeneration by 27%. These vitamins, available over the counter, are Ocuvite Preservision, ICAPS Multivitamins and ICAPS AREDS formula. Our Brooklyn macular degeneration treatment specialists will determine whether it is necessary for you to begin taking these vitamin supplements.
Normal human retina
There are now multiple macular degeneration treatments available to slow the progression of wet macular degeneration. In the past, the only treatments available used laser therapy which was not always effective and could cause vision loss after therapy. Recently, a class of medicines called vascular endothelial growth factor (VEGF) inhibitors became available that can stop retinal bleeding, new vessel formation and vascular leakage seen in wet macular degeneration. The drugs, the most popular of which are Eylea, Lucentis and Avastin, have shown remarkable effectiveness in halting the progression of the disease and preserving vision. Eylea and Lucentis are injected into the side of the eye at our clinic for macular degeneration by our specially trained retinal specialist using a fine needle, in a painless procedure taking only a few seconds. VEGF inhibitors like Eylea and Lucentis have dramatically improved our ability to reduce the vision loss from wet macular degeneration.
With proper evaluation, treatment and followup at our clinic for macular degeneration, the vision loss from macular degeneration can be slowed down, helping preserve the quality of life and independence important to all of our elderly patients.