Recurrent Breast Cancer

Friday, March 28, 2014

Macular Degeneration

     Early detection and treatment of macular degeneration reverses vision loss and improves vision. Wet Macular Degeneration (WMD) causes vision loss in the macula, the center of the eye’s vision field. Dry Macular Degeneration (DMD) is more common and less severe. Symptoms of both conditions include vision distortion, such as as straight lines appearing wavy or crooked, and decreased color intensity. A doorway or street or sign might appear lopsided. Objects appear smaller or further away than they really are. WMD often begins as the dry type. 
Risk factors for macular degeneration include smoking, obesity, high blood pressure, elevated cholesterol, a diet lacking fruits and vegetables, and heart disease.  Macular degeneration doesn't affect side (peripheral) vision. It usually doesn't cause blindness. It can, however, diminish central vision, crucial for driving, reading, and recognizing faces. 

Diagnostic testing includes a dilated eye exam and an Amsler Grid test, both of which detect central vision distortion. A fluorescein angiogram involves injecting dye into an arm vein to identify leaking blood vessels. The procedure identifies blood vessels that could be associated with WMD. 

First line treatment includes Bevacizumab (Avastatin), a prescription cholesterol lowering medicine. It prevents growth of new eye blood vessels and is first-line treatment.   Ranibizumab (Lucentis), Pegaptanib (Macugen), and Aflibercept (Eylea) are medicines injected into the eye. They partially recover vision loss and allow retinal (vision) cells to regain function. 

Photodynamic therapy includes injection of verteporfin (Visudyne) into an arm vein. It administers laser light to the affected blood vessels, which activate the medication within the vessels. This causes the abnormal blood vessels to close and stop leakage. Sometimes photodynamic therapy requires repeat treatment.   

Laser photocoagulation is a high-energy beam that destroys abnormal blood vessels under the macula, preventing further macula damage and slowing vision loss. Ways to improve vision skills without invasive treatment include magnifying devices, enlarging computer font size, and brighter lights at home. 

Use caution while driving. Consider public transportation. Ask family members for help, especially for night driving.  

Smoking cessation, taking required medicines, regular exercise, and hypertension treatment are crucial. A healthy diet full of fruits and vegetables provide antioxidants that reduce macular degeneration risk. These include Omega-3 fatty acids, fish, and nuts.   

Ask your eye doctor how often you should undergo routine eye exams. A dilated eye exam can identify macular degeneration.
Stop smoking. Smokers are more likely to develop macular degeneration than nonsmokers.


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