Macular Degeneration

Age Related Macular degeneration (ARMD) is a progressive, degenerative eye disease that disrupts your central vision: the vision you need to see fine details and recognize faces. Lifestyle choices such as smoking, consuming an unhealthy diet and excessive ultraviolet light exposure can increase your risk of developing macular degeneration, but the major risk factors are age and genetic predisposition.

A Difference You Can See

We provide patients with an easy method to test their AMD progression at home using an Amsler Grid – free of charge

Symptoms of Macular Degeneration

Like many eye conditions, the earliest stages of AMD may not have any serious symptoms. As the disease progresses, you will start to notice an increase in these symptoms:

  • Dark or blurry areas in central vision while peripheral vision remains clear
  • Distortion and waviness of objects and lines

Types of Macular Degeneration

There are two forms of ARMD: Dry and Wet.

  • 90% of all macular degeneration cases are the dry form of ARMD. Dry ARMD can occur when there is a collection of drusen under the macula (yellow deposits comprised of a fatty protein). As these build up, they can cause the retinal tissue to dry out and become thinner.
  • Wet ARMD occurs when abnormal blood vessels grow under the macula, and is often preceded by dry ARMD. Although not as common as dry ARMD, it is oftentimes more serious because if the abnormal blood vessels leak fluid or bleed, rapid vision loss can occur. In wet AMD, high intraocular levels of the protein vascular endothelial growth factor(VEGF) are produced.

Diagnosis of Macular Degeneration

Amsler grid testing, dilated examination, Spectral Domain Ocular Coherence Tomography (OCT), and Fluorsecin Retinal Angiography are the diagnostic methods we use.

Macular Degeneration Treatment

The proper treatment will depend on the type and severity of your condition. Dr. Robert Pendleton may recommend:

  • Nutritional supplements: Although only proven to be effective for patients with moderate to severe vision loss, the AREDS formulation of nutritional supplements is recommended for most patients with diagnosed ARMD
  • Intraocular injections of the anti-VEGF medications such as Avastin or EYLEA© may be necessary to treat wet ARMD. Surprisingly, when done properly, intraocular injection is a very well tolerated, in office procedure.
  • Laser Treatment. Once the mainstay of treatment, laser treatment is still used for select cases of wet ARMD

Strategies for treatment of wet ARMD

In wet ARMD, abnormal blood vessels under the retina leak fluid and or blood that obscure the central vision.  Intraocular injections are now the mainstay of treatment for wet ARMD, and a host of new pharmacologic agents are currently being developed.  Several related strategies for treatment have evolved:

  • Treat as Needed.  A series of monthly injections are given until the retina is “dry” (free of blood and fluid), and/or the vision can no longer be improved.  Monitoring visits are then carried out at regular intervals and treatment is resumed only if fluid returns.
  • Treat and Extend.  A series of monthly injections is given until the retina is “dry”.  The interval between injections is then slowly increased in one to two-week increments.  If fluid returns, the interval between injections is shortened.
  • Continuous treatment.  Once the retina is “dry”, injections are repeated at regular intervals.  The interval between injections is rarely shorter than one month.

The most appropriate strategy for you will depend on the severity of your disease, and its response to treatment, and in fact, the most appropriate strategy for a given patient may vary over time.  If you have wet ARMD, Dr. Pendleton will work with you to minimize the number of injections and maximize your vision.

If you have a family history of ARMD, it is important to have regular eye exams to monitor your retinal health to catch this common disease in its earliest stages.

To learn more about macular degeneration in Oceanside, California, contact us today.