The eye works like a camera. It has two parts, a lens and a film. The film layer lines the back wall of the eyes and is called the retina. There is an area of the retina responsible for the central vision called the macula.
Age-related macular degeneration (AMD) refers to specific age-related changes in patients 50 years and older. Wet age-related macular degeneration is characterized by the formation of undesirable abnormal new blood vessels. These blood vessels have a tendency to leak and bleed which decreases the quality of vision. Blood is toxic to the retina and may cause permanent damage to the vision if it accumulates underneath the area responsible for central vision.
In this case, bleeding has occurred from abnormal new blood vessels, but it is not involving or threatening the area of central vision. Therefore, no treatment is required. However, close monitoring is critical so that should changes occur, they are discovered, and treated very early.
The goal of treatment in this case is preventing the development of wet AMD in the other eye and early detection and treatment of these abnormal new blood vessels should bleeding increase or involve the central vision.
The Age Related Eye Disease Study Number 2 (AREDS2) vitamin decreases the risk of losing vision from macular degeneration by 25%. This formulation is different from a multivitamin. Taking a multivitamin plus lutein/zeaxanthin does not contain the same contents as an AREDS2 vitamin. Patients who regularly take a multivitamin may take an AREDS2 in addition if recommended by their doctor.
Eating green leafy vegetables and fish on a regular basis decreases the risk of experiencing worsening macular degeneration. A diet rich in omega-3 vitamins may further decrease the risk of macular degeneration worsening. Using polarized sunglasses while outside for extensive amounts of time can decrease retinal damage from significant sun exposure. Maintaining a healthy weight can also decrease the risk of macular degeneration worsening.
Smoking increases the risk of macular degeneration worsening by 3 times compared to a non-smoker. Discontinuing smoking decreases this risk by 50%.
Monitoring vision is recommended for patients who have one eye with dry macular degeneration. Monitoring with an Amsler grid dramatically decreases the risk of vision loss from this condition. New distortion or blurriness discovered on an Amsler grid may be a sign of wet macular degeneration. Early detection and treatment of wet AMD can significantly improve visual results with treatment.
An Amsler grid should be used to check each eye individually at a reading distance. Patients are instructed to look at the black dot in the center of the grid paper. Patients who notice new distortion or missing lines may be experiencing a conversion to the wet form of macular degeneration (see example below).
