central_scotomaMacular Degeneration is a serious disorder of the Eye and can be caused from age related problems and toxic effects of certain medications.

It is a major cause of blindness in older adults.

Often the center of the visual field (macula) is affected.

Medications that can be involved are: Chloroquine or Phenothiazine.

 

Dry vs Wet

1.)  Dry

The nerves of the eye are found in the Retina, followed by the Choroid which contains the blood supply to the eye, and finally the Sclera which is the white aspect of the eye.

Drusen Deposits (yellow in color) occur where cellular debris accumulates between the Retina and the Choroid.

As a result, the retina can become detached.

Initially after deposits begin – vision is normal.

Drusen is related to elevated cholesterol deposits and may respond to cholesterol-lowering agents.

2.)  Wet

This is the more severe case.

Blood vessels expand from behind the retina – in the Choroid area. As they expand, a detachment can occur.

Occasionally, laser can be used to coagulate or reverse the growth of the blood vessels.

 

Symptoms

  • Drusen
  • Hemorrhages in eye
  • Vision changes
  • Vision loss
  • Blurry vision
  • Shadows in vision
  • Distorted vision
  • Trouble discerning colors

Amsler Grid Test

  • Simple and Effective method for patients to monitor their maculae.
  • This is a pattern of intersecting lines.
  • There is often a dot in the middle
  • Fixate on dot.
  • With normal vision – all lines surrounding dot will look straight and evenly spaced.
  • When disease is present – the lines will look bent, distorted, and/or missing.

macular-degeneration-diagram

 

Risk Factors for getting Macular Degeneration

1.)  Age
2.)  Family History  (genetics)
3.)  Stargardt’s disease
4.)  Hypertension (High Blood Pressure)
5.)  Elevated Cholesterol
6.)  Obesity
7.)  Race
8.)  Smoking
9.)  Others

 

Treatment

Some drugs/medications may help worsening of Macular Degeneration

Ranibizumab
Aflibercept

No drug options

  • Carotenoids – Lutein and Zeaxanthin
  • Omega-3 fatty acids

Laser

  • Photodynamic Therapy
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