By Deborah Jeanne Sergeant
Macular degeneration is one of the nation’s leading causes of blindness and low vision, affecting 1.8 million Americans, according to the Centers for Disease Control and Prevention.
Age-related macular degeneration or “dry” macular degeneration is more commonplace, 70%-90% of cases, than wet macular degeneration.
Either type of macular degeneration affects the central vision, which is important for reading, filling out paperwork and driving.
Patients may see fine in their peripheral vision, but not in the center. For example, they may see a person’s clothing and hair, but not the face. Schedule a health fund eye test if you start having problems with your vision.
WMD occurs when blood vessels grow abnormally under the macular and leak blood and fluid. This vision loss is rapid, and typically presents with straight lines appearing wavy. AMD is a slower process as the macula thins, which eventually blurs vision. Patients have a 10% chance of progressing into WMD.
Although there is no cure for AMD, doctors may provide ophthalmology services which can help treat WMD to reduce its effects with anti-VEGF injections to decrease the bleeding in the back of the eye and photodynamic therapy, a less common treatment sometimes used with anti-VEGF injections.
The injections “are generally very effective,” said Luca Zatreanu, MD, ophthalmologist with Reed Eye Associates in Pittsford and Irondequoit. Reed Eye also operates an office in Newark.
“Patients need to realize that these are treatments, not cures.”
They will need to return to the office for injections to prevent further damage. Even a week’s delay can negatively affect vision. With an effective laser treatment, WMD can be managed for years—even decades—thanks to current protocols with a much lower risk of losing vision.
Photodynamic therapy uses a cold laser to target a light sensitive medication in the eye to break down blood vessels that cause the vision loss. Patients may need repeated treatments to maintain the effect.
Zatreanu tells adult children of someone with macular degeneration to regularly undergo a dilated eye exam of the back of the eye “even if they don’t have problems with their vision,” he said.
He also advises patients in lifestyle modifications for those with macular degeneration that can reduce their risk for further vision loss, including avoiding exposure to smoking and other sources of carbon monoxide, such as a woodburning stove.
“That can potentially accelerate the condition,” he said. “If you’re outdoors, even in winter, put on sunglasses as UV exposure can accelerated.”
Supplements can also help, including brands such as Preservision and Ocuvite.
Early diagnosis can help patients make lifestyle changes that can slow macular degeneration progress. In addition to smoking, the greatest risk factors for macular degeneration include age, family history, gender (women are more prone), high blood pressure, high cholesterol and poor diet.
Melissa Goddeau, registered dietitian nutritionist with Nutrition Care of Rochester, PLLC in Pittsford, recommends improving the diet by including more healthful foods to prevent further degradation for eye health and in general to promote eye health and reduce the risk of eye issues. She recommends improving intake of vitamins C and E.
“Some examples vitamin C-rich foods include oranges, strawberries, raspberries, cantaloupe, red peppers, cauliflower, broccoli and Brussels sprouts,” she said. “Vitamin E sources include nuts, seeds, sunflowers, peanut butter, shrimp, fish, wheat germ and spinach.”
Phytochemicals lutein and zeaxanthin can also help. Goddeau noted that leafy green vegetables like spinach and dark-leaf lettuce, cruciferous vegetables like kale and broccoli, and eggs and peas are good sources.
“Omega 3 fatty acids are an anti-inflammatory,” Goddeau added. “That will help combat oxidative stress that contributes to macular degeneration. “Eating fatty fish like salmon or tuna a couple times a week is helpful or taking, fish oil supplement if they don’t eat fish. Ground flaxseed and walnuts are also good sources.”
For people watching their sodium intake, shopping for walnuts in the baking aisle can make it easy to avoid added salt since these nuts are typically sold plain, unlike nuts sold from the baking aisle.
“Nuts improve symptoms of depression and other mental health disorders,” Goddeau added. “They can reduce the tendency for the blood to clot. It also can help lower elevated triglyceride levels.”