Macular Degeneration (ARMD) at Baltimore Washington Eye Center serving greater Baltimore & Washington, D.C.

Macular Degeneration or Age Related Macular Degeneration (ARMD) is a disease
of the Retina in which the central portion of the Retina, called the Macula, is
damaged.

Macular Degeneration is an important eye disease to understand because ARMD is an incurable eye disease and is the leading cause of legal blindness for those aged 60 and older in the United States, affecting more than 10 million Americans in some fashion.

Macular Degeneration is caused by the deterioration of the central portion of the Retina, the inside back layer of the eye that records the images that you see and sends them via the Optic Nerve from the eye to the brain.

The Macula is responsible for providing central vision. Central vision is the sharpest or clearest area of your vision and is required for activities such as seeing fine detail of faces, reading and recognizing colors. The Macula provides you with the precise vision required for driving a car and is responsible for central or “straight ahead” vision.

There are a number of different types of Macular Degeneration. Age Related Macular Degeneration (ARMD) is the most common type of Macular Degeneration. Your chances of developing Age Related Macular Degeneration (ARMD) are directly related to your age. The older you are, the greater the chance that Macular Degeneration will affect you.

Causes of Age Related Macular Degeneration

Age Related Macular Degeneration (ARMD) is a degenerative condition of the Macula that is caused by hardening of the small arteries supplying oxygen and nutrients to the Retina. The hardening and narrowing of these arteries deprives the Macula of oxygen and nutrition. This results in a slow but progressive loss of function. The visual effects of Macular Degeneration can be relatively minimal with a mild “dimming” or “distortion” of your central vision, or very profound resulting in a complete loss of your central vision. However, Macular Degeneration DOES NOT cause total blindness. Since the effect of Macular Degeneration is limited to the central Retina, its effects are limited to central vision and thus it does not cause any loss of your peripheral vision.

Types of Age Related Macular Degeneration

There are two types of Age Related Macular Degeneration:

• “Dry” Macular Degeneration
• “Wet” Macular Degeneration

Dry Macular Degeneration

Dry Macular Degeneration is the most common type of Age Related Macular Degeneration. Dry Macular Degeneration makes up approximately 85-90% of cases of Macular Degeneration. If you have Dry Macular Degeneration, during the examination of your Retina, the Baltimore Washington Eye Center eye doctors will see small, yellow colored deposits between the retinal layers, which are called Drusen. Dry Macular Degeneration results in a slow, gradual progressive “dimming” of your central vision. Many people 50 years of age or older begin to display some Drusen as they age. Drusen are not a problem or a risk to your vision unless they are large, soft, or confluent. If you have Drusen, your doctor may ask you to schedule eye examinations more frequently in order to monitor them, as there is some possibility that Dry Macular Degeneration will progress to Wet Macular Degeneration over a period of time. Thus, people with Dry Macular Degeneration, even without any noticeable change in vision, need to be followed closely as Wet Macular Degeneration has far more serious consequences for vision loss. 

Wet Macular Degeneration

Fortunately, Wet Macular Degeneration only accounts for about 10-15% of cases of Macular Degeneration, as it is likely to cause far more serious vision loss than Dry Macular Degeneration. Wet Macular Degeneration is characterized by an abnormal growth of new blood vessel under the retina. These new blood vessels are called “neovascularization”. Neovacularization is not made up of “normal” blood vessels in that they are unusually weak in their structure. In fact, they are quite fragile and are prone to be leaky and can easily break and bleed. If leakage occurs, the Macula may actually begin to swell. If the new blood vessels break and bleeding occurs, it can result in scarring as it heals. Scarring of the Macula can cause a sudden, rapid and severe loss of central vision, which is irreversible.

Treatment of Macular Degeneration

Vascular Endothelial Growth Factor Inhibitors (VEGF)

Avastin and Lucentis Injections

As a result of advanced research in the area of “angiogenesis” or new blood vessel growth, considerable information has been gathered and applied to the treatment of Wet Macular Degeneration. Researchers discovered that a specific protein called “Vascular Endothelial Growth Factor” (VEGF) causes the growth of new blood vessels or “neovascularization” to occur in the eye. From this work, drugs that can be injected into the eye in order to slow or stop the growth of new blood vessels have been developed. Two drugs, Macugen and Lucentis have been developed and FDA approved with specific indications to treat Wet Macular Degeneration. One drug, Avastin has been FDA approved with an indication for the treatment of metastatic colorectal cancer and breast cancer. However, once a drug is approved by the FDA, physicians may use it “off-label” for other purposes, if they are well-informed about the product, base its use on firm scientific method and sound medical evidence, and maintain records of its use and effects.  Many Ophthalmologists now use Avastin “off-label” to treat Age Related Macular Degeneration and other eye conditions that cause neovascularization, since research indicates that VEGF is one of the causes of the growth of the abnormal vessels that cause these conditions.  Each of these drugs works by inhibiting Vascular Endothelial Growth Factor (VEGF) so that there is little or no stimulus to grow new blood vessels in the Retina.

Avastin, and Lucentis Injections are intravitreal injections-that means an injection that is placed directly into the Vitreous of the eye. Generally they need to be repeated every four to six weeks. Clinical studies of these anti-VEGF Injections indicate that when given to patients who have evidence of new blood vessel formation monthly, over 90% of patients will maintain their vision.

Age Related Macular Degeneration & Diet

It is believed that nutrition may play a role in the likelihood of developing Macular Degeneration. Studies indicated that people who have a diet that is rich in fruits and vegetables-particularly green leafy vegetables-have a considerably lower incidence of Macular Degeneration. The Age Related Eye Disease Study (AREDS), which was sponsored by the National Eye Institute, showed that taking high levels of antioxidants and Zinc could reduce the risk of developing Age Related Macular Degeneration by about 25%. This is not a cure, but we need to consider this information as a possible way to help patients who are at risk for Age Related Macular Degeneration vision loss.

NOTE: A VERY SPECIFIC FORMULATION WAS USED IN THIS STUDY

Before patients begin taking any course of vitamin or antioxidant supplements, you should fully discuss the risks and benefits with our doctors, who in consultation with your family physician or Internist, will determine whether this is safe and effective for you to try.

Macular Degeneration is a complex eye disease. Fortunately with early diagnosis it may be possible to have a treatment options available to help preserve your vision. If you, a family member of friend have not had a recent eye examination or if you feel that you may be at risk for Macular Degeneration, please schedule an appointment for an examination and consultation. Patients wishing to learn more about the Macular Degeneration in the greater Baltimore or Washington, D.C area will find that Baltimore Washington Eye Center is conveniently located for those coming from Arbutus, Carney, Clarksville, Columbia, Dundalk, Edgemere, Essex, Ellicott City, Ferndale, Glen Burnie, Kenwood, Laurel, Linthicum, Lutherville, Millersville, Odenton Owings Mills, Reisterstown, Towson, Parkville, Randallstown, Rivera Beach, Pasadena, Severna Park, South Gate, and Woodlawn Maryland. To schedule an appointment for a Macular Degeneration consultation or examination please call us at 800.495.3937.