As the over-65 American population grows, so do the number of people affected by the serious vision disorder macular degeneration. Approximately 1.75 million Americans are currently living with the condition and that number is projected to grow to more than 3 million by 2020. In fact, macular degeneration is the leading cause of vision loss and blindness in people 65 and over.

“Sight is one of our most precious gifts,” says Dr. Miles J. Varn, Chief Medical Officer, PinnacleCare. “We are committed to working with our Members to help them assess their risk factors, develop a plan to protect their vision and connect them with the top ophthalmology practitioners for eye care and treatment.”

What is macular degeneration?

The most common form of the disease, known as dry or non-neovascular macular degeneration, occurs when the part of the retina called the macula becomes thinner and damaged by the aging process. The macula is the area where light sensitive cells (rods and cones) needed for clear central vision are located. As we grow older, the layer of tissue that nourishes these cells and removes the waste products they produce thins. Because the tissue is thinner, it can no longer effectively transport the needed nutrients or remove waste products and the macula becomes damaged and unable to transmit normal signals through the optic nerve. The result is blurry vision in the center of your field of vision which makes it hard to read, drive and take part in other every day activities.

In about 10 percent of cases, dry macular degeneration progresses to a more aggressive form of the disease called wet macular degeneration. Also known as neovascular macular degeneration, the condition occurs when an excess of fragile new blood vessels grow under the retina. These blood vessels leak blood and fluid into the retina, killing light sensitive cells and creating blind spots in the central vision. The new blood vessels form because the body is trying to provide new pathways for nutrient and oxygen delivery to the eye. But instead of nourishing the eye, these vessels rapidly cause damaging scarring.

What are the symptoms of macular degeneration?

Vision loss caused by macular degeneration causes no pain or discomfort. The loss of vision is usually gradual, so many people do not realize that they are experiencing the early stages of the disease. For the dry form of the disease, symptoms include:

Blurry vision
A need for more intense light when reading or doing other close work and trouble adapting to a change from bright to dimmer light, for example coming into the house on a sunny day
Colors appear less bright
Blurred or blind spots in the center of your field of vision
Trouble recognizing faces

The symptoms of wet macular degeneration often progress more quickly. Symptoms include:

Distorted vision, for example straight lines appear wavy or objects seem to be farther away and smaller than they are
Blurry or blank spot in your central vision

Risk factors: Steps you can take to protect your sight

While you cannot control the main risk factors for macular degeneration, growing older and your genetic makeup, there are steps you can take to decrease your risk. Specialists at PinnacleCare Center of Excellence New York Presbyterian Hospital note that studies have linked smoking and cardiovascular disease to an increased risk for macular degeneration. Smoking doubles your risk for the disease. According to experts at the Mayo Clinic, being obese increases the risk of dry macular degeneration progressing to the more severe from.

Some studies suggest that too much exposure to ultraviolet light may increase the risk of macular degeneration, but none of those studies has been deemed definitive and more research is needed. Low blood levels of important nutrients including zinc, lutein, zeaxanthin and antioxidant vitamins A, C and E also appear to play a role in the disease.

To proactively protect your vision, you can make some lifestyle changes.

Eat a diet rich in antioxidants. The best sources include leafy greens, fruits and vegetables.
The Age-Related Eye Disease Study (AREDS) conducted by the National Eye Institute found that taking supplements that included vitamins C and E, beta-carotene and zinc cut the risk of progressing to wet macular degeneration by 28 percent. These findings are still being explored, but talk with your physician to learn if supplements may help protect your sight.
A recent study linked consumption of omega-3 fatty acids with a decrease in macular degeneration risk. Add omega-3-rich fish to your diet.
Quit smoking.
Maintain a healthy body weight and exercise regularly. One study linked moderate exercise three or more times a week to a 70 percent reduction in macular degeneration risk.
Manage your cholesterol, blood pressure and other cardiovascular conditions to preserve the health of you vascular systems.
Get regular eye exams, especially if you have been diagnosed with the early stages of macular degeneration.

Treatment options and innovations in the pipeline

Unfortunately, there currently is no treatment for dry macular degeneration, though the AREDS research suggests that nutritional supplementation may slow the progress of the disease. For wet macular degeneration, there are several treatment options.

Photocoagulation, an option for only a small portion of those with wet macular degeneration, uses a laser to seal off and destroy the abnormal blood vessels that have developed under the macula.
Photodynamic therapy, which combines a cold laser and the light-sensitizing drug verteporfin, is another option used to destroy the abnormal blood vessels.
Macular translocation surgery, which is rarely used, involves detaching the retina and removing the abnormal blood vessels surgically.

Thanks to recent discoveries that pinpointed some of the genes linked to macular degeneration, researchers have developed new drugs that can slow and, in some studies, reverse some of the damage caused by wet macular degeneration. These drugs, anti-vascular endothelial growth factor (anti-VEGF) medications, include Macugen and Lucentis, and they are injected directly into the eye.

New discoveries are opening the door for the development of new treatments. Researchers have found that activating a cell surface protein involved in the development of new blood vessels called Roundabout-4 or Robo-4 can help prevent blood vessels in the eye from leaking. This provides a new target for the development of drugs with the potential to reverse and perhaps even prevent macular degeneration and another eye disease, diabetic retinopathy, according to the researchers involved in the study.

Several other drug treatments are in development, including ones that attack enzymes and cells that encourage abnormal blood vessel growth. Also under investigation is a technology that encapsulates genetically engineered cells that are implanted in the eye and released over time to replace damaged cells. Implantable artificial retinas and computer chips are also in the early stages of development.

Rely on PinnacleCare to help guard your sight

Developing a proactive plan to protect your vision can be a complex and time-consuming process. But PinnacleCare Members have a distinct advantage. They can rely on their personal Advocates to provide detailed information on macular degeneration and available treatments as well as available clinical trials for treatments in development.

Resources

“Hormone replacement may cut risk for age-related eye disease.” The Washington Post explores new research out of Harvard that links hormone replacement therapy with a nearly 50 percent reduction in the risk of wet macular degeneration for women. http://www.washingtonpost.com/wp-dyn/content/article/2008/04/14/AR2008041401926.html