Age-Related Macular Degeneration and Diabetic Eye Disease

Age-related macular degeneration (AMD) is one of the leading causes of irreversible vision loss among people aged 50 or above, and its two subtypes – non-neovascular or dry AMD and neovascular or wet AMD – account for almost all irreversible vision loss over time.

Risk factors associated with AMD include age, family history of macular degeneration, smoking and light eye color. Some risk factors can be modified, including blood pressure, cholesterol levels, weight and diet.

Dry Macular Degeneration

Dry age-related macular degeneration (DRMD), the most frequent form of macular degeneration, occurs when light-sensitive tissue in the center of the retina known as the macula breaks down, affecting central vision required to drive a car, read, recognize faces and colors and other activities. DRMD typically progresses gradually without leading to severe vision loss.

80-90% of patients suffering from macular degeneration have dry forms of the condition. Ten to 15% have wet forms of macular degeneration characterized by abnormal blood vessels under the retina that leak blood and fluid quickly and severely, leading to rapid vision loss. Sometimes this form develops from dry forms.

There is no cure for wet macular degeneration; however, certain medications have been proven to slow its progress and improve visual results. Such medicines include vascular endothelial growth factor inhibitors or VEGF injections at regular intervals (ideally four weekly), to block abnormal blood vessel formation causing wet macular degeneration.

Some ways you can help slow the progression of dry macular degeneration include eating foods rich in lutein and zeaxanthin – two antioxidants thought to help promote eye health – such as deep sea fish. You should also refrain from smoking, follow advice from an ophthalmologist regarding cardiovascular disease and high blood pressure management as these can increase your risk for macular degeneration.

If you have early AMD, it is crucial that you visit our office at least annually for a dilated exam in order to identify whether you have dry or wet AMD and begin treatments to stop further progression of this eye disease.

Neovascular (Wet) Macular Degeneration

Wet Age-Related Macular Degeneration, also known as Neovascular AMD, occurs when abnormal blood vessels form under the retina – known as Choroidal Neovascularization – leaking fluid that permanently damages central vision. Wet AMD is more severe and often develops much faster than its dry counterpart; in fact, it is the leading cause of blindness among people aged 65 or above.

The retina is a layer of neurosensory tissue at the back of your eye that converts light into neural signals that are processed by your brain into images. The retina plays an essential role in central vision, which allows us to clearly perceive things and distinguish colors. When macular degeneration occurs, however, macular tissue becomes thinner and loses its ability to process sharp details; untreated, this could result in blurry or darkened central areas called central scotomas that interfere with everyday tasks such as driving or reading and make recognizing faces difficult – as well as making straight lines appear wavy!

While no cure exists for macular degeneration in its dry form, a combination of vitamins have been proven to slow its progression into wet macular degeneration in some patients. These vitamins include vitamins C and E as well as lutein and zeaxanthin. Furthermore, an ongoing clinical trial is looking into whether gene therapy provides sustainable outcomes in wet macular degeneration cases.

Studies have shown that anti-VEGF injections can help stabilize or improve vision for those suffering from wet macular degeneration by restricting new blood vessel growth and limiting leakage. Intravitreal Aflibercept (BAY865321) is currently FDA-approved drug used to treat wet AMD; however, another investigational drug called Ixoberogene Soroparvovec (RGX-314, Ixo-vec) showed similar visual gains and safety ratings as Aflibercept in two clinical trials conducted PULSAR and PHOTON trials reducing injection requirements significantly.

Visudyne drug treatment (photodynamic therapy, or PDT), another solution for those living with wet macular degeneration, offers hope. Under this procedure, photosensitizing medication verteporfin is administered and then your eye doctor shines a non-thermal laser into your eye to activate and destroy abnormal blood vessels that contribute to wet macular degeneration. About 15% of those treated with Visudyne experience improved vision while this procedure can help slow its progression.

Diabetic Eye Disease

Diabetic eye disease results from high blood sugar levels damaging tiny blood vessels in the retina at the back of the eye. At first, these vessels swell and leak fluid or even close completely; over time they may grow abnormal new vessels on their surface which cause floaters, blurred vision and difficulty distinguishing colors – the best way to protect your vision would be keeping blood glucose and blood pressure under control as well as having regular dilated eye exams at least annually.

Macular Edema occurs when fluid leaks into the center of your retina, causing it to swell and distort your vision. Your eye doctor can use laser photocoagulation therapy to seal off these leaking blood vessels and stop any further growth; it is a painless solution that may significantly lower your risk of vision loss.

Left untreated, diabetic eye disease can eventually result in a detached retina and blindness. This stage is known as proliferative diabetic retinopathy (PDR) and occurs when retinal blood vessels close off, depriving your eye from blood supply. Your retina then attempts to restore flow by creating fragile new vessels but these new blood vessels bleed easily, eventually leading to detachment. Although less common than its precursor stages, diabetic retinopathy still poses significant threats to vision loss.

Although there is no cure for diabetic eye disease, treatment plans can help slow or stop its progress. The key is keeping both blood sugar and blood pressure within normal range while seeing an eye care professional for regular dilated eye exams as recommended by your physician.

Patients living with diabetes should also make an effort to wear sunglasses to shield their eyes from UV rays, follow a healthy diet and regularly engage in physical exercise – doing this will lower their risk of diabetic eye disease as well as conditions such as cataracts and glaucoma.