Drusen and Macular Degeneration Treatment

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drusen macular degeneration treatment

Drusen are abnormal extracellular matrix deposits found most commonly in age-related macular degeneration (AMD). When present, dry AMD leads to the appearance of these deposits which then precede choroidal neovascularization and visual loss.

OCT imaging studies have identified drusen growth and decreased ONL/HFL thickness at the apex of soft drusen as two indicators that may predict type 3 macular neovascularization.

Early

Early stages of age-related macular degeneration involve yellow deposits known as drusen, which accumulate under the retina (the light-sensitive membrane at the back of your eye). Drusen by themselves do not result in vision loss, however an increase in size or number increases the risk that macular degeneration will progress into its later stages (called dry macular degeneration ), where vision may become impaired. Initially vision remains unaffected during this phase. Eyes cannot tell us anything directly; therefore, only an extensive eye exam including use of an Amsler grid can give an accurate evaluation. OCT or optical coherence tomography is another test which can detect fluid or changes to the retina. Fluorescein angiography, an easily administered yet painless test, may also be necessary to diagnose macular degeneration. Here, a harmless dye is injected into an arm vein before digital images of your retina are captured as it travels through your body. If abnormal blood vessels underneath your retina leak this dye into the body, a physician can detect this and make their diagnosis of macular degeneration accordingly.

People in the early stages of AMD typically exhibit small to medium sized drusen and may notice blurring of central vision, although vision loss should not be a concern at this point in time. Regular eye exams are recommended because as macular degeneration progresses from early, intermediate, and late stages, central vision loss becomes significantly worse.

Intermediate macular degeneration, or AMD, is characterized by multiple or one or more large drusen that accumulate together to cause noticeable vision loss. With no central portion of the macula remaining clear or blurry, it becomes difficult to see straight lines, objects in motion and read; additionally it may cause difficulties with color recognition.

Treatment at this stage is generally not advised; however, one study revealed that patients with small to medium sized drusen who underwent photobiomodulation (PBM) therapy for three weeks using multiwavelength LED lights showed significantly improved best corrected visual acuity (BCVA), contrast sensitivity, central drusen volume while their overall retinal thickness and vascular density remained stable.

Intermediate

Macular degeneration is a progressive eye condition that gradually degrades sharp central vision in both eyes. Damage occurs to the macula, an area at the back of your retina that enables you to clearly view fine details while performing activities such as driving and threading a needle. As macula degeneration progresses, blurriness, dark areas and distortion become prominent within central vision – making it hard for drivers, readers or people recognizing faces to drive or read or recognize faces in traffic lights or faces when driving at night! It can even impede everyday tasks such as driving, cooking cleaning or household tasks when trying to complete them successfully.

Dry macular degeneration (AMD), which affects roughly 80% of those diagnosed, is the most prevalent form. This occurs when parts of the macula thin with age and protein deposits known as drusen form underneath the retina, eating away at its cells over time until gradually losing central vision while keeping peripheral (side) vision intact.

Early and intermediate macular degeneration symptoms may not manifest themselves yet, but as your drusen become larger or more numerous, you are at increased risk for advanced macular degeneration. A common sign of advanced AMD is usually a blurry spot at the center of your vision that your eye care professional can detect during a comprehensive dilated eye exam.

Though its precise cause remains unknown, research indicates that macular degeneration may be caused by multiple factors including age, family history of AMD, smoking, high blood pressure, light eye color and obesity – each increasing your chances of developing it. Some studies also indicate that certain nutritional supplements – specifically vitamin C and E as well as beta-carotene can slow the progression of macular degeneration.

Wet AMD, though less common than dry macular degeneration, can be far more serious. Here, new blood vessels sprout under the retina and leak blood or fluid into the macula causing scarring; leading to faster vision loss than seen with dry AMD. Multiple studies have demonstrated how Visudyne can destroy these new blood vessels to slow progression while other medications working similarly are being tested as potential solutions.

Late

Age related macular degeneration is a progressive condition affecting the macula of your eye, which controls central vision. This part of your eye allows you to see fine details such as faces, read and drive safely. Age-related macular degeneration is one of the leading causes of blindness among people over 50 in the US, often making reading, driving and color recognition more challenging; and could eventually cause it’s complete loss altogether if untreated – thus it is important to carefully monitor changes as this could worsen over time.

Drusen are yellow deposits beneath the retina that result from macula cell breakdown, leading to two forms of AMD: dry macular degeneration and wet macular degeneration. With dry macular degeneration, due to age related tissue thinning drusen may form under the retina over time and progress gradually without leading to vision loss initially; if they expand however they could lead to loss of central vision over time.

Wet macular degeneration occurs much more rapidly than dry AMD, when abnormal blood vessels form beneath the retina – known as choroidal neovascularization or CNV. If left untreated, wet AMD can quickly damage macula causing rapid vision loss; fortunately new treatment options exist that may slow its progression and help slow vision loss progression.

An extensive dilated eye exam is necessary to detect these changes. Your eye care professional will use dilation drops and an ophthalmoscope to inspect the back of your eye, as well as imaging tests to detect type and extent of hard or soft drusen (hard or soft), signs of AMD or any other symptoms; such as digital color fundus photography under full, green, blue light; red-free images and fluorescein angiography.

Treatment

About 80% of those suffering from AMD have the dry form, in which parts of the macula become thinner as yellow protein called drusen form and gradually lead to vision loss. About 10% have wet AMD which occurs when abnormal blood vessels grow under the retina and leak fluid or blood, causing the macula to scar resulting in serious vision loss; treatments include anti-angiogenesis drugs and laser treatment as possible solutions.

Routine eye exams are the ideal way to detect drusen macular degeneration even without symptoms. Your eye care provider will use an Amsler grid to look for straight lines that appear wavy or contain dark spots, helping them gauge how far along macular degeneration has progressed.

Drusen can indicate an increased risk for advanced AMD if they increase in size or number or form yellow spots beneath the retina. If significant drusen have appeared alongside pigment changes that suggest macular degeneration and you have an established family history of macular degeneration, an eye care professional should evaluate you to discuss potential solutions available to you.

Age-Related Macular Degeneration, more commonly known as AMD, occurs when deposits known as Atrophic Macular Changes accumulate underneath the retina and result in gradual central vision loss. Most individuals living with dry AMD are capable of reading and driving safely but may find difficulty seeing fine details such as faces or street signs clearly.

There are various nutritional supplements available to slow the progression of atrophic macular degeneration, including zinc, zeaxanthin, vitamin C and E. Studies have revealed that these vitamins and minerals may reduce rates of macular degeneration by up to 25%.

Laser photodynamic therapy may be used to address wet macular degeneration by targeting any damaged blood vessels and creating an annulus of 60 barely visible burns on the retina, 150 to 2500 microns from its center; this allows an ophthalmologist to use a special lens and create grid of 60 burns centered within this annulus to avoid retinal vessels or any previous treatments that had left scars behind.

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