The answer to “does macular degeneration run in families” seems to be yes. If an immediate family member has macular degeneration you are 3-4 times more likely to develop it yourself. There are also genetic tests that determine if you have the genes most likely thought to cause the disease.

Who is at most risk for macular degeneration?

  • ARMD tends to affect our seniors the most, those over the age of 60 are the highest risk age group. 
  • Caucasians are by far the race most heavily affected by macular degeneration. 
  • Those with a family history. 
  • Smokers are up to 4 times more likely to develop macular degeneration.
  • If you are Obese and have many complications that go with it such as Diabetes and high cholesterol.
  • Those with cardiovascular disease.
  • People with excessive Blue light exposure.

What is Macular degeneration?

Macular degeneration is a disease that affects the small area of the retina called the macula. This is the area of retina that provides your detailed vision. Everything outside of the macula is for peripheral vision.  For most this disease occurs later in life and has a slow onset, however it can happen earlier in life and proceed rapidly in some instances.  AMD (Age-related macular degeneration) or ARMD is caused from the retinal tissue thinning or atrophying and small deposits called drusen accruing in the macular area.  This stage is called dry macular degeneration.  If these drusen get big enough and break through a membrane it allows for fluid to go into the other layers of the retinal. At this point it becomes wet macular degeneration.  Wet AMD is very devastating to the vision and the tissue.  Wet AMD causes the tissue to starve for oxygen and will result in new blood vessel formation called neovascularization. This occurs in an attempt by the body to supply oxygen to the area.  These blood vessels are very small and fragile and can easily break and cause more fluid leakage compounding the problem.

What are the early signs of macular degeneration?

  • Early in the disease most people don’t notice any symptoms. When they do, they tend to be subtle and progress fairly slowly. 
  • The early signs will be slight blur of detailed things like print in a book. Distortion of straight lines, like wavey or missing print in the newspaper. 
  • Glare at night is common. 
  • Loss of contrast sensitivity. 
  • If the visual loss is significant the person may experience ghost images or see things that aren’t there.

Can you be tested to determine if you are at risk for inheriting macular degeneration?

Luckily technology is advancing rapidly and there are several different test now available for determining if you are at risk for AMD. One such test is called Macula risk. This is a DNA test done in the office with a cheek swab and tests for some of the known genes to play a role in age related macular degeneration.  A recent study has determined that some of those with dry amd that take an AREDS supplement with zinc in it are at higher risk for converting to the wet form.  There is now a genetic test (vita risk) also done in the office to determine if you are one of the approximately 13-15% who zinc affects negatively and can worsen your macular degeneration.  

There are also in office macular testing devices that can show early signs of ARMD before there are symptoms. Early detection and preventative measures are key to slowing the progression.

Prevention

  • We now know that ARMD can be inherited, but we also know that genes can be turned on and off or expressed by activation from environmental factors. Knowing what we can do to prevent getting or progressing this disease is so important.
  • Probably the biggest environmental factor is smoking, you are four times more likely to get AMD if you are a smoker. Smoking reduces oxygen to all of your tissues; it is an oxidative process which creates free radicals which cause our tissues to deteriorate. It causes hardening of the arteries and plaques to accumulate in those arteries further reducing the oxygen supply.
  • Wear good sunglasses that protect from blue light. This should also be done if you spend a lot of time looking at computer, tablet or phone screens. Blue light filters are available for all of your ophthalmic lenses in your glasses.
  • Eat a healthy diet of lots of fruits and vegetables, especially lots of green leafy vegetables that contain a lot of antioxidants. A good ocular vitamin is also recommended.
  • Manage other health conditions that affect your cardiovascular system such as hypertension, cholesterol and diabetes.
  • Eat fish regularly or take fish oil. Fish oil and omega fatty acids have a synergistic affect in combination with the antioxidant vitamins. They keep our cell walls healthy to facilitate the pumping of the vitamins into the cell.
  • Get yours eyes checked! Before the age of 40 you should have them checked every 2-3 years, 40-50 every 1-2 years and after 50 every year.

Treatment

If you have the dry version of AMD there isn’t really any treatment beyond all the things listed above for prevention. All of those things also reduce the rate of progression.  If your condition has progressed to the wet version, you should be seen by a retinal specialist immediately.  The retinal specialist will more than likely treat you with a shot of a medicine called an ANTI-VEGF.  This will help to dry up the fluid and reduce the new blood vessel growth.

If your vision has declined to the point where your normal glasses or contacts can no longer help you to do your daily activities you should consult a low vision specialist.