March is Low-Vision and Age-Related Macular Degeneration (AMD) Awareness Month

SAN FRANCISCO – Although age-related macular degeneration (AMD) is currently the leading cause of visual impairment in Caucasians over the age of 50 in the United States, affecting more than 1.5 million people, there is hope for progress in combating it. As part of Low-Vision/AMD Awareness Month in March, the American Academy of Ophthalmology, the Eye M.D. Association, reminds people that although there are no known cures for AMD, recent research and new treatments are showing great promise. Some of these are approved by the Food and Drug Administration (FDA), and others are being studied in clinical trials. Current treatments include:

• Vitamin and mineral supplementation: The Age-Related Eye Disease Study found that high levels of antioxidants and zinc can reduce the risk of vision loss by about 25 percent in patients with “early” or “intermediate” AMD in one or both eyes and those with “advanced” AMD in only one eye. (Smokers and ex-smokers should not use beta carotene because studies have shown an association with lung cancer and beta carotene in smokers.)
• Conventional laser therapy was demonstrated to be of value in a selected but unfortunately small percentage of AMD patients in a study sponsored by the National Eye Institute (NEI). .
• Photodynamic therapy is a treatment that combines laser surgery with use of light-sensitive drugs, and has been shown to stabilize or improve vision in up to 60 percent of patients with the wet form of AMD. The FDA has approved this therapy.
• Anti-VEGF drugs inhibit the development of unwanted blood vessels that cause wet AMD, and these agents therefore help prevent further visual loss and even improve vision. At the current time, these are injected directly into the eye. One drug has already been approved by the FDA, and several others are in the process of gaining FDA approval.
• Anti-inflammatory drugs also inhibit or reduce the actions of abnormal blood vessels, and these are being investigated as both individual treatments and as therapy combined with other drugs.

For people who have lost vision from AMD, rehabilitation to maximize function and independence is important. Academy clinical correspondent Lylas G. Mogk, MD, Director of the Visual Rehabilitation and Research Center of the Henry Ford Health System, and chair of the Academy’s Vision Rehabilitation Committee, said, “Depression with vision loss correlates not to how much vision is lost but to how many daily activities are lost. It is essential, therefore, to keep up your activities in spite of vision loss, and fortunately, the tools, training and resources that can help those with macular degeneration do that are available in most places.”

To learn more about vision rehabilitation, ask your ophthalmologist for the SmartSight handout from the Academy Web site, and to locate vision rehabilitation services in your area, call VisionConnection at 800-829-0500 or go to Help Near You at www.visionconnection.org.

AMD is a progressive disease that affects the macula, the spot on the retina at the back of the eye responsible for central vision, causing central vision to blur, but leaving peripheral vision intact.  The two types of AMD are dry, or atrophic, and wet, or exudative. Approximately 90 percent of people with AMD have the dry form, which is caused by aging and thinning of the macula and causes more gradual vision loss. Although only 10 percent of people with AMD have the wet form, it generally progresses more quickly than the dry form and causes 90 percent of the most severe visual impairment. Wet AMD is characterized by the growth of abnormal retinal blood vessels that leak blood or fluid, causing rapid and severe central vision loss.

Risk factors for AMD include:

• Smoking
• High blood pressure
• Use of thyroid hormones and antacids
• Use of diuretics or presence of arthritis
• Farsightedness
• High body mass index, a measure of obesity

The Academy encourages those over 50 to see an ophthalmologist for a comprehensive, dilated eye examination every one to two years to help ensure that AMD and other vision-threatening conditions are detected and treated early.