Q: My eye doctor diagnosed some early changes in my eye that may be the beginnings of macular degeneration. My mother had that and lost a lot of her reading ability over time. What can I do to avoid the same fate?
A:
You are right to be concerned, as most Age-related Macular Degeneration, called AMD, is genetically determined. There are steps you can take to lessen your chances of developing the same or similar retinal damage as your mother. And there are several “treatments” that are of little or no value.
First, most AMD begins in the early stages with changes deep in the retinal nerve layers. Today, we use optical scanning technology to actually “see” through the retina to find or diagnose those early warning signs. When the tiny blood vessels in and behind the retina leak, we can find evidence of serum or actual blood leakage with this diagnostic scanning. This is referred to as an “OCT scan”, and can be shown to you immediately after the scan is completed. This is a painless, in-office procedure.
Based on those results, we can better plan your treatment for prevention and/or treatment. The earliest changes can show us tiny accumulations of metabolic waste in the retinal layers, called “drusen”. Drusen may indicate progression for some patients, but not all. Often these early changes can be found before any noticeable vision change has occurred! We generally recommend more filtering of Ultraviolet light and blue light in glasses, and can provide an at-home screening tool to help patients identify early progression. Wearing these eyewear lenses full time is important.
Most oral supplements were studied in patients with “wet” AMD, meaning they already have signs of leakage in the retina. However, we often recommend the same supplements for patients with “dry” AMD, as we have no other clinically proven supplements for that milder version of AMD. These may include a widely available product called AREDs 2 Preservision, available at most pharmacies. We also recommend higher dietary levels of carotenoids to prevent UV-induced inflammation and possible progression. These include lutein, zeaxanthin, and meso-zeaxanthin. While these are available in green leafy vegetables like kale, spinach, and collard greens, most of us do not eat much of those. Contrary to popular belief, eating more carrots is not useful.
New wavelength-specific light treatments may also prove to be useful in slowing or preventing progression. These are new and not well proven yet, so stay tuned for more updates. Commonly used treatments for wet AMD and longer-term geographic atrophy (GA) are medications injected into the eye to slow the progression and protect your current vision quality. Generally, those treatments are only administered by a retinal specialist. Typically, your family eye doctor will refer you for such when indicated.
So be sure to see your family eye doctor each year, and be sure you are having the appropriate retinal examination performed with OCT scanning.