Screening for Macular Degeneration

Tweet Age Related Macular Degeneration  (ARMD) is a common eye problem, and in some cases will progress to legal blindness, so where possible, we should try to nip it in the bud!

There are two types of ARMD, the so called "Dry" variety and the "Wet" type. The good news is that the early stages of ARMD don't usually cause any serious problems, and the other good news is that there are treatments now that can control the more serious "Wet" variety. But the "not so good" news is that there is no current cure for either types and no specific active treatment at all for the "Dry" variety!

The disease is caused by problems with the lining at the back of the eye where light entering the eye is turned into electrical impulses and transmitted to the brain in order to reach "consciousness".  In the direct "Visual Axis" of the eye where we do most of our seeing, there is an area known as the Macular, which is where there is a massive concentration of our light receptors. When these are damaged by ARMD, then we lose vision in that area - leaving a blanked out area smack bang in the middle of our vision!

Early detection is important and one of the tools that are used is the Amsler Grid.

Amsler Grid

 

By using this grid areas of distortion to our vision can be detected. If you wear glasses for reading then wear them whilst doing the "test". View the grid by holding it in your normal viewing position and cover one eye and stare at the central spot. In the normal situation the grid should remain a grid with all the lines straight and all of the grid visible. Further investigation may be necessary is

• Any of the lines look wavy, blurred or distorted.
• If any areas are missing or there are dark areas in the grid.
• If you cannot see all corners and sides of the grid.

And remember to test both eyes.

 

If you do notice a distortion then get a Specialist check up as you might have early stages of ARMD. For those who do test positive, there is a specific combination of Vitamins that you can take that may reduce the risk of progression by 25% - but discuss this with your treating Doctor.

For the more serious Wet ARMD, new generation drugs can control the disease, and can conserve sight - so please don't take any risks, get your eyes checked: they're very precious!
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Keeping an eye on the future

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Macular Degeneration (MD) is the leading cause of blindness in Australia with 1 in 7 people over the age of 50 being affected by it. In hard numbers this means that each year there are 17,700 new cases and the frequency of the problem increases as we get older. In the US the numbers are even more startling with over 7 million people suffering from the condition. The experts talk of Dry and Wet forms of the disease with the wet form being more amenable to treatment, and the dry form - the far more common one - having no effective treatment at all.

What we do know about MD is that it's hereditary with a 50% chance of developing in those with a strong family history. We also know that smokers are at three times greater risk of developing MD and may show signs of the condition 10 years earlier than non smokers: but quitting smoking for 20 years reduces the risk to that of the normal population. We might not be able to change our genetics, but we can stop smoking or make sure our children never smoke!

On the microscopic scale, the problem is one of "neuro-inflammation" caused by activation of Microglial cells, inflammatory cells in charge of cleaning up dead and dying material in the eye. Enter Mayo Clinic ophthalmologist Raymond Iezzi, M.D and his colleagues who worked with Nano-engineers to develop a Nano-particle called a Dendimer, that has enabled them to deliver Steroids to the retina and reduce the inflammation. According to Dr Kannan, a collaborator of Dr Iezzi, "The activated Microglia in the degenerating retina appeared to eat the Dendrimer selectively, and retain them for at least a month. The drug is released from the Dendrimer in a sustained fashion inside these cells, offering targeted neuroprotection to the retina."

Predictably, all the work so far has been done on rats, and researchers are not suggesting that this is a cure but offers the prospect of good control. If, as hoped, the results are reproduced in humans, then this will be an enormously relief for everyone who hopes to live beyond the age of 50!
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