Macular Degeneration (AMD)

The eye doctors and Houston retinal specialists at The Eye Clinic of Texas offer diagnosis of age related macular degeneration (AMD) as well as treatment of AMD with Lucentis® Injections. Macular Degeneration is an incurable eye disease and is the leading cause of legal blindness for those aged 55 and older in the United States, affecting more than 10 million Americans in some fashion. Your chances of developing Age Related Macular Degeneration (AMD) are directly related to your age. The older you are, the greater the chance that Macular Degeneration will affect you. The Macula is responsible for providing central vision which is the sharpest or clearest area of your vision and is required for activities such as for driving, seeing fine detail of faces, reading and recognizing colors. 

Dry Macular Degeneration

Dry Macular Degeneration is the most common type of Age Related Macular Degeneration. makes up approximately 85-90% of cases of Macular Degeneration. If you have Dry Macular Degeneration, during the examination of your retina we will see small, yellow colored deposits between the retinal layers, which are called Drusen.

Dry Macular Degeneration results in a slow, gradual progressive “dimming” of your central vision. Many people 50 years of age or older begin to display some Drusen as they age. If you have Drusen, you may be asked to schedule eye examinations more frequently in order to monitor them as there is some possibility that Dry Macular Degeneration will progress to Wet Macular Degeneration over a period of time. Thus people with Dry Macular Degeneration, even without any noticeable change in vision, need to be followed closely as Wet Macular Degeneration has far more serious consequences for vision loss. 

Clinical Image - Dry Macular Degeneration

Wet Macular Degeneration

Wet Macular Degeneration only accounts for about 10-15% of cases and results from an abnormal growth of new blood vessels under the retina, called neovascularization. These are unusually weak and fragile and are prone to be leaky and can easily break and bleed. If leakage occurs, the Macula may actually begin to swell. If the new blood vessels break and bleeding occurs, it can result in scarring as it heals. Scarring of the Macula can cause severe loss of central vision, which may be irreversible.

Clinical Image - Wet Macular Degeneration

It is often possible to detect early signs of macular degeneration during your regular eye examination. Scheduling regular eye exams is an excellent way for the eye doctors at The Eye Clinic of Texas to make an early diagnosis of macular degeneration. It is also important that you become familiar with the symptoms that may indicate the early presence of macular degeneration. If at any time you experience “distortion” or “twisting”, “shadowing” or “bending” of objects in your vision, you should schedule an appointment at The Eye Clinic of Texas immediately. Be sure to let the receptionist know that you are experiencing these symptoms. If you are over the age of 40-45 and you have a family history of Macular Degeneration, we recommend that you have a thorough eye examination, including a dilated retinal evaluation, each year. Please be sure to tell our staff if you have a family history of macular degeneration. During your eye examination, eye drops will be put in your eyes to dilate your pupils in order to carefully examine the macula and retina using various types of instruments and sources of high magnification. In order to most precisely diagnose Macular Degeneration, it may be necessary to take detailed color photographs of your Macula and retina taken as well as a Fluorescein Angiogram which uses a series of photographs taken in rapid succession using a high-speed digital retinal camera after a dye has been injected in your arm. Fluorescein Angiography gives our retina specialists a great deal of information regarding whether certain types of treatments such as Lucentis® Injections might help stabilize your vision and prevent vision loss. We may also need to perform OCT or “optical coherence tomography” digital imaging to create a contour map of the retina and macula and detect microscopic changes in thickness or the accumulation of fluid beneath the retina or macula. 

Today, thanks to the advances in treating Wet Macular Degeneration, if caught early, it may be possible to avoid suffering significant vision loss. Researchers discovered that a specific protein called “Vascular Endothelial Growth Factor” (VEGF) causes the growth of new blood vessels or “neovascularization” to occur in the eye. Drugs that can be injected into the eye in order to slow or stop the growth of new blood vessels such as Lucentis® are available with specific indications to treat Wet Macular Degeneration.

Lucentis® Injections are intravitreal injections-that means an injection that is placed directly into the Vitreous of the eye. Generally they need to be repeated every four to six weeks. Clinical studies of these anti-VEGF Injections indicate that when given to patients who have evidence of new blood vessel formation monthly, over 90% of patients will maintain their vision.

Clinical Image -Macular Degeneration

Studies indicated that people who have a diet that is rich in fruits and vegetables-particularly green leafy vegetables-have a considerably lower incidence of Macular Degeneration. The Age Related Eye Disease Study (AREDS) demonstrated that taking high levels of antioxidants and Zinc could reduce the risk of developing Age Related Macular Degeneration by about 25%. This is not a cure, but we need to consider this information as a possible way to help patients who are at risk for age related macular degeneration prevent vision loss.

Before patients begin taking any course of vitamin or antioxidant supplements, you should fully discuss the risks and benefits with your eye doctor who in consultation with your family physician or Internist, will determine whether this is safe and effective for you to try.