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The Medical Consumer:
Macular Degeneration

Age-related macular degeneration is an increasing concern for seniors and their caregivers—and for good reason.  According to researchers from Johns Hopkins University, 1.75 million Americans have developed this debilitating condition, now the leading cause of severe vision loss in people age 60 and older.  And as its name suggests, the chances of developing macular degeneration increase with age.  One in six Americans between the ages of 55 and 64, one in four between 64 and 74, and one in three over the age of 75 will develop this underlying causes of macular degeneration, though they know that heredity plays an important role.  Regardless of its cause, the effects of macular degeneration have been well documented.  Macular degeneration is a chronic disorder of the retina, the light-sensitive layer of cells at the back of the eye.  The macula is the portion of the retina responsible for perceiving fine detail and the central portion of your field of vision.

In the dry form of the disease, which accounts for 85 percent of all cases, waste products, called drusen, produced by photoreceptor cells in the retina accumulate in the tissue beneath the macula.  As a result, the light-sensitive cells in the macula begin to degenerate slowly over time.  Occasionally, people with the dry form of the disease progress to the wet form, which advances more rapidly and causes more severe vision loss.  In wet macular degeneration, new blood vessels appear under the macula.  These blood vessels leak fluid or blood, causing the central vision to blur.

Right now, there is no treatment for dry macular degeneration.  There is, however, an ongoing clinical trial of a technique called laser photocoagulation, a procedure normally used to destroy abnormal blood vessels that characterize the wet form of the disease.  The idea is to use low-intensity lasers to remove some of the drusen buildup. Studies have also shown that patients with advanced cases of dry macular degeneration can moderately lower the risk of developing the more severe wet form of the disease by taking a daily dose of antioxidant vitamins and zinc.

There have been several encouraging advances in treating the wet form of the disease.  On June 30, 2006, the Food and Drug Administration approved injections of Lucentis, a form of the colorectal cancer treatment drug Avastin.  Lucentis impedes new growth of abnormal blood vessels and shows promise of reversing the effects of macular degeneration, not just preventing vision loss.

The good news is that substantial resources are being devoted to finding more effective treatments for the disease, and progress is being made.  If your loved one has macular degeneration, check with their physician periodically about the availability of new therapies as well as clinical trials for emerging treatments.

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