By Dr. Domenic Turco

Nonexudative age-related macular degeneration, also known as the “dry” type of macular degeneration, is the most common type of macular degeneration.  The hallmark finding of this type of macular degeneration is accumulation of drusen in the central macula as well as changes to the pigment epithelium of the retina, ultimately culminating in atrophy (also called geographic atrophy) and breakdown of the central macula which can reduce central visual acuity.  The most common form of management of this nonexudative form of macular degeneration has been through the use of oral vitamins, known as AREDS vitamins, of which the most recent and most common is the AREDS 2 formula.  Their use has traditionally been to prevent worsening of disease in patients with intermediate to advanced disease, but they have not been shown to reverse damage that has already accumulated.

Patients often ask if there are any other treatments for nonexudative macular degeneration, and even though there isn’t anything other than AREDS 2 vitamins currently, there are several other treatments being researched for use in the general population.  There are two drugs currently in phase 3 trials, pegcetacoplan and avacincaptad pegol, that are designed to work on decreasing the rate of growth of areas of geographic atrophy.  These drugs are delivered inside of the eye through an intravitreal injection.

Another promising potential new drug is one that has been used for many years in drop form for treatment of glaucoma-brimonidine.  They are studying injecting brimonidine on a biodegradable intravitreal implant into eyes to try to slow the rate of growth of geographic atrophy.

Lastly, researchers are working on implanting stems cells, known as induced pluripotent stem cells, into the retina on a scaffold in an effort to stop the photoreceptor cells from dying.  This novel treatment is currently in phase 1 trials but has very promising potential.

Preparing for Your Eye Examination

By Dr. Jill Finke

New experiences can sometimes make us feel nervous, but knowing what to expect can help put our minds at ease. When you have an eye examination, the goal of the exam is to assess your vision as well as your eye health. Additionally, an eye exam can help to detect eye and general health problems before you may notice their effects.

Because your eye health is linked to your overall health, your exam will include gathering information about your current medical conditions, your current medications, as well as you and your families’ medical histories. The best way to share this information with your doctor is to complete our patient paperwork. Our office would be glad to send your forms to complete in advance of your appointment.

In addition to bringing a list of your current medications and supplements to your exam, your eye doctor can also learn more about your visual health when you bring your past pair of glasses and/or contact lenses and boxes. Measuring your vision with what you currently use can help your doctor to assess how to maximize the clarity of your eyesight.

Maintaining healthy eyes is essential to maintaining clear vision. Therefore, your doctor will also assess your ocular health at your examination. By completing simple testing of how your eyes respond to light, measuring the pressure inside of your eyes, and observing the eye structures, your doctor can assess your eyes for common eye diseases and conditions. Your doctor may also recommend eye dilation at your appointment.

Eye dilation occurs when eye drops to widen your pupils are instilled into your eyes. This dilation allows your pupil size to increase temporarily so that the doctor can have a more complete view of the inside of your eyes. Eye dilation can make your vision slightly more blurred for a few hours, however, most people find this effect to be mild.

In summary, an eye examination is essential to maintaining visual clarity and detecting eye diseases and even general health problems before you may be aware a problem exists. Regular eye examinations as recommended by your doctor are valuable in maintaining a lifetime of health vision. And if you have vision changes, eye discomfort, or eye conditions you would like to know more about, your eye doctor is here for you.

Age-related Macular Degeneration

By Dr. Domenic Turco

Macular degeneration is an umbrella term for diseases that affect the macula—the location in the retina responsible for your central vision.  Age-related macular degeneration (ARMD) is one of the most common types of macular degeneration and affects almost 10% of the world’s population ages 45-85.  Aside from increasing age, other risk factors for ARMD include positive family history, smoking history, high blood pressure, high cholesterol, obesity, and having a diet high in saturated fats.

There are two types of ARMD—non-exudative and exudative.  Non-exudative, which is commonly referred to as the “dry” form of macular degeneration, is the more common form and is seen in about 80% of patients with ARMD.  Exudative, also called the “wet” form, is less common but nonetheless can cause significant central vision loss.

There is unfortunately no cure for ARMD.  The non-exudative form is generally managed by taking oral medications with special ingredients called the AREDS2 formula which includes vitamins C and E, lutein, zeaxanthin, zinc, and copper.  The exudative form is treated in many cases with injections of medications into the eye called anti-VEGF agents.  These injections help to reduce leakage of blood vessels which can lead to fluid accumulation within and underneath the retina.  Although the central vision is affected in both forms of the disease, patients maintain their peripheral vision.  In many cases, patients learn to adapt to their new level of vision, sometimes with the help of low-vision aides, to maintain the ability to perform their daily visual functions.

It is important to have regular eye exams as you age, especially if you have a family history of significant eye disease.  If you have any questions regarding your eyes or vision, please call our office for a consultation.

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