Treatments
Because having dry AMD puts you at risk for developing wet AMD, you'll need regular vision tests (see on later). If wet AMD is caught early, the chances are better that it can be halted with laser surgery or a treatment called photodynamic therapy.
Lifestyle changes
Even though effective treatments for AMD are scarce, there is much you can do on the lifestyle front to preserve the vision you have:
In some people, nutritional supplements can help prevent AMD from progressing. The Age-Related Eye Disease Study (AREDS), a 10-year trial sponsored by the National Eye Institute in the US and
published in 2001, found that people with Intermediate-stage dry AMD who took high-dose antioxidants and zinc supplements every day reduced their risk of advanced AMD by about 25 percent. The benefit was found to be greater when both antioxidants and zinc were taken, rather than just one or the other.
To get this result, you'll need daily doses higher than you can get from diet alone or from ordinary multivitamins: 80 mg of zinc picolinate, along with the antioxidnats vitamin C (500 mg), vitamin E (400 U) and beta-carotene (15 mg). You should also take copper (2 mg) to counteract the tendency of large doses of zinc to interfere with copper absorption. Other research has shown that a diet rich in green leafty and bright-coloured vegetables, such as spinach, carrots and squash, may also be beneficial to eye health.
Supplements for lutein and zeaxanthin, which are both caroteniods like beta-carotene, are widely used by people with AMD, but their benefits in preventing or slowing down this ailment are still unproven. And taking beta-carotene in high doses (without other carotenoids) may actually increase the risk for a smoker to develop lung cancer.
Procedures
If you have wet AMD, your doctor may be able to use larger surgery to seal the leaking blood vessels under your macula. This outpatient procedure, known as laser photocoagulation, takes about half an hour and requires only local anaesthesia. However, it is recommended for only a small percentage of people with wet AMD. If your doctor can't see the leaking vessels, they are called occult (hidden) and laser photocoagulation is not an option for you. It is also not advised if the leakage has reached the central part of the macula (called the fovea), since the laser would damage that area.
The procedure works best on newly formed, well-demarcated vessels, clustered in a specific area. To locate the vessels, your doctor will use a procedure called fluorescein angiography, in which a dye called fluorescein is injected into your arm and circulates through your eyes. If you have this treatment, the laser will cause some vision loss, but less than if you were completely untreated. Such surgery can halt the progress of wet AMD, but it can't restore lost vision, and there is at least a 50 percent chance that the disease will recur. If this happens, it can be treated with more laser surgery.
EASIER READING AND WRITING
There are a number of simple things you can do to make reading a newspaper and writing easier on your failing eyes:
Medications
The first ever drug therapy for wet AMD was recently approved by the TGA. Here's how it works: a medication called verteporfin (Visudyne) is injected into your arm and absorbed by the abnormal blood vessels in your eye; then photodynamic thearpy (see above) is performed. In clinical trials using Visudyne, 67 percent of people found that their vision loss was halted after this therapy.
Because having dry AMD puts you at risk for developing wet AMD, you'll need regular vision tests (see on later). If wet AMD is caught early, the chances are better that it can be halted with laser surgery or a treatment called photodynamic therapy.
Lifestyle changes
Even though effective treatments for AMD are scarce, there is much you can do on the lifestyle front to preserve the vision you have:
- Monitor your eyes. You best defence against vision loss is to act promptly. See your eye doctor regularly and monitor your eyes at home with an Amsler chart, a piece of paper with a grid of black
- lines (ask your doctor for one). Cover one eye at a time so you can test each eye individually. If straight lines look way or there is a gap in the lines, call your eye doctor at once.
- Eat your fruit and vegetables. The old saying that carrots are good for the eyes is true. Studies have shown that a balanced diet rich in fruit and vegetables--especially those containing carotenoids such as beta-carotone and lutein--can help preserve eye health. This means eating foods of green, red, orange or yellow hue (tomatoes, corn, squash, kiwi fruit, oranges), as well as green leafy vegetables.
- Cut down on fat. A high total fat intake is associated with increased risk of AMD. This is especially true of animal fats but also includes the omega-6 fatty acids (found in vegetable oils). There's one exception: the omega-3 fatty acids in salmon, tuna, mackeral, and other fish may help preserve your vision.
- Keep up your health. High blood pressure is associated with AMD, so this gives you another reason to control your blood pressure and cholesterol levels. If you have diabetes, which can also affect eye health, continue your efforts to keep your blood sugar levels under tight control.
- Don't smoke. People who smoke are at a greater risk for AMD, and more likely to respond poorly to laser surgery.
- Avoid bright sunlight. When you go outdoors, wear sunglasses that absorb all UVA and UVB radiation and also shade your eyes with a wide-brimmed hat.
- Steroids may inhibit abnormal blood vessel growth in the eyes and halt progression of wet AMD, according to preliminary studie. Anecortave acetate, a modified steroid developed by Alcon Laboratories, is one candidate, another candidate is triamcinolone (kenalog).
- Drugs that prevent new blood vessels from forming, called anti-angiogenic agents, show evidence of being able to inhibit the growth of new vessels in the eyes. This would certainly help prevent wet AMD.
- Several experiments surgical procedures are very promising. One is called macular translocation, in which the macula is moved away from the diseased area of the retina to a healthier part. To restore lost vision, scientists are experimenting with transplantation of healthy cells into diseased retinas and implantation of a silicon chip that serves as a 'bionic eye'.
- Experimental new medicines have had starting results in stopping vision loss and in some cases actually restoring the vision of people with wet AMD. One of the drugs used is rhufab, may by Genentech. In people who had injections of this medication soon after they noticed AMD symptoms, most stopped losing their sight and from one-quarter to one-third experienced significant improvement in their vision.
In some people, nutritional supplements can help prevent AMD from progressing. The Age-Related Eye Disease Study (AREDS), a 10-year trial sponsored by the National Eye Institute in the US and
published in 2001, found that people with Intermediate-stage dry AMD who took high-dose antioxidants and zinc supplements every day reduced their risk of advanced AMD by about 25 percent. The benefit was found to be greater when both antioxidants and zinc were taken, rather than just one or the other.
To get this result, you'll need daily doses higher than you can get from diet alone or from ordinary multivitamins: 80 mg of zinc picolinate, along with the antioxidnats vitamin C (500 mg), vitamin E (400 U) and beta-carotene (15 mg). You should also take copper (2 mg) to counteract the tendency of large doses of zinc to interfere with copper absorption. Other research has shown that a diet rich in green leafty and bright-coloured vegetables, such as spinach, carrots and squash, may also be beneficial to eye health.
Supplements for lutein and zeaxanthin, which are both caroteniods like beta-carotene, are widely used by people with AMD, but their benefits in preventing or slowing down this ailment are still unproven. And taking beta-carotene in high doses (without other carotenoids) may actually increase the risk for a smoker to develop lung cancer.
Procedures
If you have wet AMD, your doctor may be able to use larger surgery to seal the leaking blood vessels under your macula. This outpatient procedure, known as laser photocoagulation, takes about half an hour and requires only local anaesthesia. However, it is recommended for only a small percentage of people with wet AMD. If your doctor can't see the leaking vessels, they are called occult (hidden) and laser photocoagulation is not an option for you. It is also not advised if the leakage has reached the central part of the macula (called the fovea), since the laser would damage that area.
The procedure works best on newly formed, well-demarcated vessels, clustered in a specific area. To locate the vessels, your doctor will use a procedure called fluorescein angiography, in which a dye called fluorescein is injected into your arm and circulates through your eyes. If you have this treatment, the laser will cause some vision loss, but less than if you were completely untreated. Such surgery can halt the progress of wet AMD, but it can't restore lost vision, and there is at least a 50 percent chance that the disease will recur. If this happens, it can be treated with more laser surgery.
EASIER READING AND WRITING
There are a number of simple things you can do to make reading a newspaper and writing easier on your failing eyes:
- Use adjustable lamps for close-up work.
- Position a book or newspaper on a reading stand and, when possible, get large-print publications.
- Make type look bigger with a magnifier lamp. Or consider a mobile electronic magnifier, worn like a pair of glasses. Another option is a closed-circuit television system designed to magnify and enhance type.
- Use bold-lined paper to help with writing, and stencils to guide cheque writing and envelope writing.
- If you're a computer user, try special screen display software or a system that converts computer text into sound.
Medications
The first ever drug therapy for wet AMD was recently approved by the TGA. Here's how it works: a medication called verteporfin (Visudyne) is injected into your arm and absorbed by the abnormal blood vessels in your eye; then photodynamic thearpy (see above) is performed. In clinical trials using Visudyne, 67 percent of people found that their vision loss was halted after this therapy.
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