Download Macular Degeneration

Macular Degeneration
John Fontenot
Bridget Deckard
Miriam Rios
Brianne Korth
Trenton Adkins
What is Macular Degeneration?
MD is a disease that occurs in the macula, (small
area in the retina). When the macula is damaged,
central vision may be blurry, with dark or
distorted areas.
 MD affects the ability to see near, far and can
make near acuity tasks almost impossible.
 MD usually does not affect the peripheral
vision.

Risk Factors

Being over the age of 50 years old
◦ Cells in the retinal pigment epithelium (RPE) deteriorate with age and lose
pigment, making it less efficient in removing outer segment waste. Drusens,
(yellow fat-like deposits) begin to appear under cones and rods.

Having a family history of age-related MD
◦ Researchers have identified some genes associated with MD. Future genetic
screenings may be helpful for testing early risk.

Cigarette smoking
◦ Doubles risk of MD
◦ Single most preventable cause of MD


Abnormal cholesterol levels
Deposits under the retina (drusen)
◦ Usually do not cause vision loss alone, but when there is a large
number or size of them, there is more of a risk of age-related MD.
Mayo Foundation for Medical Education and Research. www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=risk-factors
Age-related Macular Degeneration
In people over 50, MD may occur from aging.
Known as age-related MD, this is the most
common type.
 Free radicals are formed from reacting with
oxygen in the environment and can sometimes
damage cells. This is known as oxidative stress,
which is thought to contribute to the
development of age-related MD.
 Many people have genetic changes which make
them more prone to this cell damage.

Non-neovascular (Dry) MD


90 % of people with agerelated MD have the ‘dry’
type, which is caused by
damage from oxidative
stress. This results in
thinning of the macular
tissue, and vision loss is
usually gradual.
Causes difficulty adjusting
to changes in lighting. For
example, when walking
indoors from a bright
outdoor environment.
http://www.ernsteyehealth.com/index.cfm?content.display&pageID=107. 2010 Ernst Eye
Health Associates. Retrieved: August 4, 2010.
Neovascular (Wet) MD


10% of people with
age-related MD have
the ‘wet’ form, which
progresses quickly
and causes
significant vision loss.
The cause is
abnormal blood
vessels that form
underneath the
retina which leak
and blur central
vision.
http://www.sureeyes.com/cataract-surgery-chicago/macular_degeneration.htm. 2005. Sure Vision
Eye Centers. Retrieved: August 4, 2010
Symptoms of Macular
Degeneration
•MD
can cause many different symptoms in different
patients.
•Sometimes only one eye is affected first.
•When both eyes are affected, the loss of central
vision happens quickly.
•Vision loss is noticed when:
•
•
•
words on a page look blurred
a dark or empty area appears in the center
of vision
straight lines look distorted
Symptoms of Macular Degeneration
American Academy of Ophthalmology. The Eye M.D. Association, Jan 2004. Retrieved:
August 4, 2010. http://www.jaymulaney.com/eyediseases/maculardegeneration.html
Dr. Mike Li Optometry. www.drmikeli.com/photo_gallery. Retrieved:
August 4, 2010.
Stages of Macular Degeneration

Early Stage
◦ Several small drusen or few medium-sized drusen are detected
on the macula in one or both eyes. Generally, there is no vision
loss in the earliest stage.

Intermediate Stage
◦ Many medium-sized drusen or, 1 or more large drusen are
detected in 1 or both eyes. At this stage, your central vision may
start to blur and may need extra light for reading or doing a
detailed near task.

Advanced Stage
◦ Several large drusen, as well as extensive breakdown of lightsensitive cells in the macula detected. This causes a well defined
spot of blurring in central vision. Blurred area may become
larger and more opaque over time.
Mayo Foundation for Medical Education and Research. www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=risk-factors
Stargardt's Disease
Inherited form of Macular Degeneration that
affects children and young adults.
 The disease is thought to be passed to the
children from both parents carrying the gene
mutations that are responsible for Stargardts.

◦ Even though the parents may not have the disease themselves,
they can carry recessive genetic traits of it.
 5% of the human population carry gene mutations that cause inherited
retinal diseases like stargardts and retinitis pigmentosa. (Ophthalmology,
March 2004.)

Exposure to bright light was thought to trigger
retinal damage that leads to Stargardt’s.
All About Vision. Access Media Group LLC. 2000-2010. Stargardt’s Disease (Fundus Flavimaculatus). Marilyn Haddrill. Retrieved: August 5,
2010. http://www.allaboutvision.com/conditions/stargardts.htm
Progression of Stargardt’s.
Vision loss appears within the first 20 years of
life, more particularly in early childhood.
 There are many variations of Stargardt’s disease,
even in family members with similar inherited
tendencies.
 When measured on an eye chart, Stargardt’s
ranges from 20/50 to 20/200.
 Fundus Flavimaculatus is the most severe form
of the disease, but is not as quickly onset. It
usually occurs in middle life.

Symptoms of Stargardt’s Disease
•Blurry
or distorted vision
•Inability to see in low light environments
•Difficulty recognizing familiar faces
•Loss of color vision may occur in the late stages
Living with Stargardt’s Disease
There is no known treatment
 Patients are often advised to wear sunglasses with UV
protection to reduce farther damage from the sun.
 Special filters can be worn in eyeglasses to block out
certain wavelengths of light that may damage the eye.
 Low vision eye exams should be given annually, at least.
 Low vision counseling and services may be used to
accommodate the child in school and independent living.

References

American Academy of Ophthalmology. The Eye M.D. Association, (2010). Macular Degeneration A Closer Look.

Mayo Foundation for Medical Education and Research. (2008, August 26). Risk Factors. Retrieved from
www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=risk-factors

Li, M. (n.d.). In Dr. Mike Li Optometry. Retrieved August 4, 2010 from http://www.drmikeli.com/photo_gallery

American Academy of Ophthalmology. The Eye M.D. Association, (2004, January). Macular Degeneration. Retrieved
August 4, 2010 from http://www.jaymulaney.com/eyediseases/maculardegeneration.html

Ernst Eye Health Associates. (2010). Macular Degeneration. Retrieved August 4, 2010 from
http://www.ernsteyehealth.com/index.cfm?content.display&pageID=107

Sure Vision Eye Centers.( 2005) Macular Degeneration. Retrieved August 4, 2010 from http://www.sureeyes.com/cataractsurgery-chicago/macular_degeneration.htm

Haddrill., M.,& Thompson, V., Tufty, G. (2010). Stargardt’s Disease (Fundus Flavimaculatus). Retrieved August 5, 2010 from
http://www.allaboutvision.com/conditions/stargardts.htm