Retinopathy

What is Diabetic Retinopathy?

The central portion of the retina directly opposite the lens is called the macula. It enables us to see fine detail and color. In macular degeneration, the light sensing cells of the macula malfunction and may over time cease to work.

Macular degeneration occurs most often in people over 60yrs old, in which case it is called Age-Related Macular Degeneration (ARMD). Less commonly are several hereditary forms of macular degeneration, which usually affect children or teenagers.

With increased longevity worldwide, macular degeneration is the leading cause of blindness. A study done by National Eye Institute showed that one out of five people between the ages of  65 to 74. One of three people over age 75 in this country will suffer some visual impairment due to Macular Degeneration.

Types of ARMD?

The dry form of ARMD develops and progress slowly over a period of 10 years or longer. The less prevalent, wet type of ARMD is characterized by the ingrowth of new blood vessels from the choroid. Wet ARMD progresses much more rapidly, over a period of weeks or months, and usually results in legal blindness in the central portion of the visual field.

 

How do you evaluate ARMD?

Clinical examination, coupled with fluorescein angiography, optical coherence tomography and in some cases, indocyanine green angiography are the tests used in finding out the type of  ARMD, its prognosis and outcome.

 

Will it eventually affect the opposite eye?

While there is no cure for glaucoma, elevated IOP is currently the only treatable risk factor. It is important to treat aggressively with the most effective products such as prescription eye drops that can provide maximum reduction of the elevated IPO with long-term control. In some cases, surgery can also help.

It is important for patients to use medication as prescribed and maintain regular examinations with an ophthalmologist who can evaluate glaucoma progression and treatment options.

 

Risk factors associated with ARMD?

The strongest risk factors are:

  • The incidence of all forms of ARMD rises steeply with advancing age. In one large study, ARMD increased from approximately 4% of individuals at 43 to 54 years of age, to 23% in those 75 years or older.
  • Pigmentary changes in the macula are considered to be diagnostic of early atrophic ARMD.
  • The incidence of both wet and dry ARMD has strongly correlated a history of smoking.The degree of risk is proportional to the amount of cigarette consumption.
  • Genetic factors. Several studies have demonstrated a high rate of concordance in the development of ARMD among twins, particularly among identical twins. In family-based studies, the likelihood of developing ARMD is nearly 20 times higher if one or both parents have ARMD. It is highly likely that one or more gene alterations carried by the affected individual increase the susceptibility in his/her offspring.

 

How does diet influence macular

degeneration?

Several studies now indicate that diets rich in green leafy vegetables, such as spinach, chard and mustard greens, can reduce the risk of ARMD. These and other vegetables are rich in certain pigments known as carotenoids.

Among these, lutein and zeaxanthin are two that are highly concentrated in the macula where they may have effects that protect RPE and/or retinal cells from injury caused by the formation of peroxides and other toxic products of the visual cycle.

Lutein and zeaxanthin are now widely available as dietary supplements; however, their efficacy when consumed in this form has not been well studied.

 

What are the Treatments for Macular Degeneration?

20 years back, laser photocoagulation was used for the first time to treat ARMD. For the last 5 years, newer treatments, which are more effective, are coming up. The most commonly applied clinical approach to Age Related Macular Degeneration  which in some cases can slow the progression of the disease, but does not restore already lost vision are variable. This is possible with special laser called Photodyanamic therapy. Injections like Lucentis, avastin and  newer drugs inside the eye is also possible.

Know more about the treatment.

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