Currently, 11 million people in the United States are diagnosed with macular degeneration.
With macular degeneration, you might see the clock’s numbers but not the hands
Macular degeneration is the leading cause of irreversible severe vision loss and blindness.
By 2050, it is projected that the incidence of diagnosed macular degeneration will double to 22 million. The prevalence of this disease may be more than we know. Recent reports reveal that approximately 25% of patients after having a dilated eye examination had macular degeneration that was undiagnosed.
Sadly, by the time patients are diagnosed with macular degeneration, 78% have already suffered irreversible vision loss. Early detection of macular degeneration through a reliable eye care center with the latest diagnostic tools is essential to retaining healthy vision.
Texas Macular Degeneration Associates, Inc.
in coordination with the Eye Doctor’s Office offers the most advanced testing tool for early detection of macular degeneration: the AdaptDx.
We are proud to be among the first eye care practices in North Texas who have access to this new diagnostic technology. We can detect signs of this dreadful disease up to three years earlier when compared to a routine eye examination.
In addition to our technology, our optometrists, Dr. Bob Consor and Dr. Jennifer Nguyen, are part of a team of affiliated off site ophthalmologists and retinal specialists associated with:
- Texas Retina Associates,
- The Retina Foundation of the Southwest Dallas Texas
- Primary care physicians
- Medical sub-specialties
Through our affiliation, we provide our patients with the most comprehensive eye exam utilizing the latest in eye care technology for the detection, management, and treatment of macular degeneration.
Earlier detection of this very serious eye disease means earlier treatment for ultimately better patient outcomes. By taking advantage of new, innovative technology, we can provide earlier prognosis for acular degeneration and prevent visual acuity loss.
Early Detection Benefits Patients of Any Age
Although macular degeneration is more common in patients above the age of 50, the disease can occur even in younger patients. Not only can the AdaptDx detect early signs of macular detection, we can further evaluate each of our patients risk factor for the disease with new advances in genetic testing. We've developed treatment plans in the form of nutritional supplements and lifestyle changes to minimize the effects of macular degeneration and other diseases to improve the quality of one’s life and preserve theirvision.
What are the early signs of Macular Degeneration?
One of the earliest symptoms of macular degeneration is impaired night vision or dark adaptation.
Impaired dark adaptation is the first detectable consequence of macular degeneration and can be used to identify patients with subclinical disease.
The definition of subclinical is before any eye doctor can physically see the disease on a routine examination. Dark adaptation impairment can be present up to three years before macular degeneration shows up in a routine clinical eye exam.
The macular zone (the center of the retina) is rich in photoreceptors called rods that provide us with quality night vision. When the rod cells become compromised and sick, they cease to function effectively causing visual disturbances in low levels of illumination. The AdaptDx measures the integrity, sensitivity and the ability of the rod photoreceptors to detect visual stimuli in a dark environment. This is called dark adaptation hence the name of the instrument, AdaptDx.
What to Expect During an AdaptDx Test
Fast & Effective: AdaptDx Technology
The test takes up to six minutes per eye.
First, your eyes are exposed to normal illumination. Then, you look in to the AdaptDx which simulates a dark environment. You are finally asked to recognize light stimuli at various intensities using a hand held response button. The test is non-invasive.
The entire test is conducted in a darkened room with the patient’s chin and forehead resting on comfortable supports similar to those on other eye care instruments.
What Does This Test Feel Like?
Just imagine going to the movies on a bright sunny day. As you leave the sunny outdoors and enter the dark theater, your vision slowly adapts to the darkness of the theater. That’s called dark adaptation.
However, macular degeneration impairs this process, which is referred to as impaired dark adaptation. The recovery time for your vision to transition from daylight to darkness is the only biomarker of age-related macular degeneration and is one of the earliest symptoms of macular degeneration that can be detected.
In clinical studies involving more than 1,000 patients, AdaptDx has proven to be 90% sensitive and 90% specific for the presence of macular degeneration. The clinical studies were conducted at renowned research centers, such as Harvard University, Duke University, the National Eye Institute, and the University of Alabama at Birmingham.
Another early marker of macular degeneration are Drusen.
Drusen are yellow spots around the macular representing sick impaired rod photoreceptor cells.
By the time drusen appear on the retina, unfortunately, this indicated advanced macular degeneration and impaired dark adaptation after many years, which likely went undetected during a routine eye exam.
Drusen are typically caused by macular degeneration, and by the time that macular degeneration related drusen are noted clinically in the examination chair, 78% of those patients have already experienced vision loss.
What Are Drusen?
Drusen are yellow deposits in or around the macular zone, which appear as the yellow spots on the retina. Drusen are the by-products of sick Retinal Pigment Epithelial cells (RPE)
- Retinal pigment epithelial cells are the outermost layer of the macula
- When the RPE cells become ill, they deposit locally generated cholesterol beneath the RPE cell layer (In Bruch’s membrane) before Drusen are formed
- As macular degeneration progresses, cholesterol will continue to accumulate. When these focal areas of cholesterol are sufficiently thickened to be identifiable on the surface of the retina, they are referred to as drusen.
This cholesterol accumulation causes three primary insults to the macular and retina
- Oxidative stress
- Disruption of oxygen and nutrition supplied to the outer retina.
Impaired dark adaptation is the first detectable consequence of AMD and can be used to identify patients with subclinical disease.
Who Should Be Concerned About Macular Degeneration
We feel that everybody should be concerned and aware of the risks and methods to prevent macular degeneration, especially:
- Close family member(s) diagnosed with macular degeneration
- Smoked Cigarettes or tobacco products in the past
- Secondary smoke inhalation
- Hardly wore polarized sunglasses
- Experience night vision problems
- Experience distorted vision
- High blood pressure or hypertension
- Elevated cholesterol
- People who don’t exercise
- Deficient in vitamins & minerals (primarily found in green, leafy vegetables)
The Importance of Early Detection
The goal of managing macular degeneration is to preserve visual function, including but not limited to visual acuity. To achieve this goal early detection, monitoring and treatment must be practiced. Texas Macular Degeneration Associates eye care practitioners, Bob Consor OD and Jenifer Nguyen OD have a deep understanding of the causes, detection and management of this serious vision threatening eye disease that not only affects vision but the quality of life. They are dedicated to a continuance of their education and the investment in the latest technology in diagnosing and management of macular degeneration. Along with a support team of affiliated Ophthalmologists and retinal surgeons they are part of an eye care team that works together through common knowledge and inter-referral to provide you with the best of care and outcomes.
- Eye doctors nationwide are missing in the detection of macular degeneration in the course of an examination 25% of the time.
- Currently doctors are not carefully looking or have not embraced some of the new innovations in technology to look for and find the early subclinical (before detectable in an eye examination) and clinical signs.
- Many are too passive in treating when diagnosing macular degeneration. One reason is that in the very early stages of the disease vision is not affected except for night vision.
- Dry macular degeneration is not diagnosed until patients present with drusen (see paragraph above) and visual acuity loss. By this time the patient has probably had macular degeneration for years and has lost some of the potential benefits of early detection.
- There is no cure for macular degeneration and the goal is to halt or slow the disease progression. Early detection allows for early treatment, which leads to better patient outcomes. With proper care significant visual acuity loss and improved quality of life can be preserved in many patients.
Nutrition & Mediterranean Diet
This diet includes high intake of fruits, legumes, vegetables, nuts, seeds, and other grains; olive oil as the main source of monounsaturated fat; dairy products, fish, poultry, and wine in moderate amounts; and limited intake of red and processed meats.
Studies suggest that subjects who regularly consume a Mediterranean-like diet carry an overall lower risk of development of advanced AMD as compared to those who regularly consume a traditionally Western diet. A recommendation should be made that patients avoid traditionally “Western” dietary pitfalls (high glycemic index foods, high-fat dairy products, fried foods, and processed meats), and instead, follow healthier eating styles like the Mediterranean diet.
Control Your Cholesterol
Elevated cholesterol can contribute to macular degeneration in the form of drusen. (see drusen topic above)
Take Nutritional Supplements
Multi-vitamins and other nutritionals like AREDS-2 OTC supplements and Omega fatty acids like fish oil.
Treatment for Macular Degeneration
Treatment should commence the moment an eye doctor first detects MD regardless of the stage it is in. We've shared below part of the overall treatment plan & prevention for macular degeneration.
Stop smoking and stay away from smoke filled environments. Smoking increase your risk by two to five times and causes oxidative cellular damage that can contribute to the development of macular degeneration.
Studies showed a beneficial effect of high doses of antioxidant vitamins (C, E, Lutein, Zeaxanthin) a low dose Zinc (25mg) supplementation and Omega 3 fatty acids. These supplements reduce cellular stress and oxidation caused by inflammation.
A body mass index of (BMI) greater than 30 has a 2.5 times increased risk of developing MD. Any exercise is good from brisk walking, yard work or going to a local gym. Just do something to increase your heart rate but be sure to check with your medical doctor first.
Intake a lot of green leafy vegetables (the greener the better), fruits, nuts, olive oil and healthy fats like eggs. A low fat Mediterranean Diet is a good example (see below). A person with a body mass index greater than 30 has a 2.5 greater risk of developing macular degeneration.
Always wear sunglasses outdoors, ultraviolet rays cause macular degeneration and other eye diseases
Visit your eye doctor at least once a year or sooner if advised and control any medical diseases you are being treated for, as many diseases of the body carry and increased risk of macular degeneration.
If you were given an Amsler Grid by your eye doctor please use it as directed. It can help to detect early subtle changes in macular degeneration.
Dr. Bob Consor & Dr. Jennifer Nguyen often prescribe Blue Blocker anti-reflection treatment for prescription lenses. Blue Blocker lenses help protect patients from the low wavelength (400-495nm) blue portion of the visual spectrum emitted by LED screens that can cause damage to the macula, cause visual disturbances and eye fatigue.
Studies indicate that blue light exposure has a role in the cause of macular degeneration from damage to the rod photoreceptors.
There are non-modifiable risk factors that still should be considered—namely genetics. Genetic testing is currently available and being refined to identify and manage macular degeneration earlier. Knowing the outcome of treatments of relatives who have had MD will better prepare eye doctors to treat other family members. We plan to soon offer genetic screenings. We also work with and refer patients to the Retina Foundation of the Southwest in Dallas for research and management in select cases.
Eye Injections (Anti-VEGF Therapy) are reserved for a severe advanced form of macular degeneration called wet macular degeneration. Although often times beneficial for some patients to stop the inflammation and minimize the growth of unwanted blood vessels in the macular area, Injections are currently used in select cases. Our office works closely with retinal specialists at Texas Retina Associates of Dallas in the medical management of wet macular degeneration.
Currently, there is no cure for Macular Degeneration (MD).
The management of MD has two primary goals
- Preserving vision preventing progression to more advanced MD
- Effectively detecting and managing wet MD (Choroidal Neovascular Membranes)
Achieving these goals will allow the patient to enjoy additional years of high-quality central vision, enhancing the odds of a better quality of life. Since people are living longer early diagnosis and consistent, aggressive management of the disease is required to minimize risk of vision loss.
The importance of following your doctor’s orders to return for follow up care and monitoring cannot be overstated. The management of macular degeneration by your eye doctor is crucial to maintaining and prevention of permanent vision loss.