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Age Related Macular Degeneration

 

As we age it is normal for our retina to lose some of its sensitivity over time. Some of us experience an above normal rate of decline in our central vision, called Macular Degeneration ( also known as ARMD - Age Related Macula Degeneration, previously known as SMD - senile macular degeneration or AMD). ARMD is devided into two main types, dry macular degeneration and wet macular degeneration.

 

 

 

Dry macula degeneration has 2 main subtypes, Drusen based and Atrophy based. In Drusenoid macula degeneration there is a gradual accumulation of the various waste products from the process of seeing in the retina at the level of the Retinal Pigment Epithelium which lies just underneath the photo-receptors. the presence of these drusen deposits can disrupt the normal regular spacing of the photo-receptors and distort our central vision. This process is normally slow and currently the only proven way to attempt to slow down the progression of this build up is to take an antoxident vitamin/mineral supplement such as Visionace (this is available from our on-line shop).

The other form of age related macular degeneration is called Atrophic Macular Degeneration. In this type the photoreceptors and their pigments waste or atrophy away, thereby reducing macular sensitivity. There is research at present to see if taking oral supplements of these pigments helps reduce the speed at which they leach out of the retinal tissues.

There is at present research into a new treatment called Fenretinide which may have potential to stop dry macular degeneration from progressing. An american eye surgeon, from the University School of Medicine, New York, Jason Slaker, presented a paper on Fenretinide, which showed that in his sample Fenretinide reduced the liklihood of dry macular degeneration converting to wet macular degeneration by more than 50% . According to Dr Slaker, Fenretinide works by removing the lipofusin and vitamin A metabolites that build up within the retinal tissues. In the study after 6 months the growth of atrophic are related macular degeneration was only half as much as in the control group who were taking a placebo. After 2 years, 22% of those taking the placebo had progressed to wet macular degeneration compared to 13.5% of those taking Fenretinide*.

*Currently the clinical trial of Fenretinide has been suspended due to manufacturing processes.

Certain of these waste products that build up in the retina can now be picked up much earlier than previously by a technique called Autofluorescence Photography. Matheson Optometrists are working with retinal camera developers to develop a camera system for this purpose. When Lipofusin in the retina is illuminated with a particular wavelength of visible light, usually a greenish-blue colour, it fluoresces, or glows with a different wavelenth of light. By the clever use of exciter and barrier filters, it is possible to photograph this emmitted light of different colour, which gives us a measure of how much lipofusin is present in the retina.

Currently, the most efficient way we can detect and monitor Macula changes is the use of our Ocular Coherence Tomography equipment. Please click here for more information.