Age-Related Macular Degeneration Treatment
in Portland OR

What causes macular degeneration?

The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Deprived of nutrients, the retinal tissues begin to weaken and die, causing vision loss. Patients may experience anything from a blurry, gray, or distorted area to a blind spot in the center of vision.

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What are the symptoms of macular degeneration?

• A gradual loss of ability to see objects clearly
• A gradual loss of color vision
• Distorted or blurry vision
• A dark or empty area appearing in the center of vision

what are the types of AMD

There are two kinds of AMD: wet (neovascular/exudative) and dry (non-neovascular). About 10-15% of people with AMD have the wet form. “Neovascular” means “new vessels.”

Wet AMD

Accordingly, wet AMD occurs when new blood vessels grow into the retina as the eye attempts to compensate for the blocked arteries. These new vessels are very fragile, and often leak blood and fluid between the layers of the retina. Not only does this leakage distort vision, but when the blood dries, scar tissue forms on the retina as well. This creates a dark spot in the patient’s vision.

Dry AMD

Dry AMD is much more common than wet AMD. Patients with this type of macular degeneration do not experience new vessel growth. Instead, symptoms include thinning of the retina, loss of retinal pigment, and the formation of small, round particles inside the retina called drusen. Vision loss with dry AMD is slower and often less severe than with wet AMD.

how common is AMD?

AMD is the number-one cause of vision loss in the U.S. Macular degeneration doesn’t cause total blindness because it doesn’t affect peripheral vision. Possible risk factors include genetics, age, diet, smoking, and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.

How is macular degeneration diagnosed?

At The Eye Clinic, we conduct a thorough eye exam and review your medical history to start a diagnosis. From there, we may conduct these tests:

• Examine the back of the eye — After dilating your pupils, we use a special instrument (a slit lamp) to examine the back of your eye. We’re looking for a mottled appearance that’s caused by drusen, the yellow deposits that form under the retina. 
• Test for defects in your central vision — We will use an Amsler grid to test for defects in the center of your vision. This grid with a single dot in the center will be seen as a series of straight lines in normal vision. But macular degeneration may cause some of the straight lines in the grid to look faded, broken, wavy, or distorted. 
• Fluorescein angiography — After we inject a colored dye into an arm vein we use a special camera to take several pictures as the dye travels through the blood vessels in your eye. The images will show if you have retinal changes or abnormal blood vessels, which are a sign of wet macular degeneration. 
• Indocyanine green angiography — Like fluorescein angiography, this test uses an injected dye. It is usually used in tandem with that fluorescein angiography to identify the type of macular degeneration. 
• Optical coherence tomography — These imaging tests create detailed cross-section images of the retina. This helps identify areas where the retina is thinning, thickening, or swelling. These can be due to fluid accumulation from leaking blood vessels in and under your retina. 

What are the treatments for age-related macular degeneration?

There is no cure for age-related macular degeneration, but treatment with Dr. Wilkins and Dr. Donohue can slow the progress of the disease. There tend to be more treatments to address the abnormal blood vessels with the wet form than the drusen of dry macular degeneration.

Here are some treatment methods we may use at The Eye Clinic:

• Anti-angiogenic drugs — For wet macular degeneration, injections of these drugs are made into the eye. They stop new blood vessels from forming and block the leakage from already existing abnormal vessels. In some patients, these injections can allow them to regain some vision that has been lost. 
• Laser therapy — Lasers can be used to destroy the actively growing abnormal blood vessels, also from the wet form. Also, photodynamic laser therapy uses a light-sensitive drug that is activated to damage the abnormal blood vessels. 
• AREDS2 vitamins — Research from AREDS (Age-Related Eye Disease Study) has shown some success in reducing the risk for vision loss in some patients with intermediate to advanced dry age-related macular degeneration.
• Low vision aids — Magnification can be a key to maintaining independence. Special lenses or electronic systems can magnify nearby objects, especially smaller types. 

Can macular degeneration be prevented?

While there is no cure for age-related macular degeneration, there are things you can do to reduce your risk of getting the disease and suffering subsequent vision loss. Following these steps and others given to you by Dr. Wilkins and Dr. Donohue at The Eye Clinic are particularly important if you have a family history of AMD. 

Here are some steps to take to hopefully prevent, or at least slow the progression of, macular degeneration. 

1. Don’t smoke — Smokers are four times more likely than non-smokers to have macular degeneration. 
2. Eat plenty of dark, leafy green vegetables such as raw spinach — These foods are rich in carotenoids, which lower the risk of developing wet AMD.
3. Take a daily multivitamin — These fill in holes in your diet and help your eyes. 
4. Eat more fish or take a fish oil supplement — studies have shown that people over age 50 who eat fish at least once a week were 40 percent less likely to have beginning-stage AMD. Those who ate fish at least three times a week were less likely to have late-stage AMD.
5. Exercise regularly and maintain a healthy weight — Research has shown that people who live a healthy lifestyle and manage their weight were 70 percent less likely to have AMD. This isn’t some sort of unattainable exercise regimen, just walking at least two miles a day, three times a week, or the equivalent. 
6. Eat fruits and nuts daily — Studies have shown higher intake of fruits and nuts reduces the risk of wet AMD and they help slow the progression of early or intermediate AMD. 
7. Limit your intake of refined carbohydrates — Foods that cause a rapid increase in blood sugar and insulin release are thought to increase the risk of developing AMD.
8. Keep your blood pressure and cholesterol under control — High cholesterol levels and high blood pressure are both linked to a higher risk of many health problems, including AMD.
9. Have regular eye exams — The key to successfully managing age-related macular degeneration is early intervention to slow its progression. And the only way that can happen is if we see you in our St. Vincent offices regularly. The goal is every two to three years if you’re between 45 and 60 and every year if you’re over 60.

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Macular Degeneration FAQs:

Will age-related macular degeneration cause blindness?

Macular degeneration is the leading cause of severe vision impairment in adults over the age of 60. The patient’s vision decreases as the macula deteriorates. Early signs include blurred vision and trouble seeing color and fine details. As the macula is impacted to a greater extent you lose the central vision. 

Dry AMD tends to progress more slowly and can be managed more successfully by Dr. Wilkins and Dr. Donohue. Wet AMD is less common, but also more damaging. It is responsible for 90 percent of legal blindness from macular degeneration.

While a person will not become fully blind, meaning they no longer see any light, they will lose enough vision to become categorized as “legally blind.” To be legally blind in one eye, your vision is 20/200 or less. That means a person with normal vision could stand 200 feet away and see the object clearly, but the person with 20/200 vision would need to be only 20 feet away to see the object clearly. 

How long does it take to lose vision with macular degeneration?

The American Macular Degeneration Foundation recognizes three phases of macular degeneration: early, intermediate, and late. In the early stage, the patient may not have any noticeable symptoms or vision issues. In the intermediate stage, you’ll likely begin to experience difficulty with your central vision. In the late stages, you’ll have difficulty seeing clearly and surgery may be necessary. 

On average, it would take about 10 years for a patient to move from an initial diagnosis to legal blindness. 

Is macular degeneration hereditary?

Macular degeneration has a hereditary component. Researchers have identified several genes that are related to developing AMD. Other studies show your chances of developing age-related macular degeneration are three to four times higher if you have a parent, child, or sibling with the condition.

Patient Testimonials:

“I trust this clinic with my eyes for decades. The staff is caring. The doctors are all great and take their time for your concerns.” – S.N.

“Great clinic with compassionate, professional and very knowledgeable staff and MD’s. Patient for last 10 years. Have recommended and will continue to recommend this clinic for both simple and complicated ophthalmology care.” – S.A.

“I was visiting friends in Portland from out of town and I had an issue with a contact lens stuck in my eye. The clinic was able to take care of me, fit me in quickly, and took care of my problem and all of my worries. Dr. Wilkins was great, would highly recommend this clinic.” – G.M.

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Recent developments in ophthalmology allow doctors to treat many patients with early-stage AMD with the help of lasers and medication.

If you’re interested in learning more about macular degeneration treatment please contact us for a consultation at 503.297.4718 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.

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