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Dr. Hibberd  

Are There Any New Treatments for Macular Degeneration?

Tuesday, March 23, 2010 8:11 AM

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Question: Is there anything new for dry macular degeneration? I've been told that my only hope is that it will progress to wet and will then be operable.

Dr. Hibberd's Answer:

Macular degeneration is an eye disorder that causes a loss of vision in the central field, while the peripheral vision remains undisturbed early on. Risk factors include smoking, excess unprotected sunlight exposure, race (white), genetics, high cholesterol, obesity, oxidative stress, high fat diets, and hypertension.

The retina contains photoreceptors that translate visual stimuli to a nerve impulse. The choroid lies behind the retina and contains the retina's blood supply.

In dry macular degeneration, cellular debris accumulates with yellowish deposits between the retina and choroid, forcing a distortion or even a retinal detachment. This causes loss of photoreceptors. The detachment is repaired and prevented from expanding by laser treatment.

Wet macular degeneration is often more severe with blood vessels growing and proliferating abnormally between the choroid and the retina. It can also cause retinal detachment. Laser treatment will limit the detachment and shrink back the excess blood vessels. It can be treated by specialized medication injected carefully into the vitreous of the eye. These anti-angiogenic medications are expensive ($2,000 per treatment), often painful, and usually need to be repeated monthly.

Now, I'm sure you do not want to convert to wet degeneration, even though some patients with the anti-angiogenic treatment have seen regression of their disease, although at a significant investment of time, money, and suffering. Generally the dry form is not as aggressive.

Advanced macular degeneration of either type may result in significant vision loss but not usually total blindness. Retinal detachment may result from either form of macular degeneration, and may result in total vision loss in the affected eye if left untreated.

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