The macula is a part of the retina that gives you your central vision ie: the ability to see faces, read and write. Macula degeneration or ARMD (age related macula degeneration) is an ageing change at the back of the eye due to ‘wear and tear of the macula’. This results in a grey / black blob or smear in the centre of your vision resulting in the inability to read or recognise peoples faces. It can also cause distortion, that is straight lines appear wavy.
There are two main types of ARMD – dry and wet.
The dry form is literally wear and tear ie the macula actually thins out. Of the two forms this is the less severe and more slowly progressive. There is however no treatment as yet, but there are some promising drugs in trial phases at the present.
The wet form causes much more severe and rapid vision loss. It is due to scar tissue forming beneath the retina at the macula. This scar can leak or bleed resulting in disturbance and loss of function of the macula. This is now treated with Anti -Vegf drugs such as Lucentis, Eylea and Avastin. These drugs have been shown to halt progression of wet macula degeneration in up to 90% of patients with up to 30% gaining some vision. Treatment is performed by intravitreal injection ie; injections into the eye. This consists of 3 loading injections a month apart, followed by further injections as needed or as part of a Treat and Extend protocol. Successful treatment is aided by early detection. It is therefore imperative for you to seek urgent assessment if you notice any loss of central vision or distortion. For further information try one of the links provided on the Links page.
The macula service at The Croft Shifa Health Centre (Rochdale CATS) and North West Macula service, currently provide some of the best visual outcomes in the country.
There are a number of promising treatments being developed for all forms of ARMD. Hopefully we will have more information in the future.
Nutrients and ARMD:
There have been two significant studies called the AREDS 1 and 2 studies which showed that the use of mineral supplements could reduce the risk of development of ARMD in at risk groups. There are many supplements available such as:
Occuvite preservision (Bausch and Lomb). Occuvite complete.
Retenere: This is the ONLY supplement that is approved to be prescribed by a medical practitioner
The current recommended daily formula (www.rnib.org.uk) is:
500mg Vitamin C
400iu Vitamin E (equivalent to 270mg)
2 mg Zeaxanthin
25mg Zinc (up to to 80mg)
2 mg copper (cupric oxide)
If you wish to find out more information then contact my secretary to make an appointment. Due to NHS constraints some of these are only available from your pharmacist.
Smoking, Diet and wet AMD :
There is a very strong association with smoking. Patients are advised to seek help in smoking cessation.
Eat plenty of dark, leafy greens rich in carotenoids such as spinach, kale and collard greens.
A well balanced ‘5 a day’ diet will help prevent macula diseases.