macular degeneration

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macular degeneration,

eye disorder causing loss of central vision. The affected area, the macula, lies at the back of the retina and is the part that produces the sharpest vision. The most serious visual impairment occurs when abnormal blood vessels form and leak serous fluid or bleed into the tissue of the macula, ultimately producing scar tissue. Peripheral (side) vision is unaffected. Onset may be acute with hemorrhage but usually is gradually progressive. Although some vision is retained, the ability to read, recognize faces, and drive a motor vehicle is greatly reduced. The condition is painless.

Macular degeneration is a major cause of vision impairment among elderly people. Although its underlying cause is unknown, it sometimes appears to run in families. Serious macular degeneraton, if diagnosed early, may have its progress stemmed by laser or photodynamic (cold laser and drug) treatment that closes leaking vessels. Antiangiogenic drugs, which inhibit the formation of new blood vessels, can be injected into the eye to stop degeneration and in some cases even improve vision. Sudden change in vision in someone over age 50 thus requires immediate medical attention.

Bibliography

See H. Grunwald, Twilight: Losing Sight, Gaining Insight (1999).

References in periodicals archive ?
Delage et al., "Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA study," Investigative Ophthalmology and Visual Science, vol.
Negi, "The association of age-related maculopathy susceptibility 2 polymorphisms with phenotype in typical neovascular Age-related macular degeneration and polypoidal choroidal vasculopathy," Molecular Vision, vol.
Curcio, "Apolipoprotein B in cholesterol-containing drusen and basal deposits of human eyes with age-related maculopathy," The American Journal of Pathology, vol.
(14.) Klein R, Klein BEK, Franke T: The relationship of cardiovascular disease and its risk factors to age-related maculopathy. The Beaver Dam Eye Study.
Multidisciplinary vision rehabilitation programs, including scotoma awareness and eccentric viewing training, have been shown to be effective in improving reading ability, the performance of activities of daily living, and the quality of life of persons with age-related maculopathy (Scanlan & Cuddeford, 2004).
Racial/ethnic differences in age-related maculopathy. Third National Health and Nutrition Examination Survey.
Plasma ad macular responses to lutein supplement in subjects with and without age-related maculopathy: a pilot study.
As the authors describe, two large trials (AREDS and the Vitamin E, Cataract, and Age-Related Maculopathy study [VECAT]) with long treatment duration and 4-6 years of follow-up, and six smaller trials with smaller sample sizes inform this meta-analysis.
Christen, Sc.D., of Brigham and Women's Hospital, Boston, and his coauthors tested whether p-carotene supplementation affected incident age-related maculopathy (ARM) responsible for a visually significant decrease in best-corrected visual acuity to 20/30 or worse.
The relationship of age-related maculopathy, cataract, and glaucoma to visual acuity.
Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk of age-related maculopathy. Arch Ophthalmol.