Macular degeneration: What is it?

ARMD is a degenerative condition of the central portion of the eye. There are two forms of this Eye Disease: Dry ARMD and Wet ARMD. Dry ARMD is a slowly progressive condition. The vast majority of ARMD patients have the dry type.

The less common, but more visually debilitating type is Wet ARMD. This type is characterized by the formation of Choroidal Neovascularization Membranes (CNVMs), which is the formation of new, fragile blood vessels under the Retina. The Symptoms of ARMD will depend on its severity and type. Dry ARMD is less severe since it is not characterized by bleeding or leaking blood vessels.

Symptoms may include:

  • Gradual, painless distortion or loss of central vision
  • Distortion of straight lines
  • Blurred vision
  • Color distortion
  • Reduced Contrast Sensitivity and problems with glare
  • By contrast, severe central visual loss in Wet ARMD is often rapid. Experimental Treatments for ARMD primarily focus on the destruction of CNVMs, which is a sign of Wet ARMD.

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    The ideal treatment of the future will be able to arrest the disease at a stage before CNVMs develop; i.e., when it is Dry ARMD.

    Because of its greater threat to your vision, most FDA Approved ARMD Treatments have been created to stop the progression of Wet ARMD.

    Do you have a parent or grandparent with Macular Degeneration? Has he or she experienced debilitating vision loss? You probably have many questions about this Eye Disease, not least of which: What is the Cause of ARMD? What exactly is the Cause of Macular Degeneration is poorly understood, but contributing aspects of the visual system, genetic discoveries, and environmental factors have been implicated. An ARMD Cure is not currently available, but the prospect for its development may be closer than ever before. Due to the discovery of a relatively small number of genes that seem to have a large impact on the risk of developing ARMD, both diagnostic testing and treatments are being developed.

    Since the progression of ARMD is a process resulting from a combination of genetic predisposition and environmental risk factors, the treatment regimen, particularly for early stages of ARMD, centers on ARMD Prevention measures and early detection.

    ARMD risk factors include:

  • Increasing age
  • Smoking
  • Family History of ARMD
  • Caucasian ethnicity
  • Cardiovascular disease
  • Given the fact that ARMD is the leading cause of vision loss in the United States for people age 50 and over, the emphasis in research is on treatment. Treatment for those who have severe vision loss from Wet ARMD centers on stopping new vessel growth.

    A growing body of evidence suggests that Vascular Endothelial Growth Factor A plays an important role in the development of Neovascularization and the vessel leakage that leads to central vision loss. Lucentis® is a humanized monoclonal antibody fragment designed to bind and inhibit all forms of Vascular Endothelial Growth Factor A. Lucentis® administered in intravitreal injections every 4 weeks remains the gold standard for the treatment of Wet ARMD.

    Like Lucentis®, Avastin® binds to all isoforms of Vascular Endothelial Growth Factor A, but differs in size. The off-label use of intravitreal injections of Avastin® for Wet ARMD has occurred since May 2005. Because of remarkably good results, Avastin® use expanded quickly.

    There is an ongoing controversy in the Avastin® vs. Lucentis® choice to treat Wet ARMD and hopefully the results of the CATT study (Comparison of Age-Related Macular Degeneration Treatment Trials) will help settle the debate.

    Because of its greater threat to your vision, most FDA Approved Macular Degeneration Treatments have been created to stop the progression of Wet ARMD. However, Dry ARMD is the most common type of ARMD, accounting for over 80% of ARMD cases. It leads to a mild-to-moderate loss of sight, although Peripheral Vision is spared.

    Dry ARMD is a complex Eye Disease affected by multiple external/environmental factors and internal/genetic influences. The exact mechanism for the condition is not fully understood.

    Attacking Dry ARMD on four fronts (i.e., controlling visual cycle, complement inhibition, neuroprotection, and nutritional supplementation) may open the pathway to arresting and perhaps even reversing the vision loss caused by this multifactorial Eye Disease.

    Because Dry ARMD is the more common form of the Eye Disease, research is being channeled toward finding effective treatment for it, with the hope of arresting the disease process from converting to the rarer, visually debilitating Wet ARMD form.

    As part of the management strategy for this Eye Disease, your eye doctor may give you an Amsler Grid to take home with you so that you can monitor for any loss of your central vision.

    Although the Amsler Grid is cost effective, can be performed almost anywhere, and may help increase the chances of saving your vision, Amsler Grid has its limitations. Research and new technology have developed better diagnostics to monitor vision loss.

    Along with better diagnostics, the quest for a cure has driven multiple Macular Degeneration Clinical Trials and research. From this copious research is emerging New Treatment for Macular Degeneration which may hold the promise of a cure.

    With the threat of eight million people being at high risk for advanced ARMD, you are certainly not alone if you get this diagnosis. Besides seeking treatment for ARMD, you want to find the available resources to mediate its negative impact of on your daily life.

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