Macular degeneration
(or age-related maculopathy) is the leading cause of blindness in
the United States. It usually affects older patients- retirement age
and above. Initial signs of macular degeneration may be picked up
earlier, in the 40’s and 50’s. This is important since there
is evidence that intervention with nutritional supplements and life-style
changes may reduce the development of this blinding disease.
 There
are two forms of macular degeneration- dry and wet. The dry form
is usually less severe and reading vision is often maintained. The
dry forms results from degeneration of the the outer layers of the
retina- the light absorbing photoreceptors and the retinal pigment
epithelium (RPE). The RPE forms the blood retinal barrier between
the outer retinal circulation ("choriocapillaris) and the outer
retina (photoreceptors). With age, the waste products of vision
accumulate beneath the RPE in little mounds called drusen. These
proteinaceous and fatty-like deposits impede the flow of oxygen
and nutrients and result in degeneration of both the RPE cells as
well as the visual cells (photoreceptors).
In the wet form of macular degeneration,
abnormal blood vessles
grow from the outer retinal circulation (choroid) beneath the retinal
pigment epithelium (RPE) and sometimes into the retina itself. These
blood vessels can leak fluid and protein and eventually form a scar.
With early diagnosis of these blood vessels, laser surgery may be
used to close the blood vessels and prevent further vision loss.
Fluorescein angiography and indocyanine green angiography
may be used to image the abnormal blood vesselss and guide laser
treatment. In addition, we have and will participate in a number
of clinical studies using frontier therapies for the treatment of
the most blinding form of macular degeneration.
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