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Age-related macular degeneration, AMD, macula, retina disease - A State of Sight #13

Retinal surgeon Carey Pate, MD joins 'A State of Sight' with Isaac Porter, MD to discuss macular degeneration, one of the leading causes of blindness. This episode defines macular degeneration, explains who is at risk, and covers treatment options for the various stages of macular degeneration.




(Dr. Porter)
Welcome to A State of SIght, I’m your host, Isaac Porter, from Lowry Porter Ophthalmology, and this is your weekly update in ophthalmology and eye care. This week we have a very special episode, because we have Dr. Carey Pate with us, a retinal specialist from the Taylor Retina Center. Today we will explain macular degeneration and Dr. Pate is going to give us some good information about macular degeneration.  
 
First of all, could you please tell us about the macula and macular degeneration?  
 
(Dr. Pate)
First of all, thanks to Isaac Porter, MD for having me here today. The macula is the center part of your vision, that is critical to read, drive and do detailed things like threading a needle or using a computer. When people get macular degeneration it’s basically an early aging process in the eye that can cause damage in the central vision and cause people not to be able to see and read small print.
 
(Dr. Porter)
So then who is at risk of getting macular degeneration?
 
(Dr. Pate)
We don’t really know why certain people will get it and why other people don’t, but typically it occurs in fair skinned individuals, and if people live long enough, they will likely have some changes from macular degeneration. It definitely runs in families so people are at higher risks if family members, or parents specifically, have it.
 
(Dr. Porter)
At what age do you usually start seeing macular degeneration and when do you recommend that people who have a family history of macular degeneration be checked for it?
 
(Dr. Pate)
If you have a family history of AMD, you should have an eye exam in your 60’s. If we see someone who has a family history and they have no macular degeneration whatsoever, we will follow up with them every year or two. Once you get into your 70’s and 80’s that’s typically when we start to see more macular degeneration. By the time people are in their 90’s, AMD becomes very prevalent.
 
(Dr. Porter)
What are the different stages of macular degeneration?
 
(Dr. Pate)
There are two kinds of macular degeneration and this is the hardest concept for people to understand. The first type is the dry macular degeneration, and that’s typically the first kind that people get. That is an abnormal aging process where the area underneath the retina starts to degenerate. It’s kind of like soil eroding in a garden, where the plants are not so fertile over it. That’s a very slow change and people that have dry macular degeneration might not notice any changes early and it might take many, many years before they really notice functional visual decline.
 
The second stage is wet macular degeneration. This occurs when blood vessels grow underneath the retina that can leak and bleed. It’s kind of like weeds that grow in a garden, where they can over take it pretty fast. When wet macular degeneration begins, you get leakage of fluid under the retina and bleeding, so the vision can decline very rapidly. I like to tell my patients that wet is the worst and that helps them remember between dry and wet.
 
(Dr. Porter)
What treatments do you have?
 
(Dr. Pate)
For dry macular degeneration, typically we use different vitamin combinations. We’ve been studying these for years and there seems to be a certain few vitamins that can prevent the progression from dry AMD to wet AMD.
 
Wet macular degeneration has a much more aggressive course and we can treat that with injections of medicine directly into the eye. It’s actually extremely effective for stopping the aggression of macular degeneration in these patients.
 
(Dr. Porter)
That is great, and I know there has been a lot of new treatments that have come along in the last few years for macular  degeneration that can help these patients keep a lot of vision they have or even regain some vision they may have lost.

I want to say a big thanks to Carey Pate, MD for joining us today on A State of Sight. As always if you have any questions please interact with us, we will be happy to converse with you. Until next time, good health and good sight.