Macular Degeneration John Fontenot Bridget Deckard Miriam Rios Brianne Korth Trenton Adkins

What is Macular Degeneration? MD is a disease that occurs in the macula, (small area in the retina). When the macula is damaged, central vision may be blurry, with dark or distorted areas. MD affects the ability to see near, far and can make near acuity tasks almost impossible. MD usually does not affect the peripheral vision.

Risk Factors Being over the age of 50 years old ◦ Cells in the retinal pigment epithelium (RPE) deteriorate with age and lose pigment, making it less efficient in removing outer segment waste. Drusens, (yellow fat-like deposits) begin to appear under cones and rods. Having a family history of age-related MD ◦ Researchers have identified some genes associated with MD. Future genetic screenings may be helpful for testing early risk. Cigarette smoking ◦ Doubles risk of MD ◦ Single most preventable cause of MD Abnormal cholesterol levels Deposits under the retina (drusen) ◦ Usually do not cause vision loss alone, but when there is a large number or size of them, there is more of a risk of age-related MD. Mayo Foundation for Medical Education and Research.

Age-related Macular Degeneration In people over 50, MD may occur from aging. Known as age-related MD, this is the most common type. Free radicals are formed from reacting with oxygen in the environment and can sometimes damage cells. This is known as oxidative stress, which is thought to contribute to the development of age-related MD. Many people have genetic changes which make them more prone to this cell damage.

Non-neovascular (Dry) MD 90 % of people with age- related MD have the ‘dry’ type, which is caused by damage from oxidative stress. This results in thinning of the macular tissue, and vision loss is usually gradual. Causes difficulty adjusting to changes in lighting. For example, when walking indoors from a bright outdoor environment Ernst Eye Health Associates. Retrieved: August 4, 2010.

Neovascular (Wet) MD 10% of people with age-related MD have the ‘wet’ form, which progresses quickly and causes significant vision loss. The cause is abnormal blood vessels that form underneath the retina which leak and blur central vision Sure Vision Eye Centers. Retrieved: August 4, 2010

Symptoms of Macular Degeneration MD can cause many different symptoms in different patients. Sometimes only one eye is affected first. When both eyes are affected, the loss of central vision happens quickly. Vision loss is noticed when: words on a page look blurred a dark or empty area appears in the center of vision straight lines look distorted

Symptoms of Macular Degeneration American Academy of Ophthalmology. The Eye M.D. Association, Jan Retrieved: August 4, Dr. Mike Li Optometry. Retrieved: August 4,

Stages of Macular Degeneration Early Stage ◦ Several small drusen or few medium-sized drusen are detected on the macula in one or both eyes. Generally, there is no vision loss in the earliest stage. Intermediate Stage ◦ Many medium-sized drusen or, 1 or more large drusen are detected in 1 or both eyes. At this stage, your central vision may start to blur and may need extra light for reading or doing a detailed near task. Advanced Stage ◦ Several large drusen, as well as extensive breakdown of light- sensitive cells in the macula detected. This causes a well defined spot of blurring in central vision. Blurred area may become larger and more opaque over time. Mayo Foundation for Medical Education and Research.

Stargardt's Disease Inherited form of Macular Degeneration that affects children and young adults. The disease is thought to be passed to the children from both parents carrying the gene mutations that are responsible for Stargardts. ◦ Even though the parents may not have the disease themselves, they can carry recessive genetic traits of it.  5% of the human population carry gene mutations that cause inherited retinal diseases like stargardts and retinitis pigmentosa. (Ophthalmology, March 2004.) Exposure to bright light was thought to trigger retinal damage that leads to Stargardt’s. All About Vision. Access Media Group LLC Stargardt’s Disease (Fundus Flavimaculatus). Marilyn Haddrill. Retrieved: August 5,

Progression of Stargardt’s. Vision loss appears within the first 20 years of life, more particularly in early childhood. There are many variations of Stargardt’s disease, even in family members with similar inherited tendencies. When measured on an eye chart, Stargardt’s ranges from 20/50 to 20/200. Fundus Flavimaculatus is the most severe form of the disease, but is not as quickly onset. It usually occurs in middle life.

Symptoms of Stargardt’s Disease Blurry or distorted vision Inability to see in low light environments Difficulty recognizing familiar faces Loss of color vision may occur in the late stages

Living with Stargardt’s Disease There is no known treatment Patients are often advised to wear sunglasses with UV protection to reduce farther damage from the sun. Special filters can be worn in eyeglasses to block out certain wavelengths of light that may damage the eye. Low vision eye exams should be given annually, at least. Low vision counseling and services may be used to accommodate the child in school and independent living.

References American Academy of Ophthalmology. The Eye M.D. Association, (2010). Macular Degeneration A Closer Look. Mayo Foundation for Medical Education and Research. (2008, August 26). Risk Factors. Retrieved from Li, M. (n.d.). In Dr. Mike Li Optometry. Retrieved August 4, 2010 from American Academy of Ophthalmology. The Eye M.D. Association, (2004, January). Macular Degeneration. Retrieved August 4, 2010 from Ernst Eye Health Associates. (2010). Macular Degeneration. Retrieved August 4, 2010 from Sure Vision Eye Centers.( 2005) Macular Degeneration. Retrieved August 4, 2010 from surgery-chicago/macular_degeneration.htm Haddrill., M.,& Thompson, V., Tufty, G. (2010). Stargardt’s Disease (Fundus Flavimaculatus). Retrieved August 5, 2010 from