Central retinal disease | Macular Degeneration
The central retina or posterior pole contains the Macula. This area of the eye is responsible for perception of colors and details. Someone who loses his central vision becomes legally blind. Different groups of diseases can affect central retina. Here are a few examples:
Macular Degeneration or Age Related Macular Degeneration (AMD OR ARMD) is a disorder of the macula where cell debris accumulates and impact normal function.
The main risk factor for AMD is age, but others are very important. They include, ethnicity, smoking, poor diet.
At first Macular Degeneration presents as changes in the pigment aspect of the macula. Soon after, some pockets of debris appear, they are called drusens. They can be of different sizes depending on the stage of the disease. Someone with very early macular degeneration might still be 20/20.
For all patients with risks of developing macular degeneration or early macular degeneration, life style changes are indicated. During your eye exam at our Miami office, we advise such patients to stop smoking, use sunglasses and keep a healthy diet rich in dark leafy vegetables.
At this early stage of macular degeneration, eye vitamins or supplements have not shown to be beneficial. They don't seem to cause harm but they have no benefits. Once the disease advances in moderate stages, we do recommend supplementation with AREDS 2 vitamins.
Unfortunately some patients will progress to a more serious stage called wet macular degeneration where new, weak, blood vessels grow in the macula.
Those patients are sent to a retinal specialist for assessment and usually will be injected with Anti-VEGF medicine such as Avastin. Those Vascular Endothelial Growth Factor inhibitors (Anti-VEGF) will prevent new blood vessels from forming and help with regression of newly formed blood vessels. Science has made tremendous progress in the last 10-15 years. Drugs available currently can save a patient's vision and slow down the disease progression.
Again, a routine eye exam is your best measure to make sure you don't have early macular degeneration.
Other diseases can affect the retina and central vision.
Central Retinal Artery Occlusion (CRAO) and Central Retinal Vein Occlusion (CRVO) affect the blood supply to the central retina. In the case of CRAO, the loss of vision, is sudden, absolute and unfortunately usually permanent. In the case of CRVO, some recuperation of visual function is expected with the proper care of a retinal specialist.
Those diseases are not only ocular emergencies but also systemic emergencies as they signal problems with blood pressure, blood coagulation or emboli/thrombus and eventually a heart problem. A referral to an internal medicine doctor is always made after the emergency is addressed, to deal with systemic risk factors, prevent recurrence and protect the fellow eye.