Macular
Degeneration
General Information
Age-related
macular degeneration is the leading cause of blindness in
the United States and many European countries. The neovascular
"wet" form of the disease is responsible for most
(90%) severe loss of vision. There are approximately 200,000
new cases of wet macular degeneration in the United States
each year.
The average
age of patients with the wet form of macular degeneration
is the mid-70s. It rarely occurs before the age of 50. Wet
macular degeneration is more common in whites, but occurs
in all races.
The wet form
of macular degeneration is usually associated with aging,
but other diseases which can cause wet macular degeneration
include high myopia (being very nearsighted) and some intraocular
infections like histoplasmosis.
The first proven
treatment was laser photocoagulation, but only 10-15% of
eyes with wet macular degeneration are treatable with laser.
Then recurrences after laser treatment are common (70% in
5 years). The average visual acuity 3 years after treatment
is usually 20/200 to 20/250.
Patients rarely
lose all of their vision from macular degeneration. Though
they have poor central vision, most can walk around, dress
themselves, and perform many of their normal daily tasks.
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Social
and Economic Implications of Age-related Macular Degeneration
Since ARMD
results in loss or impaired central vision, it is not surprising
that the majority of patients either become partially sighted
or legally blind. Activities
which require good central vision such as reading, writing
and carrying out certain domestic tasks are all affected.
Many
macular degeneration patients require help to perform activities
of daily living. Sometimes, their visual handicap necessitates
admission to a nursing home. The social cost of this handicap
is enormous in both personal and social terms. When both
eyes are affected, patients experience serious loss of quality
of life and independence.
What makes
macular degeneration research even more important is that
recent evidence suggests that macular degeneration is now
a more common cause of permanent visual loss than diabetes.
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How
Do We Solve This Problem?
In recent decades
we have witnessed improved technology offering solutions
for patients suffering from cataract, diabetic retinopathy,
and glaucoma. We have also seen the aging of our patient
population. Since the number of patients suffering from
blindness due to treatable conditions has fallen dramatically,
age-related macular degeneration has become the most pressing
"vision-related" public health dilemma in the
developed world.