12 Medical Tests for Psoriatic Arthritis, Explained

How To Prevent Macular Degeneration

Macular degeneration, or age-related macular degeneration (AMD), is a form of vision loss that affects your ability to see things in the center of your vision. Some people a higher risk of developing AMD. This includes those with a family history of the condition, people who have obesity, and people who smoke. While there's no way to reverse or completely stop macular degeneration, there are ways to prevent or slow its progression.

AMD is a leading cause of vision loss in those older than 60 and is a progressive disease, worsening over time. It occurs due to aging-related changes to the macula, which is the central portion of the retina—the layer of light-sensitive cells in the back of the eye critical for vision. While aging is not preventable, understanding your other risks of AMD can help you take steps to reduce your risk as you age.

Though all people are susceptible to macular degeneration, certain populations are at increased risk. Older Adults Since this condition is associated with aging, older adults—those over 55—are more likely to have it. Only 2% of those 40 to 44 have AMD; this figure rises to 46.6% among those older than 85. People Who Smoke Another consistent risk factor is tobacco smoking. The damage to the macula occurs due to toxic compounds found in smoke, which can both directly damage the macula and affect blood circulation in the eye. Oxidative stress—when the body can't get rid of toxic compounds called reactive oxygen species—results from smoking and can damage your eyes. Those With Excess Body Fat Excessive body fat or obesity—which is clinically defined as a body mass index (BMI) of 30 or higher—is another risk factor for macular degeneration. BMI is calculated by dividing your weight in kilograms (kg) by your height in meters squared (m²), meaning the formula is BMI = kg/m2. As with smoking, both being overweight and having obesity are linked with oxidative stress, inflammation (which is part of your body's immune response), and blood cholesterol levels, all of which can cause damage to the macula. Disclaimer: Body Mass Index, or BMI, is a biased and outdated metric that uses your weight and height to make assumptions about body fat, and by extension, your health. This metric is flawed in many ways and does not factor in your body composition, ethnicity, sex, race, and age. Despite its flaws, the medical community still uses BMI because it's an inexpensive and quick way to analyze health data. Those With High Blood Pressure

Researchers have found that having hypertension (high blood pressure) increases your risk of macular degeneration. At this time, it is thought that this is due to the damage and narrowing of blood vessels in the retina. This leads to areas of dead cells in the macula (geographic atrophy) as well as wet age-related macular degeneration (wet AMD), a severe form of AMD caused by abnormal vessel growth.

Those With High Cholesterol

High cholesterol, or hyperlipidemia, is another risk factor. Higher high-density lipoprotein (HDL) cholesterol levels can lead to advanced or wet AMD. Raised total cholesterol is associated with an increased risk of geographic atrophy. Cholesterol makes up more than 40% of drusen—buildups in the macula that are an early sign of AMD.

People With Diabetes

Researchers have consistently found diabetes, a chronic inability to digest sugars, to raise the risk of macular degeneration, especially the wet form. Among the health effects of diabetes, is retinopathy—damage to the retina. In addition, this chronic disease raises inflammation and oxidative stress, which can damage the macula.

Those With European Ancestry

Studies have found white people to have higher rates of early, intermediate, and advanced AMD, compared to African Americans (who have the lowest risk), Hispanic people, and Asian Americans. More research is needed to understand why this is the case and if certain genetic markers play a role.

Several genes have been associated with an increased likelihood of developing AMD, although more unidentified genes may also contribute. This makes family history a major risk factor for AMD. Mutations of complement factor H (CPH), a gene associated with immune function, can lead to drusen buildup and raise your overall risk of AMD. This is also the case for age-related maculopathy sensitivity 2 (ARMS 2), which researchers have linked to both macular degeneration onset and progression. Currently, genetic testing is not recommended for macular degeneration. The results of such tests don't affect how macular degeneration treatment is performed at this time. While there's no guaranteed way to prevent macular degeneration, there is a lot you can do to reduce your risk and slow down progression. Screening for this condition can help optometrists (eye doctors) or ophthalmologists (specialty eye doctors) identify the condition before symptoms begin and when medical treatments are likely to be most effective. In addition, lifestyle changes play a central role in prevention and management.    Full Optometric Exam Especially if you're at increased risk for AMD, you should get your eyes checked annually. This involves a full optometric exam, testing your visual acuity (how well you focus near and far), and detecting any early signs of AMD or other eye conditions. Slit Lamp Exam Regularly screening for AMD and early detection is critical for both prevention and management. Optometrists or ophthalmologists use the slit lamp exam—a high-intensity light and high-powered microscope—to examine your macula for drusen or other signs of damage. During the test, your pupils are dilated (enlarged using a temporary eye drop), allowing them to take a closer look. Quit Smoking Among many other negative health effects, cigarette smoking is a major risk factor for macular degeneration. If you smoke, quitting can help prevent onset and slow the progress of this condition. Talk to your healthcare provider about techniques and strategies to quit, if needed. Vitamin and Mineral Supplements Studies have found that taking combinations of certain vitamins and minerals may help with preventing macular degeneration. A type of supplement called AREDS 2 is sometimes recommended as a means of slowing down the progression of AMD. This includes: Vitamin C Vitamin E Copper Zinc Lutein Zeaxanthin    Always consult your healthcare provider before adding a supplement to your treatment regimen. Dietary Changes Good nutrition can help manage various risk factors associated with AMD, such as obesity and high blood pressure, while also helping to prevent AMD itself. In particular, studies have found that incorporating the Mediterranean diet reduces the risk of advanced AMD by 41%. Features of this diet include:   Increased fresh fruit, vegetables, beans, lentils, and nuts Increased whole grains, as in whole wheat bread or brown rice Increased olive oil A moderate amount of fish (rich in omega-3s) Choosing lean proteins, such as chicken, and reducing red meat consumption Limiting sugars, salt, or processed foods In addition, reducing or stopping alcohol consumption may also help. Talk to your healthcare provider about methods that can help you incorporate healthier eating habits, if needed. Physical Activity Ensuring you're getting regular, moderate-intensity physical activity can be another way to manage risk factors for macular degeneration, helping to both prevent onset and slow AMD's progress. Even small changes can help. Studies have found that as little as three hours of moderate to light activity (like walking or swimming) a week can have significant effects on your health. Treat Co-Occurring Conditions Since chronic conditions, such as high blood pressure, high cholesterol, and obesity, increase your risk, managing them can be another means of AMD prevention. In addition to making lifestyle changes, this may involve taking medications, such as statins like Lipitor (atorvastatin) for high cholesterol, or calcium channel blockers (Norvasc (amlodipine)), ACE inhibitors (Prinivil (lisinopril)), or others for hypertension.   Protect Your Eyes Light contains ultraviolet (UV) rays, which can damage your retina. Wearing wraparound sunglasses that block UV-B rays (typically labeled "UV 400") may help, especially if you're often exposed to direct sunlight. In addition, wearing glasses that block blue frequencies in light can also prevent AMD onset and slow progression. Healthy Sleep Ensuring you're getting enough sleep can also help. Studies have linked getting fewer than 6 hours of sleep a night with an increased risk of wet AMD. Others noted that sleeping too much—more than 8 hours—raises macular degeneration risk. If you're an adult, aim to get 7 to 8 hours a night; children and infants need more. Try to go to bed and get up at consistent times and avoid working, using screens, or watching TV in bed.     If you have a family history of macular degeneration or are living with increased risk, talk to your optometrist or ophthalmologist about your concerns about developing macular degeneration. Ask them about any preventive measures you can take and develop a plan for regularly checking for the condition. It can also help to consult with them if you're considering adopting any lifestyle or medical changes, as they can help you determine what types of changes are best for you. Macular degeneration is a common form of age-related vision loss that affects central vision. It typically begins during older age and worsens as you continue to age. Other risk factors for this condition include smoking and having various co-occurring conditions, such as high blood pressure, high cholesterol, and obesity. Prevention methods, which often address these factors, include everything from making dietary or lifestyle changes to taking medications and/or supplements. Thanks for your feedback!

Gene Treatment For Macular Degeneration

As researchers learn more and more about the genes that cause a number of medical conditions, opportunities for treatment with gene therapy become increasingly likely. In an interview with Jonathan Davidorf, M.D., explained exciting new advances in the treatment of some forms of macular degeneration. According to him it is the use of gene therapy to treat some forms of macular degeneration.

Researchers have recognized the gene responsible for some cases of macular degeneration quite recently. With this knowledge, and the advances in gene therapy, they are able to get the abnormal gene working again. The trick is that the virus is used to target the bad gene. The virus carries with it the repair mechanism for the gene, which is transferred when the virus "infects" the gene.

Even more exciting than being able to use gene therapy, says Dr. Davidorf, is a recently discovered method that makes getting the virus where it has to go easier. The key is getting the virus to integrate into the back of the eyeball. In the past, researchers believed they had to inject it into that area. Now, new research in the lab shows the treatment is equally as effective when the virus is injected into the center cavity.

With this treatment, researchers hope to be able to correct the deficient genes that lead to excess blood vessel growth - the main factor in wet macular degeneration. While the treatment is still experimental and is not being done in humans, Dr. Davidorf says this type of therapy offers encouraging news for the future of macular degeneration treatment.

First Treatment For Macular Degeneration Now Available In UK

Patients with a degenerative eye condition could keep their sight for longer thanks to the development of the first treatment for the condition.

After successful trials in the US, a light therapy treatment that claims to help patients maintain or improve their vision is now available in Britain.

There are currently no approved treatment options on the NHS for people with dry age-related macular degeneration (AMD), which causes blurring or distortion to vision and can lead to blindness. Instead, patients are advised to manage the condition with lifestyle changes such as eating healthily and stopping smoking.

But now a handful of private clinics are offering a painless, non-invasive light therapy treatment which researchers say could help the condition.

An estimated 700,000 people in the UK have AMD, with the condition affecting one in every 200 people over the age of 60 and one in five over the age of 90.

There are two types of AMD, wet and dry. Both involve the deterioration of the macula, a tiny part of the retina at the back of the eye which is vital for our central vision and ability to see fine detail and colour.

Around 90 per cent of AMD patients have the dry form, where the macula deteriorates as retina cells die and are not renewed. And around one in 10 have wet AMD, where abnormal blood vessels grow into the macula.

Treatments are available for wet AMD in the form of regular injections into the eye or light treatment therapy, but there are no existing approved treatments for dry AMD.

The new treatment involves a technique called photobiomodulation, uses LED light at different wavelengths to stimulate and reinvigorate cells at the back of the eye.

A randomised controlled trial of the technology in the US found dry AMD patients who had the light therapy delivered through a device called Valeda experienced almost double the improvements in their vision after 13 months of treatment, compared with those treated with a dummy device.

The patients, who were all aged over 50, received a "cycle" of nine sessions of five-minute treatment over three to five weeks, repeated once every four months.

At the end of the study, patients treated with Valeda were able to read 5.4 more letters on a sight chart. Treated patients also had less of a type of swelling within the eye, which can indicate the disease is progressing, compared with those treated with the dummy device.

The study, published last month in the journal Retina, was led by the technology's manufacturer LumiThera and tested on a small group of 100 patients.

Early results, which have not yet been formally published, from a 24-month follow-up period of the same patients suggested those treated with the light therapy were significantly more likely to retain their vision over two years and did not experience significant side effects.

The device is still classed as "investigational" in the US, which means it can only be used as part of research to determine its efficacy and safety.

Its effectiveness is currently being assessed in clinical trials and it has yet to be considered by the National Institute for Health and Care Excellence in England and Wales for use in the NHS.

But it has been approved for sale in Europe.

The technology is now available at a handful of private clinics in the UK and has just been launched by the Optegra eye hospital group – the first chain to take it on.

The company is trialling the device at its Manchester hospital before rolling it out nationally.

Sajjad Mahmood, a consultant ophthalmic surgeon at Optegra Eye Hospital Manchester, said: "After so many years of having to report to my patients that there are no direct treatment options, I am so happy to now provide hope.

"I have many patients with dry AMD and have had to watch their vision decline over the years… But now that can change. With this new treatment we hope that a good proportion of patients with the earlier forms of dry AMD will improve their vision or at least stabilise the condition."

An initial year's treatment, consisting of consultations and three cycles (each involving nine treatment sessions), costs £4,635. Each subsequent cycle is £1,495.

Cathy Yelf, chief executive of leading sight loss charity the Macular Society, said: "Finding a therapy for dry AMD is a priority. We're following these trials very closely. We look forward to seeing a more extensive study to ensure any potential benefits of this therapy can be clearly demonstrated, allowing people to take it up with confidence."

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