Risk Factors, Prevention, and Treatment of Dry Macular Degeneration and Geographic Atrophy

If you are above 60, you may have noticed some changes in your vision. It could be gaps in your vision first thing in the morning or objects that seem to disappear. These are common symptoms of dry macular degeneration.

Learn more about Dry Macular Degeneration and Geographic Atrophy from Jonathan Jonisch, MD and David Poon, MD on the VRC Podcast, Retina in Focus.

You could have been diagnosed with dry macular degeneration and are confused about geographic atrophy. Read on to find out more about dry macular degeneration and geographic atrophy.

What is Dry Macular Degeneration?

Dry macular degeneration is an eye disorder common in people with 50 years and above. It results in minimized central vision because of the thinning of the macular, the part controlling clear vision. Dry macular degeneration is a common type of age-related macular (AMD) degeneration. The other AMD is wet macular degeneration. It develops in one eye, but can also impact both eyes. Your vision becomes worse with time, and it will be hard to recognize faces or even read. However, you will not lose your sight. The loss of vision will only be mild in some people and severe in others.

If you have dry AMD, it may start from having a few yellow spots to having numerous spots. It develops slowly and is easier to monitor. You'll first notice blurry vision and have trouble seeing small details. The thinning causes vision loss, but it is usually a slow process.

Risks of Developing Dry Macular Degeneration

Here are some factors that increase the risk of dry macular degeneration.

• Age: Anyone over the age of 50 has a high risk of getting the disease.
• Family history: Dry macular degeneration has a hereditary component. If you have a family member affected by the condition, you have a high chance of getting it.
• Smoking: Smoking also increases the risk of macular degeneration.
• Cardiovascular disease: Diseases that affect the blood vessels and the heart puts you at a high risk of getting macular degeneration.
• Obesity: Being obese increases your chances of macular from being intermediates to becoming severe.

How to Prevent Macular Degeneration

Macular degeneration is an age factor, and that is a factor beyond your control. Regular eye exams will help in identifying early signs of macular degeneration. Here are measures to reduce the risk of dry macular degeneration.

Take Eye Vitamins

You can reduce the chances of developing macular degeneration by taking vitamin C, vitamin E, zeaxanthin, lutein, zinc, and copper. In the intermediate stage of the condition, you can use vitamins to reduce the risk. People with macular degeneration can get relief by taking the AREDS2 formulation.

There is research on the use of eye vitamins to help reduce macular degeneration. Micronutrients like minerals, antioxidants, and vitamins help with early intervention of the condition. The vitamins that lower the risk of age-degenerative eye disease are vitamins A, C, and E. Minerals like zinc are also helpful in eye disorders. AREDS2 study examined how regular consumption of vitamins and minerals helps with macular degeneration. Taking the Vitamins can slow down macular degeneration disease.

• Zeaxanthin and lutein: They contain carotenoids, which makes them the best replacement for AREDS. The two function as blight light filters in the retina. The two are the best replacements in the AREDS formula. For the AREDS2 dosage, 3mg zeaxanthin and 10 mg lutein are used.
• Vitamin C: The vitamin promotes immunological function by keeping blood vessels open. It, therefore, helps with blood circulation to the eyes and the rest of the body. The recommended dose of vitamin C for AREDS is 500 mg.
• Vitamin E: The vitamin supports a healthy circulatory system. It helps in blood thinning and reduces the chances of blood clots. Alpha-tocopherol is the common type of vitamin E used in AREDS trials. Vitamin E doses in AREDS are 400 IU daily.
• Zinc: The retinal vascular system and retina metabolic processes depend on zinc. Zinc help patients with aged macular degeneration maintain their vision. The zinc dosage for AREDS is 80mg.
• Copper: The copper dose for age-related eye disease is 2 mg. The copper dose for AREDS is 2mg.

Don't Smoke

Smoking increases your likelihood of developing macular degeneration. Seek help to give up smoking.

Maintain a Healthy Weight

Being obese is one of the risk factors for dry macular degeneration. Therefore, you can prevent the condition by reducing the amount of calories and exercising every day.

Eat a Diet With Fruits and Vegetables

Increase your intake of fruits and vegetables in your diet. They contain antioxidant vitamins that reduce your risk of developing the condition.

Include Fish

Omega-3 fatty acids in fish reduce the likelihood of macular degeneration. Walnuts also have omega-3 fatty acids.

What is Geographic Atrophy?

Geographic atrophy is a later stage of dry macular degeneration. It leads to permanent vision loss and central scotomas. It occurs in the areas of the retina where cells break down and finally die. The regions appear like atrophy and resemble a map, hence geographic atrophy. The regions of atrophy lead to a blind spot. It can affect one or both eyes. The patient's central vision develops blind spots. About 20% of people with dry macular degeneration will develop geographic atrophy.

Treatment

It's challenging to recognize dry-age macular degeneration symptoms, especially if a patient doesn't lose all of the central vision simultaneously. You can treat dry AMD with dietary supplements. However, there are still no FDA-approved medications or treatments for macular degeneration conditions. Clinical trials are undergoing. Your doctor can ask you to take lutein, zeaxanthin, and zinc to slow the geographic atrophy progress. Taking vitamins such as vitamin E and vitamin C also improves eye health.

There is no proven treatment for geographic atrophy. Low vision devices, magnification, and increased lighting will help patients with geographic atrophy. Therapy ranges from cell transplantation to molecular targets. New treatments are raising the hopes of patients with geography atrophy. GA progresses slowly, which has made it difficult to find a treatment.

Cell Therapy

Stem cell transplantation is used to replace the affected area of the retina and is one of the treatments used for the condition during its early stages. Patients with geographic atrophy lose their RPE cells. Replacing the cells will help to restore the photoreceptor outer segment, which helps restore some vision.

Gene Therapy

Gene therapy is still in the early stages but has a massive impact on reducing geographic atrophy. Gyroscope therapeutics, a gene therapy, has been designed for rebalancing the complement system by expressing the complement factor.

You should see a doctor when you notice changes in your central vision, and the ability to see colors has been impaired.