St. Louis, MO 63118
    Phone: 314- 771- 3000

    ( Located at the Jefferson campus
    of St. Alexius Hospital)

                                                Macular Degeneration

    The human retina has a fine layer of photosensitive cells called rods and cones which convert light
    images into electrical pulses. These are transmitted to the brain through the optic nerve. These cells are
    concentrated in the central part of the retina called  the Macula.   Macular Degeneration is malfunction
    and deterioration of these light sensitive cells that occurs most commonly in people over age 55. There
    are millions of people who have this disease in United States alone.

    In early stages there are no symptoms but later as the disease progresses, patients notice difficulty in
    activities which require fine vision such as reading or driving at night. Vision may deteriorate to the point
    that every day activity may become a challenge. Patients develop blind spots in their central vision which
    increase in size over time. This slowly progressive type of macular degeneration is called Dry type. In
    some advanced cases there is growth of blood vessels into the  macula which typically destroys the vision
    in very short time, sometime as short as few days as these vessels grow quite fast once they have broken
    into the macula. This type is referred to as Wet type and early detection is imperative to prevent visual

There is no known treatment for dry type of Macular Degeneration but some people may benefit from        
         Multiviamins and Antioxidants  which are available over the counter.

         Wet Type or Exudative Macular Degeneration responds well to some of the newer medications when
         directly injected into the eye. Usually several injections are required to stabilize the condition.

    In general, the diagnosis of macular degeneration is made by clinical examination using an
    ophthalmoscope, specially through a dilated pupil. Sometimes it may be difficult to detect very early
    changes in the retina if the doctor is looking through a cataract or a cloudy cornea. Photographs may
    be taken to follow the progression of the disease.

    Fluorescein Angiography is very helpful to look at the retina in fine detail. In this test, a small
    amount of dye is injected into a vein and as the dye passes through the retina, a series of photographs
    are taken and analyzed. This test is specially helpful to detect the wet form in early stages.

    Another test called OCT, which allows the doctor to view the layers of the retina in very fine detail, is
    also helpful in diagnosis and evaluation of the disease. This test very easy to do and is frequently used
    to monitor the condition.

    Treatment of macular degeneration has been challenging. Despite advances in medicine, many people
    continue to lose vision slowly over time, however several studies have shown changes in diet and life style
    help slow the progression. Patients should change to low cholesterol diet, eat green leafy vegetables, avoid
    smoking and use UV protected glasses when outdoors. Dietary supplements such as Lutein, Zeaxanthin,
    Zinc, vitamin A, C, E and other antioxidants are very helpful in slowing the progression. This  list continues to
    grow every day.

    Wet type is the most difficult to treat. Use of lasers destroys the offending blood vessels but also destroy
    the retina and cause a blind spot. Recently there are a few drugs which, when injected directly into the eye,
    have caused the regression of sight threatening blood vessels. These injections, though very beneficial, do
    have some side effects and a small risk of complications.   Generally these injections need to be repeated.
    Research in new drugs and other methods of treatments is very promising.

    Treatment of wet macular
    degeneration by injection.
    Side effects include bleeding
    inside the eye, infection, retinal
    detachment, glaucoma  and loss
    of vision. These complications
    may require additional surgery.
    In rare cases, vision may be lost
Macular degeneration, wet on the left, dry on the right
St. Louis STL

ST. LOUIS, MO 63118                     PHONE 314-771-3000
photograph and will look uneffected to a normal person but to a person with
moderate amount of macular degeneration it will look like a  blind spot  in the center
of the vision. In more advances cases, the blind spot will look even bigger, as seen
on the right. In extreme cases the whole central vision is lost and person may have
only peripheral vision left. In such cases getting around or  doing daily chores may
be become very difficult.
3535 S. Jefferson, Suite S-4
Saint Louis, MO 63118
Phone   314-771-3000