Age and Vision: Macular Degeneration

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Q: I am 60 years old and have recently been diagnosed with the dry form of age-related macular degeneration in the left eye. It is minimal and the retina specialist did not appear worried about it at this time. I have been reading all I can find on this condition, and one of the things I read said something about statins possibly slowing the degeneration. Can you tell me what you know about this?

A: While statins (pravastatin, simvastatin, lovastatin, others) have been very successful in lowering cholesterol, raising HDL and decreasing the risk for heart attack and stroke, they have not been proven to prevent or even slow the progression of age-related macular degeneration, or AMD. In fact, study results have been mixed and we cannot yet say whether they provide any benefit at all against this disease. In the meantime, regular visits with your ophthalmologist will keep you up to date with the latest preventive and treatment options.

Age-related macular degeneration causes damage to the central part of the retina, known as the macula. This is the area of the eye that enables us to see fine details. Depending upon the degree to which the macula degenerates, a blurry or darkening of the center of vision may occur, making common everyday tasks such as reading, driving and recognizing faces more difficult. In some cases, AMD progresses very slowly and its effects are hardly noticeable, while other cases advance very rapidly, affecting both eyes.

While the exact cause of AMD is unknown, there are certain risk factors commonly associated with the condition. These include:

Smoking. The more you smoke, the greater your risk. And if you develop age-related macular degeneration, smoking speeds the progression of vision loss.
Age. While those in their 50s have a 2 percent chance of developing AMD, the risk increases above the age of 60. Once a person has reached 75, the risk is nearly 30 percent.
Family history of this disease in a parent or sibling.
Female gender.
Light skin and eye color.
Uncontrolled high blood pressure.
Prolonged unprotected (no sunglasses) sun exposure, especially to blue light, from a person’s teenage years into their 30s.

Other potential risk factors include a diet high in saturated fats, obesity, high cholesterol and inactivity.

There are two types of macular degeneration: Dry, or atrophic, and wet. The dry type is the most common and usually causes a gradual blurring of the central vision in the affected eye. It tends to occur in one eye at a time. The wet type can quickly progress and lead to severe vision loss. Some of the symptoms of AMD include:

Fuzzy or blurry vision (especially in the dry form).
Straight lines—the sides of buildings, telephone poles, etc.—that appear wavy (may indicate the wet form).
Difficulty in seeing the middle of what you’re looking at, like a blind spot.
Trouble working up close, such as threading a needle.

Since the presence of these symptoms may be signs of other eye conditions, it is especially important to see an ophthalmologist. In checking for eye diseases, the following tests may be performed:

Visual acuity test, which checks vision at different distances (the common eye chart).
Dilated eye exam, when drops are used to look inside your eyes for any signs of AMD or other eye diseases.
Tonometry, which is an instrument that measures the pressure inside the eye to check for glaucoma.
Amsler grid, a checkerboard pattern whose lines may appear wavy, or even missing. If positive, it may indicate the presence of the wet form of AMD.
Fluorescein angiography, which uses a special dye that is injected into an arm vein. As the dye passes through the retina’s blood vessels, pictures are taken to see if there is any leaking, which may indicate the wet form of this disease.

I understand why you want to do all you can to preserve your eye health. It’s important to ask the ophthalmologist if vitamins containing lutein and zeaxanthin, as well as a diet high in green leafy vegetables, would help protect your eyes. Also, ask if special wraparound sunglasses that provide 100 percent protection against UVA and UVB light, as well as special protection against blue light, would be beneficial. And remember: Research dollars constantly are being poured into efforts to better detect, treat and prevent vision loss due to age-related macular degeneration.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)