Age-related Macular Degeneration:

WHAT YOU SHOULD KNOW:

• Age-related macular degeneration, also called AMD or ARMD, is an eye disease that may occur with aging. ARMD is a disease that targets the macula (center part) of the retina (back of the eye). The macula contains the fovea, which helps you to see images in sharp detail. With ARMD, the macula becomes damaged causing blurring or loss of vision in the center of your eyesight. These vision problems may progress slowly or quickly. ARMD may occur when the retina does not get enough nutrients (substances needed for growth). Decreased nutrients cause the supporting tissues of the retina to break down and drusen (yellow deposits or spots) to form. The light-sensitive cells of the eyes are then injured causing blurring in the center part of your sight.
  
  
• There are different stages of ARMD. Early ARMD may cause no vision changes and occurs when small drusen collect under the retina. With intermediate ARMD, more drusen, that are larger in size, collect under the retina. Patches of retina atrophy (wasting) and blurring vision may occur at this stage but there are no fovea changes. Late-stage ARMD has a dry or wet form, and causes a major decrease in your central vision and fovea atrophy. Dry ARMD, a less serious form, slowly causes vision changes and can sometimes change to wet ARMD. Wet ARMD is more severe and quickly causes damage to your central vision. Wet ARMD occurs when new, abnormal blood vessels grow in the retina. The blood vessels may break open, causing blood to leak out and damage the macula of the retina.
  
  
• Your risk for ARMD increases if you smoke or have high blood pressure. Common ARMD symptoms include blurred vision, a blind spot in your vision, or objects may look twisted. You may not see colors, depth, and detail clearly, and have trouble seeing in the dark. To diagnose ARMD you may need eye tests, including the Amsler grid, visual acuity, a dilated eye exam, or an angiography. Treatment of ARMD aims to slow or stop the disease from becoming worse. Treatment includes the use of corrective glasses, prevention and treatment of risk factors, anti-VEGF medicines, and laser treatments. With treatment, you may be able to stop your ARMD from getting worse. Treatment may help prevent permanent vision loss from ARMD.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Certain antioxidant vitamins and minerals used to treat ARMD may cause urinary problems in men. Beta-carotene may cause skin yellowing and an increased risk of lung cancer in smokers. Anti-VEGF injections may cause eye pain and pressure, swelling, and may cause you to see flashes or floaters. You may have an allergic reaction to the anti-VEGF medicine. You may have blurry vision, eye redness, eye watering, and you may be very sensitive to bright lights. Laser photocoagulation treatment may damage your vision further. You may have bleeding in your eye and tears in your retina. The medicine used for photo dynamic therapy may damage your skin where it is injected and may cause back pain. The treatment may cause light sensitivity and may cause severe vision loss that may be permanent.
  
  
• If untreated, ARMD may make it hard for you to do your normal daily activities, such as work. You may be at risk for falling often and injuring yourself. Your symptoms may get worse and you may lose your central vision completely. You may begin having visual hallucinations (seeing things that are not there). Your condition may cause you to become depressed (deep sadness). Talk with your caregiver if you have questions or concerns about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Blood tests:

You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicine:

• Anti-vascular endothelial growth factor: Anti-vascular endothelial growth factor (anti-VEGF) is medicine given as an injection (shot) into your eye. The medicine is used to treat wet ARMD. The anti-VEGF medicine may stop blood vessels from growing and leaking. The injections may keep the disease from getting worse and in some cases, the medicine may improve your vision. Ask your caregiver for more information about anti-VEGF injections.
  
  

Tests:

• Fluorescein angiography: During fluorescein angiography, pictures are taken of the blood vessels in your eye. You are given a dye for this test to help caregivers see your blood vessels better.
  
  
• Optical coherence tomography: During an optical coherence tomography test, pictures are taken of the tissues in your eye. The pictures can show if you have fluid build-up behind your retina. Pictures can also show if your retina is thicker than it should be.

Treatment options:

• Laser photocoagulation: During laser photocoagulation, a thermal (uses heat) laser is directed at leaking blood vessels in your retina. The laser treatment seals the leaking blood vessels to prevent more damage to your retina.
  
  
• Photodynamic therapy: During photodynamic therapy (PDT), you are given a shot of medicine into a vein (blood vessel). The medicine collects in the leaking blood vessels in your eye. A caregiver will shine a laser light into your eye. The laser light will seal the leaking blood vessels in your eye.
  
  
• Visual rehabilitation: Visual rehabilitation (rehab) uses activities to help you function with your vision loss in your daily life. A caregiver may help you choose tools to use, and suggest ways to keep your home or workplace safe. You may learn to use certain assistive devices during visual rehab. Ask your caregiver for information about visual rehab.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Age-related Macular Degeneration: (Inpatient Care)