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This is the genesis of new and fragile blood vessels following an occlusion (blockage) of an existing vessel. This phenomenon often occurs in the retina. It is widely considered to be highly undesirable as these fragile vessels are prone to hemorraging, thereby starving surrounding tissue of blood nutrients. Condition is traditionally treated by photocoagulation which is the use of lasers to cauterise these new vessels.
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How does neovascularization differ from angiogenesis?
Neovascularization is different from angiogenesis by the way it appears. Capillary buds will grow out, or protrude, and will out grow their area when afflicted with angiogenesis.
What conditions is retinal cryopexy used to treat?
retinal breaks or detachments; retinal ischemia (retinal tissue that lacks oxygen); neovascularization (proliferation of blood vessels in the retina); Coats' disease
How are patients with retinal vein occlusion monitored?
Patients should be seen at least monthly for the first three months to monitor for signs of other complications, such as the abnormal formation of blood vessels (neovascularization) in the iris of the eye or glaucoma.
What is the prognosis for a patient with inclusion conjunctivitis?
Untreated inclusion conjunctivitis in the newborn persists for 3-12 months and usually heals; however, there may be scarring or neovascularization. In the adult, if left untreated, the disease may continue for months and cause corneal.
What are some medical terms pertaining to diabetes?
Hemoglobin A1c, ketosis, hyperglycemia, hypoglycemia, somoyogi effect, nephropathy, retinopathy, neovascularization, end organ damage, microalbuminuria, peripheral neuropathy, C-peptide level, truncal obesity, basal dose, bolus dose, sliding scale, postprandial, hyperinsulinemia, insulin, ACE inhibitor.
What is chondroradionecrosis?
Chondroradionecrosis (CRN) of the larynx is one of the most serious complications of radiation therapy. It may progress or become fatal despite aggressive treatment measures. Hyperbaric oxygen therapy (HBO) has been used to treat radiation necrosis of the head and neckHBO is thought to repair vascular beds within the irradiated tissue, enhancing neovascularization and wound healing. The efficacy of HBO in the treatment of laryngeal CRN has been described in only a few case reports and series.
What are treatments for wet macular degeneration?
The macula is a tiny spot in the center of the retina. There are several layers of tissue that bring nutrients and oxygen to the macula and remove built up waste products. One layer of tissue is called the choroid layer - this is a layer of blood vessels that helps with the transporting in nutrients and removing waste. In wet macular degeneration new but abnormal blood vessels grow and instead of helping with this transport system, they actually are harmful. The reason for this is that these abnormal blood vessels are very tiny and fragile - meaning that they leak fluid.Wet macular degeneration gets it's name because of this excess blood and fluid from leaky blood vessels.This abundance of fluid builds up under the macula and raises it which is what causes the distortion of vision - straight lines become wiggly or wavy.What causes these unusual blood vessels to develop? There is a term called angiogenesis which means "new blood vessels."Vascular endothelial growth factor (VEGF) is a protein secreted by cells that are oxygen deprived. VEGF stimulates the growth of these abnormal blood vessels.Healthy adults secrete very low levels of VEGF, while those who have health conditions such as cancer or age related macular degeneration secrete high levels of this protein.
Cosmetic Gynaecology - How it improves lives?
Cosmetic Genecology - How it improves lives? The needs of women vary at different times in their lives, and we want to help them.” – Dr. Armen Kirakosyan (Aesthetic Gynecology Specialist) Introduction: The field of cosmetic gynecology is relatively new. The female vaginal anatomy can undergo unpleasant or unwanted alterations as a result of factors such as age, gravity, pregnancy, heredity, and chronic pelvic health conditions. Most women find these alterations distressing, but they go about their lives in silence because of changes in their pelvic supporting also a deeply personal issue that a few women bring up between themselves or even with their doctors. Why do Women Prefer It? According to research, alterations in the anatomy of the pelvis have a direct impact on sexual function. A woman’s physical health, well-being, contentment, self-esteem, and quality of life may be negatively impacted by illnesses such as pelvic organ prolapse, tissue stretching, and nerve damage, in addition to the changes that naturally occur after childbirth. Too many women assume they must live with an uncomfortable or unpleasant condition, ignorant that anatomical and functional alterations that naturally occur can be remedied. Restoring Vaginal Health – A Non-Surgical Non Invasive Strategy Surgical intervention may be necessary in some cases, but not in others. In any case, doctors always begin by discussing the least invasive options. A nonsurgical noninvasive treatment involves the process of using a laser for cosmetic gynecology. The application of laser in the genital area stimulates collagen production. Collagen fibre provides vaginal tissue its strength and pliability, much as they do in the skin. Diode laser technology has revolutionized vaginal tissue contraction and collagen production in Cosmetic Gynecology by gently heating vaginal tissue to a temperature that stimulates the development of new collagen. This enhances the functionality of the entire vaginal area by regulating blood flow, increasing lubrication, enhancing immunological resistance, and restoring the strength and suppleness of the vaginal walls How Does It help To Improve Women’s Aesthetics And Confidence? Through Laser Vaginal Rejuvenation (LVR) The vaginal mucosa loses tone as a result of aging and muscular tension in women, culminating in an atrophic process. Inflammation, dryness, and itching are all side effects of this condition, as well as tissue laxity, sexual dysfunction, and urine incontinence. Laser diode and laser handpiece action is combined in LVR process to speed up collagen formation and remodeling in the mucosa. Through Vaginal Tightening The laser procedure accelerates collagen regeneration and contraction of the elastin fibers, resulting in neovascularization and enhanced vaginal lubrication, by applying intense thermal heating and micro-ablation to the various vaginal layers. End result: thicker epithelium and new collagen fibers are embedded in the female genital tissue, resulting in a younger appearance and a smaller vaginal diameter. By Curing Stress Urinary Incontinence (SUI) One of the most prevalent and stressful conditions affecting a large number of females is Stress Urinary Incontinence (SUI). 30 percent of women between 30 and 60 years old have urine incontinence, with half of those (30 percent) being SUI, according to the American Urological Association. By Curing Vaginal Dryness & Recurrent Infections Lavatory concerns such as dryness and recurrent vaginal infections can be addressed by laser technology. Improved lubrication and normalization of the vaginal pH and flora can be achieved with the use of laser diode. The LVR treatment boosts the local immune system response and helps remove chronic vaginal infections. By Curing Post-Menopausal Genito-urinary Syndrome of Menopause (GSM) Menopause hormones cause the vaginal lining to shrink, dry up, lose its elasticity, and become irritated. The vaginal lining can be rejuvenated, the vaginal walls can be thickened, and natural lubrication can be restored with laser diode. As a result, unpleasant symptoms such as itching, burning, and friction are greatly reduced, resulting in improved sexual functioning and a better quality of life. Fore more Info: Mobile: +917306 700 964 #oreolacademy | #oreol | #oreolpromotions | oreolmedcare | #oreolmedline | #oreolmedtech
Macular degeneration - age-related?
DefinitionMacular degeneration is an eye disorder that slowly destroys sharp, central vision. This makes it difficult to see fine details and read.The disease is most common in people over age 60, which is why it is often called age-related macular degeneration (ARMD, or AMD).Alternative NamesAge-related macular degeneration (ARMD); AMD; senile macular degeneration (SMD) is an older name that is no longer in common use.Causes, incidence, and risk factorsThe retina is at the back of the eye. It changes light and images that enter the eye into nerve signals that are sent to the brain. A part of the retina called the macula makes vision sharper and more detailed.AMD is caused by damage to the blood vessels that supply the macula. This change also harms the macula.There are two types of AMD:Dry AMD occurs when the blood vessels under the macula become thin and brittle. Small yellow deposits, called drusen, form. Almost all people with macular degeneration start with the dry form.Wet AMD occurs in only about 10% of people with macular degeneration. New abnormal and very fragile blood vessels grow under the macula. This is called choroidal neovascularization. These vessels leak blood and fluid. This form causes most of the vision loss associated with the condition.Scientists are not sure what causes AMD. The condition is rare before age 55. It is most often seen in adults 75 years or older.In addition to heredity, other risk factors are:Caucasian raceCigarette smokingHigh-fat dietFemale genderObesitySymptomsYou may not have any symptoms at first. As the disease gets worse, you may have problems with your central vision.SYMPTOMS OF DRY AMD:The most common symptom in dry AMD is blurred vision. Often objects in the central vision look distorted and dim, and colors look faded. You may have trouble reading print or seeing other details, but you can generally see well enough to walk and perform most routine activities.As the disease becomes worse, you may need more light to read or perform everyday tasks. A blurred spot in the center of vision gradually gets larger and darker.In the later stages, you may not be able to recognize faces until they are close.SYMPTOMS OF WET AMD:The most common early symptom of wet AMD is that straight lines appear distorted and wavy.There may be a small dark spot in the center of vision that gets larger over time.Central vision loss can occur very quickly. If this occurs, you will need urgent evaluation by an ophthalmologist with experience in retinal disease.Signs and testsYou will have an eye exam. Drops will be placed into your eyes to widen (dilate) your pupils. The eye doctor will use special lenses to view your retina, blood vessels, and optic nerve.The eye doctor will look for specific changes in the macula and blood vessels. One of the earliest findings in dry AMD are yellow deposits in the macula, called drusen.You may be asked to cover one eye and look at a pattern of lines called an Amsler grid. If the straight lines appear wavy, it may be a sign of AMD.Other tests that may be done include:Fluorescein angiogramFundus photographyOptical coherence tomography (OCT)TreatmentIf you have advanced or severe dry AMD, no treatment can restore your vision.If you have early AMD and do not smoke, a combination of certain vitamins, antioxidants, and zinc may prevent the disease from getting worse. But it cannot give you back any vision that is already lost.The combination is often called the "AREDS" formula. The recommended supplements contain:500 milligrams of vitamin C400 international units of beta-carotene80 milligrams of zinc2 milligrams of copperOnly take this vitamin combination if your doctor recommends it. Make sure your doctor knows about any other vitamins or supplements you are taking. Smokers should NOT use this treatment.AREDS may also benefit you if you have a a family history and risk factors for AMD.The supplements lutein and zeaxanthin may also be helpful, although they are not part of the AREDS formula.If you have wet AMD, your doctor may recommend:Laser surgery (laser photocoagulation) -- a small beam of light destroys the leaking, abnormal blood vessels.Photodynamic therapy -- a light activates a drug that is injected into your body to destroy leaking blood vessels.Special medications that prevent new blood vessels from forming in the eye (anti-angiogenesis, anti-VEGF therapy) -- drugs such as bevacizumab (Avastin) and ranibizumab (Lucentis) are injected into the eye. This is a painless process.Low-vision aids (such as special lenses) and therapy can help you use the vision that you have more effectively, and improve your quality of life.Close follow-up with your eye doctor is important.For dry AMD, a complete eye exam should be performed by an eye specialist at least once a year.People who have been treated for wet AMD need frequent, perhaps monthly, follow-up visits.In AMD, early detection of vision changes is very important. Early detection leads to earlier treatment and often, a better outcome.The best way to detect changes is by self-testing at home with an eye chart, called an Amsler grid. Test each eye individually with the vision correction you normally wear for reading.Support GroupsAMD Alliance International -- (877) AMD-7171 -- www.amdalliance.org.Expectations (prognosis)AMD typically does not affect side (peripheral) vision. This is very important, because it means complete vision loss never occurs from this disease. This disorder results in the loss of central vision only.Mild, dry AMD usually does not cause disabling central vision loss. However, there is no way to predict who will develop a more severe form of the disease.Wet AMD often leads to significant vision loss.In general, macular degeneration can cause you to lose the ability to read, drive a car, and recognize faces at a distance. Most people with this eye disease are able to eat, bathe, and perform other regular tasks without too much difficulty.ComplicationsThis condition may make it hard to read, work on the computer, or drive. You may need extra light or magnification to do many of your normal activities.Calling your health care providerIf you have AMD, your health care provider may recommend that you check your vision every day on an Amsler grid. Call your provider immediately if the lines appear wavy, or you notice any other changes in your vision.PreventionAlthough there is no known way to prevent macular degeneration, lifestyle factors can reduce your risk of developing the condition:Don't smokeEat a healthy diet that is high in fruits and vegetables and low in animal fatExercise regularlyMaintain a healthy weightSee your eye care professional regularly for dilated eye exams.ReferencesBenson WE. Acquired macular disease. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins;2011:chap 23.Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.Reviewed ByReview Date: 09/16/2011Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Diabetes and eye disease?
DefinitionDiabetic retinopathy is damage to the eye's retina that occurs with long-term diabetes.See also:Type 1 diabetesType 2 diabetesAlternative NamesRetinopathy - diabetic; Photocoagulation - retina; Diabetic retinopathyCauses, incidence, and risk factorsDiabetic retinopathy is caused by damage to blood vessels of the retina. The retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals that are sent to the brain.There are two types, or stages of diabetic retinopathy:Nonproliferative develops firstProliferative is the more advanced and severe form of the diseaseDiabetic retinopathy is the leading cause of blindness in working-age Americans. People with type 1 diabetes and type 2 diabetes are at risk for this condition.Having more severe diabetes for a longer period of time increases the chance of getting retinopathy. Retinopathy is also more likely to occur earlier and be more severe if your diabetes has been poorly controlled.Almost everyone who has had diabetes for more than 30 years will show signs of diabetic retinopathy.SymptomsMost often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.Symptoms of diabetic retinopathy include:Blurred vision and slow vision loss over timeFloatersShadows or missing areas of visionTrouble seeing at nightMany people with early diabetic retinopathy have no symptoms before major bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams.Signs and testsThe health care provider can diagnose diabetic retinopathy by dilating your pupils with eye drops and then carefully examining the retina. A retinal photography or fluorescein angiographytest may also be used.If you have nonproliferative diabetic retinopathy, your health care provider may see:Blood vessels in the eye that are larger in certain spots (called microaneurysms)Blood vessels that are blockedSmall amounts of bleeding (retinal hemorrhages) and fluid leaking into the retinaIf you have proliferative retinopathy, your health care provider may see:New blood vessels starting to grow in the eye that are fragile and can bleedSmall scars developing on the retina and in other parts of the eye (the vitreous)TreatmentTo prevent diabetic retinopathy:Keep tight control of your blood sugar (glucose), blood pressure, and cholesterol levelsStop smokingPeople with the earlier form (nonproliferative) of diabetic retinopathy may not need treatment. However, they should be closely followed by an eye doctor who is trained to treat diabetic retinopathy.Treatment usually does not reverse damage that has already occurred. However, it can help keep the disease from getting worse. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.Several procedures or surgeries are the main treatment for diabetic retinopathy.Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called photocoagulation. It is used to keep vessels from leaking or to get rid of abnormal, fragile vessels.Focal laser photocoagulation is used to treat macular edema.Scatter laser treatment or panretinal photocoagulation treats a large area of your retina. Often two or more sessions are needed.A surgical procedure called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.Drugs that prevent abnormal blood vessels from growing, and corticosteroids injected into the eyeball are being investigated as new treatments for diabetic retinopathy.If you cannot see well:Make sure your home is safe so you do not fallOrganize your home so that you can easily find what you needGet help to make sure you are taking your medicines correctlySee also:Cataract removalRetinal detachment repairSupport GroupsAmerican Diabetes Association - www.diabetes.orgNational Diabetes Information Clearinghouse - www.diabetes.niddk.nih.govPrevent Blindness America - www.preventblindness.orgExpectations (prognosis)You can improve your outcome by keeping good control of your blood sugar and blood pressure.Treatments can reduce vision loss. They do not cure diabetic retinopathy or reverse the changes that have already occurred.Once proliferative retinopathy occurs, there is always a risk for bleeding. You will need to be monitored regularly, and you may need more treatment.ComplicationsOther problems that may develop are:CataractsGlaucoma -- increased pressure in the eye that can lead to blindnessMacular edema -- if fluid leaks into the area of the retina that provides sharp vision straight in front of you, your vision becomes more blurryRetinal detachment -- scarring may cause part of the retina to pull away from the back of your eyeballCalling your health care providerCall for an appointment with an eye doctor (ophthalmologist) if you have diabetesand you have not seen an ophthalmologist in the past year.Call your doctor if any of the following symptoms are new or are becoming worse:You cannot see well in dim light.You have blind spots.You have double vision (you see two things when there is only one).Your vision is hazy or blurry and you cannot focus.You have pain in one of your eyes.You are having headaches.You see spots floating in your eyes.You cannot see things on the side of your field of vision.You see shadows.PreventionTight control of blood sugar, blood pressure, and cholesterol is very important for preventing diabetic retinopathy.Do not smoke. If you need help quitting, ask your doctor or nurse.You may not know there is any damage to your eyes until the problem is very bad. Your doctor can catch problems early if you get regular exams. You will need to see an eye doctor who is trained to treat diabetic retinopathy.Begin having eye examinations as follows by an eye doctor skilled in the treatment of diabetic retinopathy:Children older than 10 years who have had diabetes for 3 - 5 years or moreAdults and adolescents with type 2 diabetes soon after diagnosisAdolescents and adults with type 1 diabetes within 5 years of diagnosisAfter the first exam, most patients should have a yearly eye exam.If you are beginning a new exercise program or are planning to get pregnant, have your eyes examined. Avoid resistance or high-impact exercises, which can strain already weakened blood vessels in the eyes.If you are at low risk, you may need follow-up exams only every 2 - 3 years. The eye exam should include dilation to check for signs of retinal disease (retinopathy).ReferencesAmerican Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care. 2011 Jan;34 Suppl 1:S11-61.O'Doherty M, Dooley I, Hickey-Dwyer M. Interventions for diabetic macular oedema: a systematic review of the literature. Br J Opthalmol. 2008;92:1581-1590.Diabetic Retinopathy Clinical Research Network (DRCR.net), Beck RW, Edwards AR, Aiello LP, Bressler NM, Ferris F, Glassman AR, et al. Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Arch Ophthalmol. 2009;127:245-251.Reviewed ByReview Date: 01/03/2012A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Ari S. Eckman, MD, Chief, Divisiopn of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network (6/28/2011).
Diabetic retinopathy?
DefinitionDiabetic retinopathy is damage to the eye's retina that occurs with long-term diabetes.See also:Type 1 diabetesType 2 diabetesAlternative NamesRetinopathy - diabetic; Photocoagulation - retinaCauses, incidence, and risk factorsDiabetic retinopathy is caused by damage to blood vessels of the retina. The retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals that are sent to the brain.There are two types, or stages of retinopathy: Nonproliferative or proliferativeNonproliferative diabetic retinopathy develops first. Blood vessels in the eye become larger in certain spots (called microaneurysms). Blood vessels may also become blocked. There may be small amounts of bleeding (retinal hemorrhages), and fluid may leak into the retina. This can lead to noticeable problems with your eyesight.Proliferative retinopathy is the more advanced and severe form of the disease. New blood vessels start to grow in the eye. These new vessels are fragile and can bleed (hemorrhage). Small scars develop, both on the retina and in other parts of the eye (the vitreous). The end result is vision loss, as well as other problems.Other problems that may develop are:Macular edema -- the macula is the area of the retina that provides sharp vision straight in front of you. If fluid leaks into this area, your vision becomes more blurry.Retinal detachment -- scarring may cause part of the retina to pull away from the back of your eyeball.Glaucoma -- increased pressure in the eye is called glaucoma. If not treated, it can lead to blindness.CataractsDiabetic retinopathy is the leading cause of blindness in working-age Americans. People with both type 1 diabetes and type 2 diabetes are at risk for this condition.Having more severe diabetes for a longer period of time increases the chance of getting retinopathy. Retinopathy is also more likely to occur earlier and be more severe if your diabetes has been poorly controlled. Almost everyone who has had diabetes for more than 30 years will show signs of diabetic retinopathy.SymptomsMost often, diabetic retinopathy has no symptoms until the damage to your eyes is severe.Symptoms of diabetic retinopathy include:Blurred vision and gradual vision lossFloatersShadows or missing areas of visionDifficulty seeing at nighttimeMany people with early diabetic retinopathy have no symptoms before major bleeding occurs in the eye. This is why everyone with diabetes should have regular eye exams.Signs and testsIn nearly all cases, the health care provider can diagnose diabetic retinopathy by dilating the pupils with eye drops and then carefully examining the retina. A retinal photography or fluorescein angiography test may also be used.TreatmentThe following are very important for preventing diabetic retinopathy:Tight control of blood sugar (glucose), blood pressure, and cholesterolStopping smokingPeople with nonproliferative diabetic retinopathy may not need treatment. However, they should be closely followed-up by an eye doctor trained to treat diabetic retinopathy.Treatment usually does not reverse damage that has already occurred, but it can help keep the disease from getting worse. Once your eye doctor notices new blood vessels growing in your retina (neovascularization) or you develop macular edema, treatment is usually needed.Several procedures or surgeries are the main treatment for diabetic retinopathy.Laser eye surgery creates small burns in the retina where there are abnormal blood vessels. This process is called photocoagulation. It is used to keep vessels from leaking or to get rid of abnormal, fragile vessels.Focal laser photocoagulation is used to treat macular edema.Scatter laser treatment or panretinal photocoagulation treats a large area of your retina. Often two or more sessions are needed.A surgical procedure called vitrectomy is used when there is bleeding (hemorrhage) into the eye. It may also be used to repair retinal detachment.Drugs that prevent abnormal blood vessels from growing, and corticosteroids injected into the eyeball are being investigated as new treatments for diabetic retinopathy.If you cannot see well:Make sure your home is safe so you do not fallOrganize your home so that you can easily find what you needGet help to make sure you are taking your medicines correctlySee also:Retinal detachment repairCataract removalSupport GroupsAmerican Diabetes Association - www.diabetes.orgNational Diabetes Information Clearinghouse - www.diabetes.niddk.nih.govPrevent Blindness America - www.preventblindness.orgExpectations (prognosis)You can improve your outcome by keeping good control of your blood sugar and blood pressure.Both treatments are effective at reducing vision loss. They do not cure diabetic retinopathy or reverse the changes that have already occurred.Once proliferative retinopathy occurs, there is always a risk for bleeding. You will need ongoing monitoring, and you may need more treatment.ComplicationsBlindnessGlaucomaRetinal detachmentCalling your health care providerCall for an appointment with an eye doctor (ophthalmologist) if you have diabetesand you have not seen an ophthalmologist in the past year.Call your doctor if any of the following symptoms are new or are becoming worse:You cannot see well in dim light.You have blind spots.You have double vision (you see two things when there is only one).Your vision is hazy or blurry and you cannot focus.You have pain in one of your eyes.You are having headaches.You see spots floating in your eyes.You cannot see things on the side of your field of vision.You see shadows.PreventionTight control of blood sugar, blood pressure, and cholesterol is very important for preventing diabetic retinopathy.Do not smoke. If you need help quitting, ask your doctor or nurse.You may not know there is any damage to your eyes until the problem is very bad. Your doctor can catch problems early if you get regular exams. You will need to see an eye doctor who is trained to treat diabetic retinopathy.Begin having eye examinations as follows by an eye doctor skilled in the treatment of diabetic retinopathy:Children older than 10 years who have had diabetes for 3 - 5 years or moreAdults and adolescents with type 2 diabetes soon after diagnosisAdolescents and adults with type 1 diabetes within 5 years of diagnosisAfter the first exam, most patients should have a yearly eye exam.If you are beginning a new exercise program or are planning to get pregnant, have your eyes examined. Avoid resistance or high-impact exercises, which can strain already weakened blood vessels in the eyes.If you are at low risk, you may need follow-up exams only every 2 - 3 years. The eye exam should include dilation to check for signs of retinal disease (retinopathy).ReferencesAmerican Diabetes Association. Standards of medical care in diabetes--2010. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.O'Doherty M, Dooley I, Hickey-Dwyer M. Interventions for diabetic macular oedema: a systematic review of the literature. Br J Opthalmol. 2008;92:1581-1590.Diabetic Retinopathy Clinical Research Network (DRCR.net), Beck RW, Edwards AR, Aiello LP, Bressler NM, Ferris F, Glassman AR, et al. Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Arch Ophthalmol. 2009;127:245-251.
Macular degeneration?
DefinitionMacular degeneration is an eye disorder that damages the center of the retina, which is called the macula. This makes it difficult to see fine details.Alternative NamesAge-related macular degeneration (ARMD); AMD; senile macular degeneration (SMD) is an older name that is no longer in common use.Causes, incidence, and risk factorsThe retina is the layer of tissue at the back of the inner eye. It changes light and images that enter the eye into nerve signals that are sent to the brain. The macula is the part of the retina that makes our vision sharper and more detailed.Macular degeneration is caused by damage to the area around blood vessels that supply the macula. This change in the blood vessels damages the macula.Two phases of macular degeneration (AMD) exist:Dry macular degeneration occurs when the blood vessels under the macula become thin and brittle. Small yellow deposits, called drusen, form under the macula. As these drusen increase in size and number, they create a blurred and dim spot in the central vision of the eye. Almost all people with macular degeneration start with the dry form.Wet macular degeneration occurs in only about 10% of people with macular degeneration. Brittle vessels break down and new abnormal and very fragile blood vessels grow under the macula. This is called choroidal neovascularization. These vessels leak blood and fluid, which leads to damage of the macula. Although only about 10 percent of people with macular degeneration have this form, it causes most of the vision loss associated with the condition.Scientists aren't sure what causes AMD. The disease is most common in people over 60, which is why it is often referred to as age-related macular degeneration.In addition to heredity, other risk factors are:Caucasian raceCigarette smokingHigh-fat dietFemale genderObesitySymptomsAt first you may not have symptoms. As the disease progresses, your central vision may be affected.The most common symptom in dry AMD is blurred vision. This is limited to the center of the field of vision. Often objects in the central vision look distorted and dim, and colors look faded. A patient may have trouble reading print or seeing other details, but can generally see well enough to walk and perform most routine activities.As the disease becomes worse, you may need more light to read or perform everyday tasks. The blurred spot in the center of vision gradually gets larger and darker. In the later stages, you may not be able to recognize faces until people are close to you.AMD typically does not affect side (peripheral) vision. This is very important, because it means you will never have complete vision loss from this disease.The most common early symptom of wet macular degeneration is that straight lines appear distorted and wavy. You may also notice a small dark spot in the center of your vision that gradually gets larger. Central vision loss can occur very quickly. If this occurs, you urgently need evaluation by an ophthalmologist with experience in retina disease.Signs and testsIf you are over age 60 and you've had changes in vision, your eye care provider will do an examination. During the exam, the doctor will use drops to enlarge (dilate) your pupils, and a special lens to view your retina and optic nerve.The doctor will look for changes in the blood vessels and the membrane that surrounds them. This may show drusen, the yellow deposits that form on this membrane in dry macular degeneration.You may be asked to cover one eye and look at a pattern of lines called an Amsler grid. If the straight lines appear wavy, it may be a sign of AMD.Other tests for macular degeneration may include:Fluorescein angiogramOptical Coherence Tomography (OCT)TreatmentNo treatment exists for dry macular degeneration. However, a combination of vitamins, antioxidants, and zinc may slow the progression of the disease. This combination of vitamins is often called the "AREDS" formula. Smokers should not use this treatment.The recommended supplements contain:500 milligrams of vitamin C400 international units of beta-carotene80 milligrams of zinc2 milligrams of copperAlthough there is no cure for wet AMD, treatments may include:Laser surgery (laser photocoagulation) -- a small beam of light destroys the abnormal blood vessels.Photodynamic therapy -- a light activates a drug that is injected into your body to destroy leaking blood vessels.Special medications that slow the formation of new blood vessels in the eye (anti-angiogenesis, anti-VEGF therapy) -- drugs such as bevacizumab (Avastin) and ranibizumab (Lucentis) are injected into the eye to stabilize or improve vision. This is a painless process.Low-vision aids (such as special lenses) and therapy can help you use the vision that you have more effectively, and improve your quality of life.Support GroupsAMD Alliance International -- (877) AMD-7171 -- www.amdalliance.org.Expectations (prognosis)Most people with mild dry macular degeneration will not have disabling central vision loss. However, there is no way to predict who will progress to a more severe form of the disease.The wet form of macular degeneration often leads to significant vision loss.Although macular degeneration can cause people to lose the ability to read, drive a car, and recognize faces that are not very close, it never causes complete blindness. This disorder results in the loss of central vision only -- macular degeneration cannot cause peripheral vision loss.Nearly everyone with macular degeneration can get around, eat, perform personal hygiene, and do other routine activities without too much difficulty.ComplicationsLoss of central vision may interfere with many daily activities, such as reading, working on the computer, or driving. You may need extra light or magnification to perform many of your normal activities.Calling your health care providerIf you have AMD, your health care provider may recommend that you check your vision every day on an Amsler grid. Call your provider immediately if the lines appear wavy, or you notice any other changes in your vision.PreventionAlthough there is no known way to prevent macular degeneration, lifestyle factors can reduce your risk of developing the condition:Don't smokeEat a healthy diet that is high in fruits and vegetables and low in animal fatExercise regularlyMaintain a healthy weightSee your eye care professional regularly for dilated eye exams.ReferencesAmerican Academy of Ophthalmology Preferred Practice Pattern in Macular Degeneration.The Age-Related Eye Disease Study (AREDS).Gohel PS, Mandava N, Olson JL, Durairaj VD. Age-related macular degeneration: an update on treatment. Am J Med. 2008;121(4):279-281.Martidis A, Tennant MTS. Age-related macular degeneration. In: Yanoff M, Duker JS, Augsburger JJ, et al., eds. Ophthalmology. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004:chap 125.
