Macular Degeneration

Age Related Macular Degeneration or ARMD is a chronic degenerative disease of the macula. The macula allows you to see fine details directly in front of you as opposed to side vision. There are two types of ARMD, a dry and a wet type.
Dry ARMD progresses slowly and is less severe than the wet type. The wet type consists of abnormal leaky blood vessels. Both types can damage the retina and can take away your central vision. There are many risk factors.
Risk factors that you cannot control include:
• Age
• Family History
• Gender: Females are more susceptible.
Risk factors that are within your control:
• Smoking
• Diet
• Excessive exposure to sunlight
• High Blood Pressure
• Obesity
Treatment of dry ARMD is focused on monitoring and slowing progression of the disease.  This is mainly accomplished by risk factor modification such as quitting smoking, wearing sunglasses on sunny days, supplementing diet with vitamins such as Vitalux and other beneficial nutrients such as omega-3- fatty acids.
Omega 3 fatty acid supplementation comes in two forms, the fish oils or long chain fatty acids, and the flax seed form or short fatty acids.  Both forms differ somewhat in their effects.  The simplest thing is to take both at least twice weekly not exceeding 3 grams per day to be safe.  Since most people with ARMD are already taking VITALUX or an equivalent which contains high doses of vitamin A then one must be careful not to take the fish oil capsules derived from fish liver oil as those also contain vitamin A which may lead to vitamin A overdose. Thus take fish capsules derived from fish body oil instead. Patients on blood thinners must be aware that fish oils may enhance the blood thinner effect.  On the other hand the flax seed version is safe to be taken with blood thinners. Furthermore, omega 3's can disrupt LDL cholesterol and blood sugar control in diabetics.  If in doubt about what you are buying ask your pharmacist for help or bring your bottle to Dr. Bozdech.
The wet ARMD is generally treated with anti-VEGF (Vascular Endothelial Growth Factor) therapy such as repeat injections of a substance called Avastatin, Eyelea or Lucentis into the eye. The Avastin is not covered by health care but Lucentis is covered by the Blue Cross depending on individual plan.  Eyelea (Aflibercept) is a new drug recently approved for use in Canada. Dr. Bozdech can provide these treatments for you in the office.
When vision becomes significantly impaired Dr. Bozdech will refer you to the Canadian National Institute of the Blind (CNIB) where expert counselling and various visual aids such as magnifiers can be custom fitted.     
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