Your Health in Focus: Macular Degeneration

By Jennifer Shipman
 

Do you or one of your loved ones live with macular degeneration? February is AMD Awareness Month (Age-related Macular Degeneration), so we're raising your awareness of this blindness-causing disease.

Macular Degeneration 

Macular degeneration is exactly that - a degeneration of the macula. The macula is the small area of the retina that controls central vision and allows you to see fine details. When the macula is affected you can get blurriness, distorted vision, or dark areas.

Macular degeneration is the leading cause of blindness among adults over the age of 55 in the US.  The exact cause of the disease is not known, but many people develop it as a part of the natural aging process. The disease is commonly known as age-related macular degeneration (AMD) and it rarely affects anyone under the age of 50. Risk factors include age, Caucasian race and cigarette smoking¹.

The are two types of macular degeneration: dry (non-exudative) and wet (exudative).

• Dry AMD: Most people have dry AMD, which involves a thinning of the macular tissues caused by drusen (yellow or white fatty deposits under the retina). There is no leakage of blood or fluid (hence the name "dry"). Vision loss is usually gradual.
   
• Wet AMD: This form is less common (about 10% of all cases are "wet") but more serious. New blood vessels form (called "neovascularization") under the retina that leak, bulging the macula and causing distorted vision and the formation of scar tissue. Vision loss can be rapid and severe.  

What are the symptoms of AMD?

Every person is different, but common symptoms are:

• words on a page are blurred;
• a dark or empty spot in the central vision;
• straight lines appear distorted.

How is AMD Diagnosed?

AMD may be barely noticeable for years; this is why it is so important to have regular eye exams with an ophthalmologist to detect the early stages, especially if you have a family history of macular degeneration or if you are over the age of 50. If AMD is suspected or detected, your examination will include the following:

• Examination of the macula with ophthalmoscopy. Dilation of the pupils allows your doctor to get a good view of the retina.
• A vision test with an Amsler grid. This is a chart that looks like graph paper; if the lines appear distorted this may indicate AMD.
• Photography of the eye to find abnormal blood vessels under the retina and/or leakage of blood or fluids.

How is AMD Treated?

AMD is followed by your ophthalmologist. If treatment is needed you will be referred to a retina specialist (a highly-trained ophthalmologist specializing in the retina and retinal diseases). At Wilkinson Eye Center, Dr. Wilkinson or Dr. Dhaliwal perform ophthalmoscopy and appropriate testing to watch the progress of macular degeneration; when further treatment becomes necessary our patients are scheduled with Dr. Stephen Saxe, our in-house retina specialist. (If you haven't already, you can "meet" Dr. Saxe in our October issue of In Focus!)

There is no true cure at this time for AMD, but treatment to slow progression of the disease has been highly successful, especially with wet AMD. Your doctor may recommend certain nutritional supplements to help maintain your vision. In certain cases of wet AMD laser treatment to seal the leakages may be appropriate. The latest technology in the treatment of wet AMD is intravitreal injections of a drug - Avastin or Lucentis - to prevent new blood vessel growth and leakage.

More Americans dread blindness more than any other disability². Our sight is a precious commodity; if you or someone you love has AMD or the symptoms of AMD, if you are over 50, or if you have a family history of AMD - please call today to make an appointment for an eye exam. Early diagnosis is often critical in helping you maintain your vision in this complicated disease. We're here to help you keep your sight!

¹Prevent Blindness America. (2002). Age-Related Macular Degeneration.  Retrieved January 28, 2010 from the Prevent Blindness America website: http://www.preventblindness.org/.

²American Macular Degeneration Foundation. Retrieved February 4, 2010 from the AMDF website: http://www.macular.org/.

Additional Resources:

http://www.preventblindness.org/ 

http://www.lucentis.com/

http://www.aao.org/

http://www.macular.org/

"Heart" Healthy - Be a Valentine!

By Jennifer Shipman

Ah, L'Amour... February means Valentine's Day, and love it or hate it, it could be good for your health!  Googling "Health Benefits of Love" returns hundreds and hundreds of results, with more articles than anyone could possibly want to read on the health benefits we get from loving - and we're not just talking about romantic love between couples.

The origins of Valentine's Day are rather hazy.  While the holiday was declared as the Feast Day of Saint Valentine in 496 A.D. by Pope Gelasius I, there is very little historical record of who Saint Valentine actually was.  Most sources connect the holiday to at least three saints by the name who all were martyred on February 14, though the first two (Saint Valentine of Rome and Saint Valentine of Terni) may have been the same man and almost nothing is known of the third except that he was martyred in Africa and is probably unassociated with the celebration. 

The first two (or one) Valentine lived in the Third Century under the Roman emperor Claudius II, were martyred on February 14 (perhaps in 269 or 270 A.D.), and are buried on the Via Flaminia.  Romantic legends credit Valentine with assisting martyrs during the persecution under Claudius II, trying to convert Claudius to Christianity, sending  letters to loved ones from jail, miraculously restoring sight to the blind daughter of his jailor, and falling in love with that same girl and sending her a farewell message signed "From your Valentine".  Perhaps most romantic is the tradition that when Claudius II, allegedly canceling all engagements and marriages to keep young men single (and recruit them to the military), Valentine secretly performed marriages for young couples anyway. 

Whatever the truth, Saint Valentine is now associated with performing acts of love and kindness.  Since probably the beginning of time religions around the world have espoused the belief that love is good for your health and the health of the ones you love.  In more modern times, science is proving this.  Studies are showing that stable relations - romantic and platonic - reduce stress, improve heart health, lower the risk of disease and keep you young.  And these are just a few of the benefits!

1. Reduce Stress and Promote Mental Health: Intimate relationships have been shown to increase production of dehydroepiandrosterone, a stress buster, and decrease the stress hormone cortisol. In long-term, stable relationships studies show more activity in the areas of the brain associated with bonding, and less in the areas that produce anxiety. There is a clear link between social isolation and depression; so it is no surprise that stable marriage relationships also show less depression and less drinking and drug abuse.
   
   Even platonic relationships can have this effect: touching, even simple touches like hugs and hand-holding, "can lower stress hormones and help you feel more connected¹".  It can also boost levels of oxytocin, the "bonding hormone" and also a relaxing hormone.  Even "unloading" on someone you love can help you cope better under stress.
    
2. Decrease Pain and Increase Immunity: Love triggers something in the brain that keeps pain under control. Studies show that happily married people complain of less pain, and volunteers helping in their community had "relief from pain related to stress-sensitive conditions like multiple sclerosis, and headaches, and lupus²".  Love can relax you and release endorphins; the stress relief lowers that darn cortisol hormone - which can hamper immunity.
    
3. Better Heart Health and Lower Blood Pressure: You know how your heart starts to pound when you see that certain someone? That's actually good for your heart: it leads to increased blood supply to the body, better circulation and more efficient organs. (So even if you are not in a relationship, you can use this as an excuse to stare at your heart's desire!) Studies also link strong relationships with lowered blood pressure: happily married people fare the best, then singles with strong social networks, then other singles, then unhappily married people.
    
4. Lower Cholesterol: Research shows that expressing affection (whether for a romantic partner, significant friends or relatives) can significantly reduce your cholesterol. According to one study, even putting your feelings down on paper works³!
    
5. Faster Healing: Happy couples who were given small wounds in a study healed faster than hostile couples; this may be linked to the increased immunity mentioned above, as happy couples and socially fulfilled singles also are less apt to get sick from the cold or flu.
    
6. Younger Life: Remember dehydroepiandrosterone, the stress buster hormone? It's also "anti-aging" so you feel younger and more vital. Plus, the endorphins released by feelings of love increase blood flow to the skin, keeping it softer, smother, and less wrinkled. It may even be that giving love keeps you younger than receiving it.
    
7. Longer Life: Feeling loved and connected contributes to a longer life! Social isolation increased the risk of early death by up to five times⁴, and people who have never been married are 58% more likely to die sooner than married people⁵. Married people also have fewer visits to the doctor or the hospital. There is a lot of evidence to support the belief that people who are loved and supported take better care of themselves: maybe spouses encourage each other to eat well, best friends work out together, or a relative pushes a loved one to have regular check-ups. Human beings are social creatures; isolation and loneliness tend to bring on earlier death.

While married couples may have better health and longer lives in part due to "mutual practical support, financial benefits, and children who provide support" (Harry Reis, Ph.D.), most researchers believe that it is the emotional connection that is the real benefactor. This is why we see so many of these benefits not only in romantically attached people but in anyone with strong social connections and positive relationships. Being loved and giving love back just makes us feel good, and when you feel good you live better.

So "reach out and touch someone" (thanks, AT&T) to boost your health.  But, we suggest you stay away from those heart-shaped candies and boxes of chocolates.

¹Kotz, Deborah. (February 13, 2009). Love and Romance: Get the Health Benefits Even if You're Single.  Retrieved February 1, 2010 from the US News & World Report website: http://www.usnews.com/.