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Encyclopedia > Macular degeneration
Macular degeneration
Classification & external resources
ICD-10 H35.3
ICD-9 362.50
MeSH D008268
Human eye cross-sectional view. Courtesy NIH National Eye Institute
Human eye cross-sectional view. Courtesy NIH National Eye Institute
Normal vision. Courtesy NIH National Eye Institute
Normal vision. Courtesy NIH National Eye Institute
The same view with age-related macular deneneration.
The same view with age-related macular deneneration.

Macular degeneration is a medical condition predominantly found in elderly adults in which the center of the inner lining of the eye, known as the macula area of the retina, suffers thinning, atrophy, and in some cases bleeding. This can result in loss of central vision, which entails inability to see fine details, to read, or to recognize faces. According to the American Academy of Ophthalmology, it is the leading cause of central vision loss (blindness) in the United States today for those over the age of fifty years.[1] Although some macular dystrophies that affect younger individuals are sometimes referred to as macular degeneration, the term generally refers to age-related macular degeneration (AMD or ARMD). The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // H00-H59 - Diseases of the eye and adnexa (H00-H06) Disorders of eyelid, lacrimal system and orbit (H00) Hordeolum and chalazion (H000) Hordeolum and other deep inflammation of eyelid (H001) Chalazion (H01) Other inflammation of eyelid (H010) Blepharitis (H011) Noninfectious dermatoses of eyelid (H02) Other disorders of eyelid (H020) Entropion... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Image File history File links Macular degeneration. ... Image File history File links Sound-icon. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 200th day of the year (201st in leap years) in the Gregorian calendar. ... Image File history File links Sound-icon. ... Image File history File links Human_eye_cross-sectional_view_grayscale. ... Image File history File links Human_eye_cross-sectional_view_grayscale. ... For other uses, see Eye (disambiguation). ... National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical research. ... The National Eye Institute (NEI) is one of the US National Institutes of Health that was established in 1968. ... human eyesight two children and ball normal vision Copyright: public domain, US gov. ... human eyesight two children and ball normal vision Copyright: public domain, US gov. ... National Institutes of Health Building 50 at NIH Clinical Center - Building 10 The National Institutes of Health (NIH) is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical research. ... The National Eye Institute (NEI) is one of the US National Institutes of Health that was established in 1968. ... human eyesight two children and ball with age-related macular degeneration Copyright: public domain, US gov. ... human eyesight two children and ball with age-related macular degeneration Copyright: public domain, US gov. ... Human eye cross-sectional view. ... Human eye cross-sectional view. ... The American Academy of Ophthalmology (AAO) is a medical association of ophthalmologists–medical doctors (MDs) specializing in eye care and surgery). ... This article is about the visual condition. ...

Contents

Age-related macular degeneration

Age-related macular degeneration begins with characteristic yellow deposits in the macula (central area of the retina which provides detailed central vision) called drusen between the retinal pigment epithelium and the underlying choroid. Most people with these early changes (referred to as age-related maculopathy) have good vision. People with drusen can go on to develop advanced AMD. The risk is considerably higher when the drusen are large and numerous and associated with disturbance in the pigmented cell layer under the macula. Recent research suggests that large and soft drusen are related to elevated cholesterol deposits and may respond to cholesterol lowering agents or the Rheo Procedure. Drusen are tiny yellow or white fat globules and extracellular material that build up in the retina of the eye or on the optic nerve head. ... The retinal pigment epithelium is the pigmented cell layer just outside the neurosensory retina that nourishes retinal visual cells, and is firmly attached to the underlying choroid and overlying retinal visual cells. ... The choroid, also known as the choroidea or choroid coat, is the vascular layer of the eye lying between the retina and the sclera. ...


Advanced AMD, which is responsible for profound vision loss, has two forms: dry and wet. Central geographic atrophy, the dry form of advanced AMD, results from atrophy to the retinal pigment epithelial layer below the retina, which causes vision loss through loss of photoreceptors (rods and cones) in the central part of the eye. While no treatment is available for this condition, vitamin supplements with high doses of antioxidants, lutein and zeaxanthin, have been demonstrated by the National Eye Institute and others to slow the progression of dry macular degeneration and in some patients, improve visual acuity. Lutein (LOO-teen) (from Latin lutea meaning yellow) is one of over 600 known naturally occurring carotenoids. ... Zeaxanthin is one of the two carotenoids contained within the retina. ...


Neovascular or exudative AMD, the wet form of advanced AMD, causes vision loss due to abnormal blood vessel growth in the choriocapillaries, through Bruch's membrane, ultimately leading to blood and protein leakage below the macula. Bleeding, leaking, and scarring from these blood vessels eventually cause irreversible damage to the photoreceptors and rapid vision loss if left untreated. An exudate is any thick fluid that is actively secreted by cells as a result of disease. ... Bruchs membrane is the innermost layer of the choroid. ...


Until recently, no effective treatments were known for wet macular degeneration. However, new drugs, called anti-angiogenics or anti-VEGF (anti-Vascular Endothelial Growth Factor) agents, when injected directly into the vitreous humor of the eye using a small, painless needle, can cause regression of the abnormal blood vessels and improvement of vision. The injections frequently have to be repeated on a monthly or bi-monthly basis. Examples of these agents include Lucentis, Avastin and Macugen. Only Lucentis and Macugen are FDA approved as of April 2007. Macugen has been found to have only minimal benefits in neovascular AMD and is no longer used. Worldwide, Avastin has been used extensively despite its "off label" status. The cost of Lucentis is approximately $2000 US while the cost of Avastin is approximately $150. Anti-angiogenics is a class of drug that prevents the formation of abnormal, new blood vessels in the eye, and dries up vessels which have already begun to leak. ... Vascular endothelial growth factor (VEGF) is an important signaling protein involved in both vasculogenesis (the de novo formation of the embryonic circulatory system) and angiogenesis (the growth of blood vessels from pre-existing vasculature). ... Ranibizumab (trade name Lucentis) is a monoclonal antibody fragment derived from the same parent murine antibody as bevacizumab (Avastin). ... Bevacizumab is an anti-angiogenesis drug used in treatment of cancer. ... Pegaptanib sodium injection (brand name Macugen) is an anti-angiogenic medicine for the treatment of neovascular (wet) age-related macular degeneration (AMD). ... The term off-label refers to the use of a drug for a medical condition other than for which it was officially approved and marketed. ...


Risk factors

  • Aging: Approximately 10% of patients 66 to 74 years of age will have findings of macular degeneration. The prevalence increases to 30% in patients 75 to 85 years of age.[citation needed]
  • Smoking: The only environmental exposure clearly associated with macular degeneration is tobacco smoking.[2] Exposure to cigarette smoke more than doubles the risk of macular degeneration.[citation needed]
  • Family history: The lifetime risk of developing late-stage macular degeneration is 50% for people who have a relative with macular degeneration vs. 12% for people who do not have relatives with macular degeneration, i.e. a fourfold higher risk.[citation needed]
  • Macular degeneration gene: The genes for the complement system proteins factor H (CFH) and factor B (CFB) have been determined to be strongly associated with a person's risk for developing macular degeneration. CFH is involved in inhibiting the inflammatory response mediated via C3b (and the Alternative Pathway of complement) both by acting as a cofactor for cleavage of C3b to its inactive form, C3bi, and by weakening the active complex that forms between C3b and factor B. C-reactive protein and polyanionic surface markers such as glycosaminoglycans normally enhance the ability of factor H to inhibit complement . But the mutation in CFH(Tyr402His) reduces the affinity of CFH for CRP and probably also alters the ability of factor H to recognise specific glycosaminoglycans. This change results in reduced ability of CFH to regulate complement on critical surfaces such as the specialised membrane at the back of the eye and leads to increased inflammatory response within the macula. In two 2006 studies at Yale Department of Epidemiology and Public Health and the Department of Ophthalmology and Visual Sciences, Moran Eye Center at the University of Utah School of Medicine, another gene that has implications for the disease, called HTRA1 (encoding a secreted serine protease), was identified. [3][4]
  • Arg80Gly Variant of the Complement Protein C3 A genetic study published in the New England Journal of Medicine in 2007 showed that a certain, common mutation in the C3 gene which is a central protein of the Complement System is strongly associated with the occurrence of Age-related Macular Degeneration.[5] The authors consider their study to underscore the influence of the complement pathway in the pathogenesis of this disease.
  • Hypertension: Also known as high blood pressure.
  • Cardiovascular status - high cholesterol, obesity.
  • High fat intake is associated with an increased risk of macular degeneration in both women and men. Fat provides about 42% of the food energy in the average American diet. A diet that derives closer to 20-25% of total food energy from fat is probably healthier. Reducing fat intake to this level means cutting down greatly on consumption of red meats and high-fat dairy products such as whole milk, cheese, and butter. Eating more cold-water fish[6] (at least twice weekly), rather than red meats, and eating any type of nuts may help macular degeneration patients.[7]
  • Oxidative stress: It has been proposed that age related accumulation of low molecular weight, phototoxic, pro-oxidant melanin oligomers within lysosomes in the retinal pigment epithelium may be partly responsible for decreasing the digestive rate of photoreceptor outer rod segments (POS) by the RPE. A decrease in the digestive rate of POS has been shown to be associated with lipofuscin formation - a classic sign associated with macular degeneration.[8][9]
  • Race Macular degeneration is more likely to be found in whites than in blacks.[10][11]
  • Exposure to sunlight especially blue light. There is conflicting evidence as to whether exposure to sunlight contributes to the development of macular degeneration. A recent study in the British Journal of Ophthalmology on 446 subjects found that it does not.[12] High energy visible light (HEV) has been implicated as a cause of age-related macular degeneration.[13][14]

The cigarette is the most common method of smoking tobacco. ... A complement protein attacking an invader. ... Factor H is a member of the regulators of complement activation family and is a complement control protein. ... The classical and alternative complement pathways. ... Wikipedia does not yet have an article with this exact name. ... Arterial hypertension, or high blood pressure is a medical condition where the blood pressure is chronically elevated. ... Food energy is the amount of energy in food that is available through digestion. ... Pro-oxidants are chemicals that induce oxidative stress, either through creating reactive oxygen species or inhibiting antioxidant systems. ... Broadly, melanin is any of the polyacetylene, polyaniline, and polypyrrole blacks and browns or their mixed copolymers. ... The retinal pigment epithelium is the pigmented cell layer just outside the neurosensory retina that nourishes retinal visual cells, and is firmly attached to the underlying choroid and overlying retinal visual cells. ... Lipofuscin is the name given to brown pigment granules composed of lipid-containing residues of lysosomal digestion. ... In ophthalmology, high energy visible light (HEV light) is high frequency light from 380 nm to 530 nm in the visible spectrum[1]. HEV light has been implicated as a cause of age-related macular degeneration[2][3]. Some sunglasses are now designed specifically to block HEV. References ↑ Dykas, Carol. ...

Signs

  • Drusen
  • Pigmentary alterations
  • Exudative changes: hemorrhages in the eye, hard exudates, subretinal/sub-RPE/intraretinal fluid
  • Atrophy: incipient and geographic
  • Visual acuity drastically decreasing (two levels or more) ex: 20/20 to 20/80.

Drusen are tiny yellow or white fat globules and extracellular material that build up in the retina of the eye or on the optic nerve head. ... A subconjunctival hemorrhage is a common and relatively minor post-LASIK complication. ...

Symptoms

Image courtesy AgingEye Times
  • Blurred vision: Those with nonexudative macular degeneration may by asymptomatic or notice a gradual loss of central vision, whereas those with exudative macular degeneration often notice a rapid onset of vision loss.
  • Central scotomas (shadows or missing areas of vision)
  • Distorted vision (i.e. metamorphopsia) - A grid of straight lines appears wavy and parts of the grid may appear blank. Patients often first notice this when looking at mini-blinds in their home.
  • Trouble discerning colors; specifically dark ones from dark ones and light ones from light ones.
  • Slow recovery of visual function after exposure to bright light

The Amsler Grid Test is one of the simplest and most effective methods for patients to monitor the health of the macula. The Amsler Grid is essentially a pattern of intersecting lines (identical to graph paper) with a black dot in the middle. The central black dot is used for fixation (a place for the eye to stare at). With normal vision, all lines surrounding the black dot will look straight and evenly spaced with no missing or odd looking areas when fixating on the grid's central black dot. When there is disease affecting the macula, as in macular degeneration, the lines can look bent, distorted and/or missing. Image File history File links From http://www. ... Image File history File links From http://www. ... The Amsler Grid, used since 1945, is a black and white grid of horizontal and vertical lines used to monitor a persons central visual field. ...


'Vision loss' or 'blindness' in macular degeneration refers to the loss of 'central vision' only. The peripheral vision is preserved. Blindness in macular degeneration does not mean 'inability to see light' and even with far advanced macular degeneration, the peripheral retina allows for useful vision.


The loss of central vision profoundly affects visual functioning. It is not possible, for example, to read without central vision. Pictures which attempt to depict the central visual loss of macular degeneration with a black spot do not really do justice to the devastating nature of the visual loss. This can be demonstrated by printing letters 6 inches high on a piece of paper and attempting to identify them while looking straight ahead and holding the paper slightly to the side. Most people find this surprisingly difficult to do.


Similar symptoms with a very different etiology and different treatment can be caused by Epiretinal membrane or macular puckeror leaking blood vessels in the eye.. Human eye cross-sectional view. ... Human eye cross-sectional view. ...


Diagnosis

Fluorescein angiography allows for the identification and localization of abnormal vascular processes. Optical coherence tomography is now used by most ophthalmologists in the diagnosis and the followup evaluation of the response to treatment by using either Avastin or Lucentis which are injected into the vitreous of the eye at various intervals. Fluorescein angiography, or fluorescent angiography, is a technique for examining the circulation of the retina. ...


Prevention

The Age-Related Eye Disease Study showed that a combination of high-dose beta-carotene, vitamin C, vitamin E, and zinc can reduce the risk of developing advanced AMD by about 25 percent in those patients who have earlier but significant forms of the disease. This is the only proven intervention to decrease the risk of advanced AMD at this time. A follow up study, Age-Related Eye Disease Study 2 to study the potential benefits of lutein, zeaxanthine, and fish oil, is currently underway. The Age-Related Eye Disease Study was a clinical trial sponsored by the National Eye Institute, one of the National Institutes of Health in the United States. ... Beta-carotene is a form of carotene with β-rings at both ends. ... This article is about the nutrient. ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ... General Name, symbol, number zinc, Zn, 30 Chemical series transition metals Group, period, block 12, 4, d Appearance bluish pale gray Standard atomic weight 65. ...


Anecortave acetate, (Retanne), is an anti-angiogenic drug that is given as an injection behind the eye (avoiding an injection directly into the eye) that is currently being studied as a potential way of reducing the risk of neovascular (or wet) AMD in high-risk patients.


Research started in 2005 has shown that intravitreal injection of Avastin (bevacizumab) can improve vision and slow down the macular degeneration. This therapy is currently being used in various centres around the world. Avastin is an immunoligic drug that prevents neovascularization. Hence it may also be effective in diabetic retinopathy. Avastin was initially used for the treatment of colorectal cancer.


A study by a neuroretinologist in the late 80's suggested that microcurrent stimulation of acupuncture points for the eye had positive effects in slowing and even stopping progression of the disease[citation needed]. This study was based on Ngok Cheng's research on the increased amounts of ATP levels in living tissue after being stimulated with microcurrent. ("The Effects of Electric Currents on ATP Generation, Protein Synthesis, and Membrane Transport in Rat Skin.")[15]


Recent studies suggest that statins, a family of drugs used for reducing cholesterol levels, may be effective in prevention of AMD, and in slowing its progression.[16] Lovastatin, the first statin to be marketed The statins (or HMG-CoA reductase inhibitors) form a class of hypolipidemic agents, used as pharmaceutical agents to lower cholesterol levels in people with or at risk for cardiovascular disease. ... Cholesterol is a sterol (a combination steroid and alcohol). ...


Studies are underway at Harvard, with the goal of reducing lipofuscin accumulation. [9] Harvard University is a private university in Cambridge, Massachusetts, USA, and a member of the Ivy League. ... Lipofuscin is the name given to brown pigment granules composed of lipid-containing residues of lysosomal digestion. ...


On September 10, 2007, in a 6-year study, researchers, led by John Paul SanGiovanni of the National Eye Institute, Maryland found that Lutein and zeaxanthin (nutrients in eggs, spinach and other green vegetables) protect against blindness (macular degeneration), affecting 1.2 million Americans, mostly after age 65. Lutein and zeaxanthin reduce the risk of AMD (journal Archives of Ophthalmology). Foods considered good sources of the nutrients also include kale, turnip greens, collard greens, romaine lettuce, broccoli, zucchini, corn, garden peas and Brussels sprouts.[17] For the suburb of Melbourne, Australia, see Research, Victoria. ... The National Eye Institute (NEI) is one of the US National Institutes of Health that was established in 1968. ... Official language(s) None (English, de facto) Capital Annapolis Largest city Baltimore Largest metro area Baltimore-Washington Metropolitan Area Area  Ranked 42nd  - Total 12,407 sq mi (32,133 km²)  - Width 101 miles (145 km)  - Length 249 miles (400 km)  - % water 21  - Latitude 37° 53′ N to 39° 43′ N... Lutein (LOO-teen) (from Latin lutea meaning yellow) is one of over 600 known naturally occurring carotenoids. ... Zeaxanthin is one of the two carotenoids contained within the retina. ... Nutrients and the body A nutrient is any element or compound necessary for or contributing to an organisms metabolism, growth, or other functioning. ... EGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGSEGGS This page may meet Wikipedias criteria for speedy deletion. ... Binomial name Spinacia oleracea L. Percentages are relative to US recommendations for adults. ... For other uses, see Green (disambiguation). ... Vegetables on a market Vegetable is a nutritional and culinary term denoting any part of a plant that is commonly consumed by humans as food, but is not regarded as a culinary fruit, nut, herb, spice, or grain. ... This article is about the visual condition. ... Advanced Micro Devices, Inc. ... This article is about the journal as a written medium. ... The Archives of Ophthalmology is a monthly professional medical journal published by the American Medical Association. ... Kale or Borecole is a form of cabbage (Brassica oleracea Acephala Group), green in color, in which the central leaves do not form a head. ... Trinomial name Brassica rapa rapa L. For similar vegetables also called turnip, see Turnip (disambiguation). ... Greens are people who support some or all of goals of a Green Party without necessarily working with or voting for that or any party. ... Cultivar Group Brassica oleracea Acephala Group Collard or collard greens is a loose-leafed cultivar group of Brassica oleracea Acephala Group, which is grown as a food crop and garden ornamental, mainly in Brazil, United States. ... Romaine lettuce Romaine or Cos lettuce (often called simply Romaine or Cos) (Lactuca sativa L. var. ... Broccoli is a plant of the Cabbage family, Brassicaceae (formerly Cruciferae). ... This article is about the fruit. ... Binomial name L. Corn (Zea mays L. ssp. ... This article needs additional references or sources for verification. ... Binomial name Pisum sativum A pea (Pisum sativum) is the small, edible round green seed which grows in a pod on a leguminous vine, hence why it is called a legume. ... Cultivar Group Brassica oleracea Gemmifera Group The Brussels sprout (Brassica oleracea Gemmifera Group) is a cultivar group of cabbage cultivated for its small (typically 2. ...


Juvenile macular degeneration

Juvenile macular degeneration is not a term in standard usage at this time. The preferred term for conditions that affect the macula in younger individuals related to genetics is macular dystrophy. Examples of these include:

The first genetic link to juvenile macular degeneration was discovered at the Cleveland Clinic. This article is in need of attention from an expert on the subject. ... Stargardts disease is an autosomal recessive genetic form of juvenile macular degeneration that causes progressive vision loss. ... Cleveland Clinic is a multispecialty academic medical center located in Cleveland, Ohio. ...


Impact

Macular degeneration, in its advanced forms, can result in legal blindness, resulting in a loss of driving privileges and an inability to read all but very large type. Perhaps the most grievous loss is the inability to see faces clearly or at all.


Some of these losses can be offset by the use of adaptive devices. A closed-circuit television reader can make reading possible, and specialized screen-reading computer software, e.g., JAWS for Windows, can give the blind person access to word processing, spreadsheet, financial, and e-mail access. JAWS (an acronym for Job Access With Speech) is a screen reader, a software program for visually impaired users produced by the Blind and Low Vision Group at Freedom Scientific of St. ... Windows redirects here. ...


References

  1. ^ de Jong PT (2006). "Age-related macular degeneration". N Engl J Med. 355 (14): 1474 - 1485. PMID 17021323. 
  2. ^ http://news.bbc.co.uk/2/hi/health/4217010.stm
  3. ^ Yang Z, Camp NJ, Sun H, Tong Z, Gibbs D, Cameron DJ, Chen H, Zhao Y, Pearson E, Li X, Chien J, Dewan A, Harmon J, Bernstein PS, Shridhar V, Zabriskie NA, Hoh J, Howes K, Zhang K. "A variant of the HTRA1 gene increases susceptibility to age-related macular degeneration." Science. 2006 Nov 10;314(5801):992-3. PMID 17053109.
  4. ^ Dewan A, Liu M, Hartman S, Zhang SS, Liu DT, Zhao C, Tam PO, Chan WM, Lam DS, Snyder M, Barnstable C, Pang CP, Hoh J. "A variant of the HTRA1 gene increases susceptibility to age-related macular degeneration". Science. 2006 Nov 10;314(5801):989-92. PMID 17053108
  5. ^ Yates JR, Sepp T, Matharu BK, Khan JC, Thurlby DA, Shahid H, Clayton DG, Hayward C, Morgan J, Wright AF, Armbrecht AM, Dhillon B, Deary IJ, Redmond E, Bird AC, Moore AT (2007). "Complement C3 Variant and the Risk of Age-Related Macular Degeneration". N Engl J Med. 357 (6): 553-561. PMID 17634448. 
  6. ^ John Paul SanGiovanni, ScD; Emily Y. Chew, MD; Traci E. Clemons, PhD; Matthew D. Davis, MD; Frederick L. Ferris III, MD; Gary R. Gensler, MS; Natalie Kurinij, PhD; Anne S. Lindblad, PhD; Roy C. Milton, PhD; Johanna M. Seddon, MD; and Robert D. Sperduto, MD (May 5, 2007). The Relationship of Dietary Lipid Intake and Age-Related Macular Degeneration in a Case-Control Study. Archives of Ophthamology.
  7. ^ Macular degeneration Types and Risk Factors
  8. ^ "Melanin aggregation and polymerization: possible implications in age related macular degeneration." Ophthalmic Research, 2005; volume 37: pages 136-141.
  9. ^ a b John Lacey, "Harvard Medical signs agreement with Merck to develop potential therapy for macular degeneration", 23-May-2006
  10. ^ Age-Related Eye Disease Study Research Group. "Risk factors associated with age-related macular degeneration. A case-control study in the age-related eye disease study: Age-Related Eye Disease Study Report Number 3." Ophthalmology. 2000 Dec;107(12):2224-32. PMID 11097601.
  11. ^ Clemons TE, Milton RC, Klein R, Seddon JM, Ferris FL 3rd; Age-Related Eye Disease Study Research Group. "Risk factors for the incidence of Advanced Age-Related Macular Degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no. 19." Ophthalmology. 2005 Apr;112(4):533-9. PMID 15808240.
  12. ^ Khan, JC; Shahid H, Thurlby DA, Bradley M, Clayton DG, Moore AT, Bird AC, Yates JR, Genetic Factors in AMD Study (Jan 2006). "Age related macular degeneration and sun exposure, iris colour, and skin sensitivity to sunlight". The British Journal of Ophthalmology 90 (1): 29-32. PMID 16361662. Retrieved on 2006-10-23. 
  13. ^ Glazer-Hockstein, C; Dunaief JL (Jan 2006). "Could blue light-blocking lenses decrease the risk of age-related macular degeneration?". Retina 26 (1): 1-4. PMID 16395131. Retrieved on 2006-10-23. 
  14. ^ Margrain, TH; Boulton M, Marshall J, Sliney DH (Sep 2004). "Do blue light filters confer protection against age-related macular degeneration?". Progress in Retinal and Eye Research 23 (5): 523-31. PMID 15302349. Retrieved on 2006-10-23. 
  15. ^ http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=7140077</ref Several similar studies are currently underway. In initial clinical trials in 2004, nearly 92% of patients showed significant improvement using micro-acupuncture.<ref>http://www.acupuncturehealth.net/articles/nat_clin_studies.php</li> <li id="_note-13">'''[[#_ref-13|^]]''' http://bjo.bmjjournals.com/cgi/content/full/882/161</li> <li id="_note-14">'''[[#_ref-14|^]]''' [http://news.yahoo.com/s/nm/20070910/hl_nm/eyesight_nutrients_dc;_ylt=AhJwo077jBEbQvMoRIMIxV2s0NUE Yahoo.com, Study finds spinach, eggs ward off cause of blindness]</li></ol></ref>

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 296th day of the year (297th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 296th day of the year (297th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 296th day of the year (297th in leap years) in the Gregorian calendar. ...

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  Results from FactBites:
 
Macular Degeneration- Health Encyclopedia and Reference (1069 words)
Macular degeneration is damage to the macula (a part of the retina in the eye) which results in central vision loss.
Macular degeneration is damage or breakdown of the macula.
It is caused by a breakdown or thinning of the tissues in the macula.
  More results at FactBites »

 
 

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