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Treatment for macular degeneration

It used to cause people to go blind, but a common eye disease can now be treated.

Black blotches in the central vision is a warning sign. Photo/Getty Images
Black blotches in the central vision is a warning sign. Photo/Getty Images

For Grant Thompson, having the drug Avastin injected into his left eye every three months is a small price to pay for retaining his ability to read, drive, garden, play sport and recognise the faces of the people he loves.

“The two big joys of my life are my wife and having the injections. The injections are making me able to see, hopefully forever – at least in my left eye,” says Thompson, 70, who was diagnosed with wet macular degeneration two years ago.

At that time, Thompson had already been ­diagnosed with dry macular degeneration, in which the tissues of the macular – the centre of the retina at the back of the eye, which allows us to read, recognise faces, drive and see colours clearly – start to thin and break down.

Dianne Sharp.
Dianne Sharp.

But it was the sudden appearance of black blotches in the central vision of his left eye that signalled it had progressed into the less common – but more serious – form of the disease, wet macular degeneration, which is caused by abnormal blood vessels growing under the retina.

Within a week, Thompson had the first of a series of monthly injections that not only stopped the vision in his left eye from getting worse, but actually improved it. He now has the injections every three months and says they are not nearly as painful as they sound. “I usually don’t feel anything, and on the few occasions when I have, it’s lasted for four to five seconds maximum.”

Thompson has also changed his diet to include more foods that contain substances that help protect his macular, such as green leafy vegetables and fish. And he takes a nutritional supplement made up of vitamins C and E, lutein, zinc and copper – a combination the US-based National Eye Institute has found helps slow the progress of macular degeneration (MD).

Thompson is one of about 20,000 older New Zealanders with wet MD, the leading form of legal blindness. And he’s one of an ­increasing number whose eyesight is being saved through early detection and treatment. Auckland ophthalmologist Dianne Sharp, who is also the chairwoman of Macular ­Degeneration New Zealand, says a decade or so ago there was little she and her colleagues could do for people like Thompson except eventually refer them to the Blind Foundation.

A cover story in 2013 featured the growing problem of macular degeneration.
A cover story in 2013 featured the growing problem of macular degeneration.

But the use of what is known as anti-VEGF drugs such as Avastin, which are injected directly into the eye, is transforming the prognosis for those affected by the disease. “In the 10 years since the treatment was introduced, there has been a reduction in the number of people who have had to be registered with the Blind Foundation.”

While the injections cannot cure wet MD, they can prevent further vision loss and in some cases even improve vision. However, Sharp says early detection is vital, as wet MD can cause significant vision loss in just a few months. “If you already have scarring and changes to the central part of the eye, then the injections won’t work.”

Degeneration of the macular is common as we get older. About one in seven New Zealanders over the age of 50 have some signs of the disease. People with a family history of MD have a higher risk of developing it, as do smokers, who also tend to get it younger than non-smokers.

Most people have dry MD, which cannot be treated but tends to progress more slowly and is less likely to cause significant vision loss. However, up to 15% go on to develop the more serious – but easily treatable – wet form.

Sharp says everyone over the age of 50 should have two-yearly eye tests to check the condition of their macular. She also recommends carrying out regular DIY vision tests using something called the Amsler Grid. If the lines in the grid look distorted or bent, you should contact an optometrist immediately.

“Early detection saves sight – and the cost of treatment is so much less than the cost of managing blindness.”

Macular Degeneration Awareness Week is from May 23 to 29.

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