Monthly Archives: February 2018

Monitoring the Progression of Age Related Macular Degeneration

Technology for monitoring those at risk for the progression to Wet AMD

Those with age-related AMD are familiar with the Amsler Grid.  The grid is a cheap and easy,

A normal appearing grid

method of self monitoring for changes in vision related to the central vision.   The grid is usually given to those patients with macular changes by their examining eye doctor.  Traditionally, it is a piece of paper or card with the grid printed on it.  The grid is held at 10 inches from the eye (the other eye is closed) and observe: are there any broken lines, missing squares, doubling of the lines, wavy lines?  The appearance of the grid should be consistent from day to day.

Dry AMD can be a slow,  progressive decline in vision. The

Grid appears distorted

intent is to keep the patient alert to the status of their vision. It is very common for people to be unaware of changes to vision, especially for those with dry AMD.

There is another category of AMD referred to as ‘wet’ AMD.  This is a much faster, progressing sight-threatening stage of AMD.  About 10% to 15% of those with dry AMD will progress to wet AMD.  If you have been identified by your eye care doctor as someone who is at risk for wet AMD, there is a technology designed to monitor and identify the onset of wet  AMD sooner.  The sooner, the better.  The sooner treatment has begun, the more sight can be saved.

The devise is called ForeseeHome by Notal Vision.  It is a table top monitoring device to be

ForeseeHome tabletop monitor

used daily . The test takes about 3 minutes per eye.  The test results are sent to Notal Vision.  If changes are detected, Notal Vision notifies you eye care doctor.  The plan is for  your doctor’s office to call to make an appointment for you to see the doctor.  In this way you can receive prompt treatment to preserve your vision.

How to get hooked up with this system:

First, you must be identified by your doctor as being at risk for developing wet AMD.  It is also the first step to getting help through insurance to get coverage for the system.

ForeseeHome test screen

Follow this link for doctors in your area who participate in this Notal  Vision program: Find a Doctor 

The set up is quite easy.  You do not need a computer or even wifi.  The Notal company has a phone number to help you get set up.

To see a video on how it works, follow this link:  ForeseeHome video

AMD, Genetic Testing, and Supplements

Personalized Medicine, One Size Does Not Fit All

Personalized medicine  identifies an individual’s risk for a disease, like macular degeneration, to help health care providers  tailor  management and treatment to reduce the risk of development and/or progression of the disease. What is good medicine for one person may not be so good for another. Genetic testing is the first step to personalized medicine.

Studies for tImage result for dna genetic materialhe treatment of macular degeneration have yeilded a lot of data on AMD and its progression.  Chief among the studies was the Age-Related Eye Disease Study (AREDS) which looked at the affect of vitamin supplementation for those at risk for age related macular degeneration (AMD) and those who had varying degrees of AMD. What they found is that some individuals responded well to vitamin supplementation and others did not respond as well.  Many groups of researchers have analyzed the data generated by the AREDS and its follow-up study AREDS 2.  The predictor of who goes on  AMD progression or wet AMD depends on 3 factors:

  • Current level of AMD,
  • Genetic Factors, and
  • Non-genetic factors (environmental, like general health, smokers, age, and education.)

There are presently two genetic tests available for macular degeneration : Macula Test PGX and Vita Test (Artic) .  These tests look at genetic markers on known AMD associated genes. The most significant finding, for why some did not do well with the AREDS supplement formula (13%), was a particular genetic profile that resulted in AMD progression, notably because of the zinc in the formula.  Genetic testing is a guide for those supplements that best helps reduce the risk for progression of the disease.  Armed with this information, an eye doctor would recommend the patient not take the AREDS formula with zinc.  This is personalized medicine.  Giving everyone the AREDS vitamin supplement does not benefit everyone the same.  Other genetic profiles do very well with the supplement.    Related image

While routine genetic testing is not  the standard of care at this time, it is an option.  Without genetic testing, doctors and patients do well by managing treatment and controlling health factors to decrease the progression of AMD.  A t this time, both of these genetic tests may not be covered by insurance plans. and must be ordered through your eye care provider.