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Learning To See With Macular Degeneration

Computer Therapy Patients To Use Good Retinal Cells

POSTED: 12:47 pm MDT July 31, 2009
UPDATED: 1:07 pm MDT August 21, 2009

Thirteen million Americans have AMD -- age-related macular degeneration. It's the leading cause of irreversible blindness and vision impairment in people over 50. Now researchers are studying a new kind of therapy for AMD. It can't reverse the damage but it's helping patients get the most out of the vision they have left.

Macular degeneration made Russell Delong's world go black.

"I was totally blind. I couldn't see nothing," he said.

He thought he was out of options.

However, a recent study found that the brain reorganizes itself to compensate for vision loss. That's the key to a new therapy that teaches patients a whole new way of seeing.

A computer maps areas of the retina damaged by macular degeneration and that are intact. Then it trains the patient to shift his vision, using the good retinal cells, to see.

Now, with special glasses, Delong can read a magazine. Back on the farm, he can see things that used to be a blur.

"If I look at it and it’s black, I turn my head a little and see around the scar tissue, there's a tractor. I can do everything out here, everything," Delong said.

Researchers are currently testing the computer therapy at Emory University. Smoking, obesity and race play a role in your risk of developing macular degeneration. Whites are more likely to lose vision from the disease than other races.

Additional Details About AMD

About 13 million Americans show signs of age-related macular degeneration (AMD), a condition that destroys central vision so things like reading, watching TV and driving are impossible. The condition also robs a person of the ability to see colors and fine detail. Because the U.S. population is expected to age rapidly, cases of AMD are only expected to increase. Middle-aged people have about a 2 percent risk of developing AMD, but this risk increases to almost 30 percent in those over 75 (Source: Emory Healthcare).

There are two types of AMD: wet and dry. Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula, the central part of the retina. Those blood vessels then leak blood and fluid that cause the macula to bulge outward. Symptoms of wet AMD often develop quickly and include seeing straight lines as wavy. Dry AMD happens when light-sensitive cells in the macula break down and blur central vision. The most common symptom of dry AMD is slightly blurred vision. The condition develops slowly.

TREATMENT: According the American Health Assistance Foundation, currently there is no treatment or cure for dry macular degeneration. However, taking a specific high-dose formula of vitamins and mineral supplements called the AREDS formula has been shown to significantly reduce the risk of progressing from intermediate to advanced or wet macular degeneration. Treatments for wet macular degeneration include drugs called angiogenesis inhibitors (Lucentis, Macugen); photocoagulation, which involves using a high-energy laser to destroy leaking blood vessels; and photodynamic therapy.

RELEARNING TO SEE: Doctors at Emory Eye Center in Atlanta, Ga., are working on a unique form of treatment for AMD that takes advantage of the brain's ability to reorganize itself to make up for vision loss. The therapy involves training AMD patients to focus on using the good cells that remain. "We are encouraging them or influencing them to be able to use those parts of the retina to be able to better utilize the residual vision," Primo said.

In the treatment, doctors first use a computer to map out the areas of the eye that are damaged. The machine then locates the areas that are still sensitive based on factors like thickness of the retina. The computer then uses biofeedback -- in this case a series of beeps that gets faster and louder as the patient moves closer to using the healthiest portion of the eye -- to train the patient to move their eye into the position that gives them the best possible vision.

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