Talk:Macular degeneration

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Clarification[edit]

The article as I just read contains the following:

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.

Could this be clarified? To the side of what? I'd like to try this, to understand, but I can't make sense of these directions.—The preceding unsigned comment was added by 24.68.241.212 (talkcontribs) 03:48, 8 September 2005 (UTC).

From what I understand to be one of the standard tests of MacDeg, here's what needs to be done (and someone please correct me if I'm wrong).
  1. Print the test sheet
  2. Try identifying the characters while looking straight ahead on the test sheet
  3. Now repeat the identification while you look straight ahead again, but this time the sheet is NOT straight ahead of you. Try identification while the sheet is to the left or right of your direct vision and you are looking straight ahead, NOT on the sheet.
As MacDeg affects straight vision but peripheral vision seems to be unaffected, any anomolies you detect might be indicative of MacDeg. Hope this helps, Mu5ti 15:08, 9 June 2006 (UTC)

Macular hole[edit]

Is this defect also know as macular hole? I have searched for the above term with no success and therefore felt this may be the likely article. If someone is sure of this hypothesis, would a redirection link for the term macular hole pointing here? That may make future searches less frastrating.

See article below for what I mean

[1]—The preceding unsigned comment was added by 62.24.112.56 (talkcontribs) 10:44, 19 October 2006 (UTC).


Macular hole is a completely different disease than macular degeneration. Macular holes are literally "holes" in the central retinal tissue; they may be caused by trauma or due to chronic vitreous traction, typically in older patients

Redirect ARMD[edit]

Could someone who knows how to do redirects arrange for "Age related macular degeneration" and "ARMD" to redirect to the macular degeneration page? Thanks PedEye1 20:41, 21 March 2007 (UTC)

Seems to have been done. Rod57 (talk) 14:44, 4 August 2009 (UTC)

Much of the coded information on this page is not visible[edit]

Can someone check the code to see why much of the information is not showing up? For example, the External Links section is not visible. 12.38.20.162 15:44, 7 August 2007 (UTC)

Macula Program[edit]

It appears to me that the material that has been recently added to the Prevention section dealing with the Macula Program and its "Drusen Hypothesis" is a scam and needs to be removed.

The person that has added this material should provide references from the scientific literature to back up this material beyond just pointing the web site that is selling "anti-aging medicine designed to balance your physiology to slow, stop or reverse Dry Macular Degeneration". Otherwise, I advise that this material be removed.

--152.132.9.2 15:51, 22 August 2007 (UTC)

image issues[edit]

This image (Amsler.jpg) is copyrighted by eyescience.com but the copyright owner has agreed to release this document only to Wikipedia; however, fraudulent attempts to take credit of this images by entities other than eyescience.com shall face legal consequences on the parties who repeatedly attempt to misstate credit from the rightful image owner. --Drlasik (talk) 00:08, 8 March 2008 (UTC)

Image by eyescience has been replaced with public domain image. DrLasik, please be aware that Wikipedia is not the place for legal threats. Justin Eiler (talk) 03:34, 8 March 2008 (UTC)

Smoking?[edit]

Why no mention of cigarette smoking? Jager et al in NEJM say it doubles the risk, and even more for people with vulnerable genetic variations. Nbauman (talk) 03:28, 1 July 2008 (UTC)

Agreed - I borrowed from this page http://www.agingeye.net/maculardegen/maculardegeninformation.php to put it out there, citing my own edit with a "citation needed." If anyone can link to either study it cites - Eye 2005;19:935-44 or "Neuner et al. Ann. Epidemiol. 2007 May 24, please do. —Preceding unsigned comment added by 173.20.132.128 (talk) 07:23, 13 May 2009 (UTC)

Ok, I quoted from the abstract and have included a link to the full article from the Journal Eye for those interested in checking the citation. I feel like there is more out there though, hope someone can add another reference or two. 173.20.132.128 (talk) 07:38, 13 May 2009 (UTC)

Lancet review[edit]

doi:10.1016/S0140-6736(08)61759-6 review of AMD. JFW | T@lk 00:01, 23 November 2008 (UTC)

Seems to need paid subscriptions. Rod57 (talk) 14:48, 4 August 2009 (UTC)
Got it : Lancet, Volume 372, Issue 9652, 22-28 November 2008, Pages 1835-1845 "Age-related macular degeneration" Coleman et al. - Review looks good but this article doesn't seem to reference this review (yet) ? (Maybe when I get more time) Rod57 (talk) 23:11, 8 December 2010 (UTC)

New article describing evidence-based recommendations for Ranibizumab (Lucentis) use in neovascular AMD[edit]

RANIBIZUMAB (LUCENTIS) IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: EVIDENCE FROM CLINICAL TRIALS

Paul Mitchell,1 Jean-François Korobelnik,2 Paolo Lanzetta,3 Frank G Holz,4 Christian Prünte,5 Ursula Schmidt-Erfurth,5 Yasuo Tano,6 Sebastian Wolf7

1Department of Ophthalmology, University of Sydney, Sydney, Australia; 2Department of Ophthalmology, CHU (Centre Hospitalier Universitaire) de Bordeaux, Bordeaux, France; 3Department of Ophthalmology, University of Udine, Udine, Italy; 4Department of Ophthalmology, University of Bonn, Bonn, Germany; 5Department of Ophthalmology andOptometry, Medical University of Vienna, Vienna, Austria; 6Department of Ophthalmology, Osaka University Medical School, Osaka, Japan; 7Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland

Br. J. Ophthalmol. published online 19 May 2009; doi:10.1136/bjo.2009.159160 132.239.130.119 (talk) 19:19, 19 May 2009 (UTC)

Not sure we needed long list of author institutions. Anyway : BJO article. - Rod57 (talk) 21:01, 22 November 2011 (UTC)

Citation needed on AMD being a major cause of blindness[edit]

Hiya,

I found a source for that but I don't yet know how to insert citations, so could someone please do that? I added the BiBTeX source below.

@ARTICLE{Resnikoff2004,

 author = {Serge Resnikoff},
 title = {Global data on visual impairment in the Year 2002},
 journal = {Bulletin of the World Health Organization},
 year = {2004},
 volume = {82},
 pages = {844-851},
 number = {11},
 month = {November}

}

KyraTafar (talk) 09:33, 23 July 2009 (UTC)

Accuracy[edit]

This article contains the following:

"Pegaptanib (Macugen) has been found to have only minimal benefits in neovascular AMD and is no longer used"

I have just been diagnosed with neovascular AMD and have undergone two treatments with Macugen. Sp it is being used. What is the source for minimaal benefits?

Paul Kellam (talk) 22:00, 23 August 2009 (UTC)


Several times in the body is mentioned "advanced AMD" - redundant? (to wit - advanced "Advanced Macular Degeneration") —Preceding unsigned comment added by 68.102.54.224 (talk) 04:02, 4 September 2009 (UTC)

Not redundant. The A in AMD is for 'Age-related' not Advanced. Rod57 (talk) 09:05, 14 April 2010 (UTC)

I'm new at this and this posting is not meant to offend anyone, but I think something extremely important has been left out of this article and I have my own neurological deficits which make learning HTML tonight impossible... Since it is the elderly who typically develop Macular Degeneration who are frequently tagged with various aspects associated with cognitive decline, I see no mention in this article about Charles Bonnet Syndrome and its relationship to this disorder. My mother-in-law had Charles Bonnet Syndrome long before she developed cognitive problems and for years her family doctor and some family members attributed this to her "nerves." As a former registered nurse whose lucid moments are limited, I am not qualified to write about the significance that Charles Bonnet Syndrome plays with MD and have not seen anything in nursing dementia articles that defines this disorder period muchless to distinguish it as not being related to dementia and something that medical practitioners, families, and patients need to be educated on... that they are not going crazy and why. --2Sleepy4U —Preceding unsigned comment added by 2Sleepy4U (talkcontribs) 01:41, 4 October 2010 (UTC)

"Elderly"[edit]

I am altering this to appear as 'older adults', since 50 is middle aged and not 'elderly'; this classification will, of course, still encompass elderly patients. 174.116.208.159 (talk) 00:03, 14 November 2009 (UTC)

The source, Harrison's Principles of Internal Medicine, says "elderly." We must follow the source. If that's what the medical source says, we can't alter it. I'm changing it back. --Nbauman (talk) 14:15, 26 August 2011 (UTC)
Changed my mind. After re-reading it, it looks acceptable like this. I didn't change it. But we should check it against the source and use the language of the source. --Nbauman (talk) 14:19, 26 August 2011 (UTC)

Supplements section overly negative tone[edit]

Undue space/weight seems to have been given to the now out of date 2006 Cochrane review. I propose to reduce the text or give more details on later studies. Rod57 (talk) 09:02, 14 April 2010 (UTC)

Disability-adjusted life year map[edit]

in the article it clearly says the people of African descent are less likely to develop Macular degeneration yet the Disability-adjusted life year map suggests otherwise. i suggest that the map be removed and a map that deals specifically with Macular degeneration, and not with all sense organ diseases, (if one can be found or made) should replace it.Walkerm930 (talk) 23:01, 23 April 2010 (UTC)

Agreed. The other sense organ diseases component seems to override the Macular degeneration component, so gives a highly misleading impression. 117.18.231.38 (talk) 15:58, 6 November 2013 (UTC)

Peculiar aberration[edit]

(This aberration is only visible as a blurring except by squinting against a bright light, and is about the width of the tip of the little finger held at arm's length)

This is a quick sketch of an aberration of vision I've noticed. I am curious whether it is a potential first step in w:macular degeneration. I should emphasize that this is not a personal medical question (no trouble was diagnosed during optical examination, and the phenomenon has remained the same for at least five years) — I'm simply curious whether this aberration has been studied scientifically.

The pattern I see is a set of small, refractile spheres (which I hypothesize to be individual blood cells) which fill a well-defined space about the size of the tip of the little finger at arm's length. The pattern is only visible as a slight blurring of the text with eyes normally open, but by squinting and against a bright light the details are revealed. The pattern begins as a narrow outer ring, moves into the center preferentially, and if left to go on it eventually fills out into a filled circle shape, even expanding slightly beyond the "rim". The rim of the pattern has a different appearance from the rest, a well-defined fold, and begins to appear almost as soon as the first refractile bits. Only occasionally is a second concentric fold visible immediately outside the first.

It occurs transiently but consistently after less than five minutes if reading in very low light while wearing corrective lenses. On only a handful of occasions after eating heavy and I think particularly fatty meals it has become apparent while reading a computer monitor with corrective lenses. It never seems to occur while reading with uncorrected myopia (-5) even in low light. It seems like particularly "active" reading (image editing or working a printed puzzle) is quicker/more likely to trigger the trouble. It usually occurs at about the same time in both eyes, but definitely a different pattern in each. Stopping reading or voluntary hyperventilation makes it go away in about fifteen minutes (the latter, I would hypothesize, by providing better oxygen support and allowing the blood vessels to constrict). Taking a lutein-zeaxanthin supplement had no apparent effect on it.

Have you ever heard of such a thing? Wnt (talk) 06:41, 14 May 2010 (UTC)

Prevention[edit]

The entire "prevention" section appears to be an advertisement for a single product whose scientific basis is dubious. The references included are all in spanish and consiste of a youtube video, a web page that does not appear to relate at all to the subject, and a news story stating that the product exists. The last news story suggests there might be actual published science about this method, but without that reference I suggest this content removed. Leopd (talk) 05:12, 31 March 2011 (UTC)

Furthermore, I propose removing this entire section from the article. The cited sources are not reliable, even if they were in english. One of the three links is no longer valid. The other two links are to popular news articles, which do not meet the criteria for reliable sources of medical information in Identifying reliable sources (medicine). Leopd (talk) 04:52, 13 April 2011 (UTC)

__________________________________________________________________________________________________________________________________________________________________________________________________________

Factors predicting progression[edit]

Dr. Seddon's recent ARVO poster was an update on her 2009 IOVS paper, as she explained in the poster

"To expand and further develop our predictive models for progression to advanced stages of AMD associated with visual loss based on demographic, environmental, genetic and ocular factors"


The reference for the original article, as well as a good review article on genetic testing in AMD is below: Seddon et al "Prediction Model for Prevalence and Incidence of Advanced Age-Related Macular Degeneration Based on Genetic, Demographic, and Environmental Variables", IOVS May 2009

Zanke et al "a genetic approach to stratification of risk for AMD' Can J Opthamology 45 (1) 2010 22-27


PubMed abstract for Seddon paper: Invest Ophthalmol Vis Sci. 2009 May;50(5):2044-53. Epub 2008 Dec 30.

Prediction model for prevalence and incidence of advanced age-related macular degeneration based on genetic, demographic, and environmental variables.

Seddon JM, Reynolds R, Maller J, Fagerness JA, Daly MJ, Rosner B.

Ophthalmic Epidemiology and Genetics Service, Tufts University School of Medicine and Tufts Medical Center, Boston, Massachusetts 02111, USA. jseddon@tuftsmedicalcenter.org

PURPOSE: The joint effects of genetic, ocular, and environmental variables were evaluated and predictive models for prevalence and incidence of AMD were assessed.

METHODS: Participants in the multicenter Age-Related Eye Disease Study (AREDS) were included in a prospective evaluation of 1446 individuals, of which 279 progressed to advanced AMD (geographic atrophy or neovascular disease) and 1167 did not progress during 6.3 years of follow-up. For prevalent AMD, 509 advanced cases were compared with 222 controls. Covariates for the incidence analysis included age, sex, education, smoking, body mass index (BMI), baseline AMD grade, and the AREDS vitamin-mineral treatment assignment. DNA specimens were evaluated for six variants in five genes related to AMD. Unconditional logistic regression analyses were performed for prevalent and incident advanced AMD. An algorithm was developed and receiver operating characteristic curves and C statistics were calculated to assess the predictive ability of risk scores to discriminate progressors from nonprogressors.

RESULTS: All genetic polymorphisms were independently related to prevalence of advanced AMD, controlling for genetic factors, smoking, BMI, and AREDS treatment. Multivariate odds ratios (ORs) were 3.5 (95% confidence interval [CI], 1.7-7.1) for CFH Y402H; 3.7 (95% CI, 1.6-8.4) for CFH rs1410996; 25.4 (95% CI, 8.6-75.1) for LOC387715 A69S (ARMS2); 0.3 (95% CI, 0.1-0.7) for C2 E318D; 0.3 (95% CI, 0.1-0.5) for CFB; and 3.6 (95% CI, 1.4-9.4) for C3 R102G, comparing the homozygous risk/protective genotypes to the referent genotypes. For incident AMD, all these variants except CFB were significantly related to progression to advanced AMD, after controlling for baseline AMD grade and other factors, with ORs from 1.8 to 4.0 for presence of two risk alleles and 0.4 for the protective allele. An interaction was seen between CFH402H and treatment, after controlling for all genotypes. Smoking was independently related to AMD, with a multiplicative joint effect with genotype on AMD risk. The C statistic for the full model with all variables was 0.831 for progression to advanced AMD.

CONCLUSIONS: Factors reflective of nature and nurture are independently related to prevalence and incidence of advanced AMD, with excellent predictive power. — Preceding unsigned comment added by Dutch Guy canuck (talkcontribs) 19:09, 13 June 2011 (UTC)

Split out detailed Causes section[edit]

The Causes [and risk factors] section is long and technical with many references. I propose that we split it out into a separate article. Should we call it Causes of macular degeneration or AMD causes and risk factors or something else ? - Rod57 (talk) 21:09, 22 November 2011 (UTC)

Hereditary consequences[edit]

There appears to to be no single article regarding the possibility of hereditary macular degeneneration! — Preceding unsigned comment added by 94.170.145.107 (talk) 18:57, 22 February 2012 (UTC)

Help needed to add comment re existing citation[edit]

I was given an error note when I tried to add comment to existing citation to the article at this point.

Higher beta-carotene intake was associated with an increased risk of AMD. Note that abstract is difficult to understand, payment of $31.50 required to access full text.1archie99 (talk) 19:40, 18 August 2013 (UTC)

Primary sources[edit]

I've just restructured this article according to WP:MEDMOS. It is still brimming with primary sources, which are generally not advisable (see WP:MEDRS). I have therefore downgraded it to "class C". There is no excuse for not using secondary sources, considering there are a number of strong recent reviews available in the core medical literature. JFW | T@lk 22:53, 13 January 2014 (UTC)

Try this in PubMed: <tt>http://www.ncbi.nlm.nih.gov/pubmed?term=%22Macular+Degeneration%22[Majr]</tt> and select "Review".
It gets 1493 sources that are MeSH "Major". Quite a bit of diabetic macular oedema in the results still. JFW | T@lk 22:58, 13 January 2014 (UTC)