Proper Diagnosis and Treatment of Age-Related Macular Degeneration Makes Seeing Clearly a Reality

Dr. Jabbour and the OR team at Mon Health.

Each February, Mon Health recognizes Age-Related Macular Degeneration (AMD) Awareness Month. 

Less than two decades ago, most people diagnosed with advanced AMD were destined to become legally blind. Today, advances in the diagnosis and treatment of AMD allow many patients with advanced AMD to keep reading, driving, and enjoying their independence. 

AMD, a disease that affects the small central area of the retina known as the macula, is the leading cause of vision loss in older Americans. More than 11 million Americans suffer from AMD, and that number is expected to double by 2050.

Macular Degeneration is the result of weaknesses and cracks in the central back layers of the eye, otherwise known as “dry AMD”. Those weak areas by themselves can cause some loss of vision, but it is when these areas start leaking (fluid and/or blood) that the vision is severely affected. This leakage is known as the “wet” form of Macular Degeneration, an advanced form of AMD in which abnormal, leaking blood vessels develop beneath the macula and can cause rapid and severe vision loss in one or both eyes.

Most patients have early or intermediate dry AMD which can remain stable for a lifetime or can slowly degrade vision. Around 10% of patients with intermediate AMD will develop wet AMD.

Over ten years ago, research showed that taking a special formula of high-dose vitamins and supplements may prevent or delay the progression of Macular Degeneration from the dry to the wet form. However, by the time the wet form starts, vitamins are no longer helpful. Thankfully, advances in early diagnosis and treatment have made it possible for many patients with wet AMD to keep and even improve their vision. This treatment is mostly centered around injecting the eye with biologic medications that may temporarily stop or decrease leakage and thus help protect from significant vision loss. Those biologics were initially developed for monthly injections, and many doctors continue to use them in that manner. This approach has helped about two-thirds of patients with wet AMD stabilize or even improve their vision by as much as 10%.

Dr. Nabil Jabbour, Opthamalogist at Mon Health Medical Center, has developed a system called Custom-Designed Approach with Treatment Algorithms (C-DATA), to decrease the number of biologics needed and improve visual outcomes. Instead of monthly injections, the C-DATA patients receive an average of two to three injections per year. These patients also end up with better long-term visual results. Approximately 80% of C-DATA patients have either improved or stabilized over three years of follow-up as compared with 65% of patients being treated with monthly injections.

But what about the remaining 20-35% of patients who continue to lose vision? Rarely, special forms of laser can help, but once the condition stops responding to medical treatment, rapid deterioration ensues, and until recently, no other treatments were available. Fortunately, Dr. Jabbour has designed a new surgical procedure to help as many of the previously “untreatable” cases as possible. 

The minimally invasive, microscopic, same-day procedure is done at Mon Health Medical Center under topical anesthesia. The surgery involves removing the source of the leakage and allowing the damaged area around it to heal. To do so, Dr. Jabbour employs special forms of electro-surgical heat (diathermy), laser, and recently, a new, FDA-approved ultrasound technology by Bausch & Lomb, the only such unit in West Virginia and the surrounding area. To date, 46 patients have been helped by this surgery at Mon Health Medical Center in addition to the hundreds who have benefitted from C-DATA injections.

Ms. Joan C., an 89-year-old artist, had lost much of her vision due to AMD that by the time she was referred to Dr. Jabbour, she was no longer able to paint, draw, sculpt, or participate in any of the hobbies she once enjoyed. After her surgery, her vision improved enough to allow her to go back to her favorite activities “almost like before!”

As we near the end of February’s Age-Related Macular Degeneration Awareness Month, Dr. Jabbour encourages our community to learn the risk factors, signs, and symptoms of AMD and to seek timely diagnosis and treatment if symptoms appear to safeguard their sight.

If you or anyone you know is suffering from the advanced stages of Macular Degeneration, visit monhealth.com or call 304-599-2733 to arrange for a consultation to see if you can be a candidate for such treatment.