Health & Fitness

WELLNESS

Eye Opener

Harnessing the effects of age-related macular degeneration.

Ruthan Brodsky

Special to the Jewish News

0

nce an avid reader, Gertrude
Lipsitt of Birmingham couldn't
focus on a printed page for
years. Today at 92, she's reading once
again.
Gertrude is among the 1.75 million
Americans who have advanced age-
related macular degeneration with total
or partial vision loss. In her mid-60s,
she showed symptoms of future vision
problems during a dilated eye exam. She
became one of the 71/2 million people
with early AMD, for which there is little
or no vision loss; but it did increase her
risk of developing advanced AMD.
"For the last 20 years, Mother's vision
gradually worsened," recalls Gertrude's
daughter, Carol Lipsitt, who is her moth-
er's caregiver.
"I researched macular degeneration
seeking treatments, looking for nation-
ally recognized retinal specialists and
experts in Michigan. Everyone said the
same thing: Nothing could be done."
"When my dad died, Mother's quality
of life went downhill rapidly because
he used to help her:' says Carol. "She
loved to read, but couldn't. She wouldn't
go to a restaurant anymore because
she spilled her food frequently and was
embarrassed. She became anxious and
depressed and reclusive."

The Backdrop
Until the last five to 10 years, there
was no treatment for either dry or
wet macular degeneration. Today, for
patients with wet macular degeneration
like Gertrude, doctors prescribe drugs
such as Lucentis, which stops the blood
vessels from growing so that the loss of
vision doesn't become worse.
The problem with these drugs is that
you have to put a needle in the eye to
inject the drug about once a month. It
is also very expensive; about S2,000 a
treatment.
"Most people tolerate the injections
well," says Dr. George Williams, chair
of the department of ophthalmol-
ogy, director of the Beaumont Eye
Institute and trustee-at-large at William
Beaumont Hospital in Royal Oak.
"Lucentis was just approved for AMD
three years ago and since then, it has
helped 90 percent of those on the medi-

cation to maintain their vision. Just like
so many other health issues, the earlier
you start on the treatment, the less
vision you'll lose. The treatment appears
to save vision for tens of thousands of
people who otherwise would have gone
blind."

Sta f f p ho to by Ang le Boon

I

On The Hunt
"I continued looking for the best retinal
specialist to figure out some solution
for my mother and happened to read
an article in the New York Times about
Dr. George Williams, M.D., retinologist,"
says Carol. "I contacted his office for an
appointment and was told his practice
was closed. I pursued. Actually, I made
a pest of myself, but it worked and
Gertrude became one of his patients. In
fact, she became part of a research study
that Dr. Williams participated in. Mother
received the injections almost a year
before the medication was approved."
"Early detection is why people
65 years and older should see their
ophthalmologist when they have any
concerns about their vision," advises
Williams.
"If your vision is blurry, don't assume
you have cataracts. Cataracts develop
slowly, but AMD can take place quite
suddenly. We can treat AMD so that your
vision doesn't get worse, but we still
have no way to prevent the disease!"
Carol kept searching for a solution to
her mother's problem of not being able
to carry out her daily activities.

Carol Lipsitt with her mother, Gertrude

What Is Macular
Degeneration?

An eye doctor, an ophthalmologist,
can diagnose whether you have early
AMD by examining your eyes for large
drusen or collections of waste. These
are leftover oxidized fats that accu-
mulate in the tissue under the retina.
The older you are, the larger the
waste (drusen) collection until your
eyes run out of room to store the
debris. For some, the immune system
doesn't recognize the drusen as part
of the self and starts to attack.
Large drusen — localized yellow col-
ored deposits that are lodged between
the retina and the layer underneath

— are a warning that one of two forms
of macular degeneration is on its way.
In the dry form, the rods and cone
cells just die. With the wet form, new
blood vessels grow behind the retina
and leak fluid or bleed.
Macular degeneration is a break-
down of the macula, a small area in
the retina at the back of the eye that
allows you to see fine details clearly
and do activities such as driving and
reading. When the macula doesn't
function correctly, the central vision
is affected by blurriness, dark areas
or distortion. It affects your ability to
see near and far and can make some
activities difficult or impossible.

Fortuitous Article
Gertrude, now using a wheelchair
after she broke her ankle, remained
depressed. About two years ago, Carol's
brother Kenneth Lipsitt, M.D., an oph-
thalmologist in Florida, told her he read
an article in a medical journal about Dr.
Lvlas Mogk and the Vision Rehab Center
located in Michigan.
Carol visited the Center and discovered
it offered comprehensive, home-based
rehabilitation for people with AMD.
"Gertrude was discouraged and
depressed when I first saw her:' recalls
Dr. Niogk, ophthalmologist and found-
ing director of the Visual Rehabilitation
and Research Center of Michigan, part
of the Detroit-based Henry Ford Health
System.

Eye Opener on page B2

May 14 a 2009

B1