2010 BC Guide in Determining Fitness to Drive

Age-related macular degeneration (ARMD)Age-related macular degeneration (ARMD) is associated with the advanced stages of age-relatedmaculopathy, or disease of the macula. The macula is the central portion of the retina and isresponsible for central vision in the eye. Most individuals with maculopathy have impairmentsin their central vision. Those with ARMD, however, experience a progressive destruction of thephotoreceptors in the macula, resulting in profound central vision loss.ARMD has two forms, dry and wet. The dry form is the result of atrophy to the retinal pigment,resulting in vision loss due to the loss of photoreceptors (rods and cones) in the central portion ofthe eye. High doses of certain vitamins and minerals have been shown to slow the progression ofthe disease and reduce associated vision loss.Wet ARMD (neovascular or exudative) is due to abnormal blood vessel growth in the eye,leading to blood and protein leakage in the macula. The bleeding, leaking, and scarring fromthese blood vessels eventually result in damage to the photoreceptors, with a rapid loss of visionloss if left untreated. Treatment for wet ARMD has improved. Recent pharmaceuticaladvancements have resulted in compounds that, when injected directly into the vitreous humor,can cause regression of the abnormal blood vessels, leading to an improvement in vision.An example of the effects of ARMD on vision is shown below 12 .Normal visionVision of individual with macular degeneration12 Source National Eye Institute - http://www.nei.nih.gov/resources/strategicplans/neiplan/frm_impairment.asp258