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February 20, 2012 08:39  by Dr. Marla Shapiro

Dame Judi Dench has announced she has macular degeneration. This is the leading cause of blindness in North America. Typically we don't see this in people under 50. As Dame Judi said - her ma had it and she now does too. 

Genetics are one of the most important risk factors for developing age related macular degeneration. Other risk factors, along with advancing age, include being white, being female, smoking, obesity and hypertension, high cholesterol and having a diet that is not rich in fruit and vegetables. 

The macula is in the center of the retina. There are two kinds of macular degeneration -- dry and wet. In wet macular degeneration there is swelling of leaky blood vessels in the back of the eye. This is not a feature of dry macular degeneration. Dry macular degeneration develops more slowly and often presents with blurred vision, needing more light to see well, difficulty recognizing faces and a gradual increase in the haziness of your vision. 

Dry macular degeneration may go on to the wet form which is more severe. While there is no treatment available to reverse dry macular degeneration, with moderate forms of the disease you will be advised to take a high dose preparation of anti-oxidant vitamins, copper and zinc. While this specific vitamin formula for age-related macular degeneration cannot cure severe vision loss, it can reduce the loss in people with intermediate forms. 

If you are a smoker -- stop. The use of beta carotene in smokers, one of the vitamins recommended, has been linked to an increase risk of lung cancer in smokers. Lifestyle changes to lower blood pressure, weight and cholesterol is important. Make sure you are eating lots of fruits and vegetables. Omega 3 from fish and walnuts is also important to incorporate into your diet. 

In the last several years, the treatment of age related wet macular degeneration has changed dramatically. Injections into the eyes are aimed at  treating vision loss by targeting the growth of abnormal, leaky blood vessels that eventually damage the macula (area of the eye responsible for central vision). In advanced or end stage disease there is also the use of an implantable miniature telescope to help provide central vision that has been lost. 

Research in this field is looking at external beam radiation, newer medications that last longer and require less frequent injections into the eye and stem cell therapy. We also have available genetic screening ( not covered by government health plans provincially) for macular degeneration, should you have a family  history. 

It is important to have regular eye exams as we age and manage all your other diseases that can contribute to an increase risk as listed above.If you notice any changes in your vision, be sure to get in quickly and have your eyes examined. Early diagnosis and treatment is important.

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Dr. Marla Shapiroclose [x]

Dr. Marla Shapiro, MDCM CCFP MHSc FRCP(C) FCFP, is a family physician and the Health and Medical Contributor for CTV's Canada AM as well as the editor of Parents Canada magazine, launched in March 2007.

She completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science in Community Health and Epidemiology. She holds a Fellowship in Family Medicine and is a NAMS credentialed menopause specialist. She is an associate professor in the Department of Family and Community Medicine at the University of Toronto, where she recently won an award for Creative Professional Activity.

Dr. Shapiro won the Society of Obstetricians and Gynaecologists of Canada/Canadian Foundation for Women's Health Award for Excellence in Women's Health Journalism in 2006 for her documentary "Run Your Own Race." Her book, "Life in the Balance: My Journey with Breast Cancer" was released in the fall of 2006 and is a national bestseller.

For her lifelong commitment to family medicine, Shapiro was awarded the College of Family Physicians of Canada's Award of Excellence for 2008.

Angela Mulhollandclose [x]

Angela Mulholland is the editor of CTV News' semi-weekly health newsletter MedNews Express as well as the MedNews Express Blog.

She has been a journalist for CTV News since 2000, covering current affairs, health and entertainment for CTV.ca. Before CTV, she worked for CBC.ca for two years.

She has a degree from St. Jerome's University in Waterloo, ON, and studied journalism at Sheridan College in Oakville. She lives in Toronto with her husband and two children.

Monica Matysclose [x]

Monica Matys has been the health and wellness reporter for CTV News Toronto since 2001. Her feature health report, Lifetime, can be seen on CTV Toronto's News at Noon and at 6 p.m.

Her interest in the medical field began while working for a medical publishing company as the editor of a monthly magazine. One of Monica's favourite days on the job was the time she got to spend a day in Credit Valley Hospital's Emergency unit. "It really opened my eyes to the strains on our system," Monica explains.

Matys grew up in Scarborough, and has an honours degree in Journalism from Carleton University in Ottawa. She lives in Toronto with her husband and two children.

Avis Favaroclose [x]

Avis Favaro has been with CTV News since 1992, producing stories for CTV National and CTV News Channel - Newsnet- as well as for CTV affiliate stations across the country.

Avis and producer Elizabeth St. Philip won the 2008 Media Awards for Excellence in Health Reporting handed out by the Canadian Nurses Association and the Canadian Medical association for a story on BPA found in food cans.

She has been nominated for an impressive 12 Geminis, winning once for a unique story on an experimental cancer treatment developed in Winnipeg in the 1940's.

Avis has a masters in journalism from UWO and a Bachelor's degree in History, and launched her journalism career as a writer/reporter at Global in 1982.

Dr. Yoni Freedhoffclose [x]

Dr. Yoni Freedhoff, MD CCFP Dip ABBM, is the founder and Medical Director of the Bariatric Medical Institute in Ottawa, a multi-disciplinary behavioural weight management program. Formally trained in family medicine, since 2004 his practice has been exclusively dedicated to the treatment of overweight and obesity.

Dr. Freedhoff has been referred to as a "nutritional watchdog" by the Canadian Medical Association Journal and a national "obesity expert" by the Canadian Obesity Network. His advocacy efforts for improved public policies regarding nutrition and obesity have found him testifying in front of the Canadian House of Commons, giving press conferences with the Ontario Medical Association, commenting regularly in the national media, and as a sought after lecturer.

Dr. Freedhoff explores issues pertinent to nutrition, obesity, public policy and advocacy in his daily blog Weighty Matters which is ranked among the world's top health blogs and was voted the top Canadian health blog of 2008 by the Canadian Blog Awards.

Dr. Grant Lumclose [x]

Dr. Lum is a sports medicine physician. He is the medical director and founder of Athletic Edge Sports Medicine, a multidisciplinary sports medicine organization offering services to the athletic and active public.

He is involved in the care of recreational, elite amateur and professional athletes, including players in the NHL, NFL and NBA. He is also involved in the performing arts medical community, taking care of musicians, vocalists, dancers and other performing artists.

Dr. Lum studied medicine at the University of Toronto, where he graduated in 1992. He completed a two-year residency in Family Medicine, and then specialty training in Sports Medicine.

He is a lecturer at the University of Toronto's Faculty of Medicine, an adjunct professor at York University's Faculty of Fine Arts, and medical director of George Brown College's Fitness and Lifestyle Management Program.

Dr. Lorne Brandesclose [x]

A senior oncologist at CancerCare Manitoba, Dr. Brandes received his MD from the University of Western Ontario in 1968.

Following post-graduate training at the Royal Marsden Hospital (London) and the University of Manitoba, he joined the faculty at U. Of M. in 1975, where he is a professor in the Departments of Medicine and Pharmacology.

He is also affiliated with the Manitoba Institute of Cell Biology.

Dr. Katy Kamkar, Ph.D., C. Psych.close [x]

Dr. Katy Kamkar, Ph.D., C. Psych., is a Clinical Psychologist at the Work, Stress and Health Program/Psychological Trauma Program, at the Centre for Addiction and Mental Health (CAMH). She also provides private practice at the CBT Associates of Toronto and is a lecturer in the Department of Psychiatry, University of Toronto.

She completed her Honours Degree in Psychology and Mathematics at York University and her Masters and Ph.D. in Clinical Psychology at Concordia University. She also completed a Clinical/Research Postdoctoral Fellowship at CAMH. She has received numerous academic awards and distinctions.

Kamkar provides consultation, comprehensive assessments, and evidence-based Cognitive-Behavioural treatment for Mood and Anxiety Disorders, including psychological distress related to stress and anxiety in the workplace. She also provides training, education, and supervision as well as various educational seminars and workshops. She adheres to a scientist-practitioner model of practice and integrates research and science with practice.

One of Dr. Kamkar's greatest interests has been to provide education to enhance public awareness of mental health/illness in general and of psychological distress in the workplace. She has written articles for comprehensive public resources and provided numerous public relations - media work.

Dr. Neil Rauclose [x]

Dr. Neil Rau grew up in Ottawa. He initially studied mathematics at the University of Waterloo before completing his MD at the University of Toronto in 1991. He completed training in Internal Medicine and Infectious Diseases at McGill University in 1996, before establishing a busy private practice in Oakville. He is currently the medical director of Infection Prevention and Control at Halton Healthcare Services.

In 2008, he completed his training in medical microbiology at the University of Toronto and he now serves as the medical microbiologist and chair of the patient safety steering committee at his hospital.

He is a lecturer at the University of Toronto. Since 2008, he has also been Infectious Diseases section head at the Association for Medical Microbiology and Infectious Disease Canada. He is also a frequent contributor to CTV News.

He lives in Toronto with his wife and two children, and is an avid amateur concert pianist.

Cara Rosenbloom, RD close [x]

Registered dietitian Cara Rosenbloom believes that nutrition can make a difference in overall health and wellness and enjoys translating complex nutrition information into usable and helpful advice.

Rosenbloom holds a literature degree from the University of Western Ontario and a Bachelor of Applied Science in Food & Nutrition from Ryerson University. She completed a dietetic internship at North York General Hospital to become a registered dietitian.

Prior to becoming a nutrition columnist, Rosenbloom worked as a dietitian at The Hospital for Sick Children for three years. She is a member of Dietitians of Canada and the College of Dietitians of Ontario and the president of Words to Eat By, a nutrition communications company.