Age-related Macular Degeneration
Age related macular degeneration is the most common cause of vision loss after the age of 65 in the developed world. Usually affects only central vision and does NOT lead to complete blindness.
It is a multifactorial disease due to aging of special cells of the retina. This disorder sometimes results in the production of neovascular tissue that causes bleeding and eventually destroys the surrounding healthy tissues of the macula.
What are the main causes of macular degeneration?
- Age: Related to normal macular cell aging combined with genetic predisposition.
- Gender: It seems to occur slightly more in women perhaps because they have a higher average age.
- Genetic predisposition: Various genes have already been blamed for the disease without always having an absolute correlation.
- Smoking: Increases both the risk of the disease and its aggressiveness.
- Sunlight: Some studies have shown a possible association without full proof.
What are the main symptoms?
They vary from patient to patient, but usually:
- Difficulty reading and small print.
- Distortion of images and faces.
- Straight lines appear crooked, or pieces are missing entirely.
- Blurred central vision.
Are there many types of degeneration?
Macular degeneration is practically divided into dry and wet form. The dry form has less intense symptoms and has a very slow progression. Usually, the patients maintain good vision.
However, there are cases in which the central vision can be significantly reduced due to geographic atrophy.
The wet form causes acute vision loss and is characterized by the appearance of exudates, swelling and bleeding of the retina. The main symptom is metamorphopsia, the appearance of blind spots in the central vision that are noticed when reading or when covering the other eye. Various names and types are known such as RAP, vascularized PED, IPCV, pred / min Classic CNVM, Occult CNVM etc., in which case it is important to have the experience and knowledge of the specialist ophthalmologist for the correct diagnosis which will lead to the selection of the appropriate treatment.
Is there a treatment for macular degeneration?
Treatment is mainly for the wet form of age-related macular degeneration. It is intravitreal injection of different drugs aiming at limiting the extent of retina edema. They are more than 95% effective in their action and have up to 30% chance of improving the initial vision. It is very important to start treatment immediately as the disease progresses rapidly.
To date, no effective treatment has been found for the dry form of age-related macular degeneration, besides vitamins as recent studies with the same type of injections for the dry form also failed.
Can I do something?
This condition seems to have an important genetic factor; however, lifestyle has also been blamed for it.
Smoking: smoking has been found to increase the likelihood of aggressive disease by up to 400%!
Diet: Neglecting the use of vegetables and fruits in the diet may worsen macular degeneration. Individuals of a specific subtype and stage of macular degeneration appear to have better protection with multivitamins according to the AREDS work.
Examination
In addition to the annual routine examination, the eye doctor can detect signs of the disease before they even show symptoms.
Required:
- Clinical examination and fundoscopy.
- Imaging of the macula (upon equivocal funduscopy).
- Macular OCT and fluorescein angiography.
