Macular Degeneration

Macular Degeneration

1. Introduction

The macula is the central part of the retina and is prone to age-related damage. Macular Degeneration is a disease of the eye that affects the macula. Age-related macular degeneration (ARMD) is an irreversible and painless disease which can lead to the loss of central vision. People with this condition often complain of image distortion in the central field of vision e.g reading letters.

Macular degeneration may be unilateral or bilateral depending on the age and severity of the disease. It affects 30 to 50 million people worldwide and is the leading cause of blindness in industrialized nations in people above 50 years. In the United States, the leading cause of vision loss is macular degeneration in people 60 years and above.

Therefore, early diagnosis and treatment of this condition plays a vital role in the prevention of vision damage. If you are experiencing blurry vision, distortion, or black spots in your vision, see our ophthalmologists at Eye Surgeon Associates who are experienced in evaluating your eyes. 

1. Causes Of Macular Degeneration 

Macular degeneration is a multifactorial condition involving genetic, environmental, and functional factors. The most common risk factor for macular degeneration is advancing age. Other risk factors include the following:

• Female gender 

• Obesity

• Working outdoors under direct sunlight

• Family history of macular degeneration

• History of smoking

• History of alcohol intake

• High blood pressure

• Ethnicity 

1. Types

There are two types of age-related macular degeneration:

• Dry/Atrophic ARMD
  

• Most common form, 90% of the cases

• Vision loss is gradual

• Moderate in severity 

• Wet/exudative ARMD

• Less common form, 10% of cases

• Sudden vision loss

• Severe impairment 

1. Signs And Symptoms Of Macular Degeneration 

The macula contains photoreceptors which help in sending images from your eyes to the brain. If cells in the macula are damaged then the brain may not be able to process visual information. 

ARMD is asymptomatic initially, but symptoms may appear as the disease progresses. The signs of age-related macular degeneration may include:

• Black or dark spots in the center of an image

• Difficulty reading

• Difficulty in differentiating colors

• Blurring of vision

• Overall decreased vision

• The appearance of straight or curvy lines in the central field of vision

1. How To Diagnose Macular Degeneration?

Macular degeneration is a slow process in most cases e.g dry ARMD and thus often asymptomatic. Routine examination of the eyes is recommended for early detection.

Your ophthalmologist may do some or all of the following to diagnose ARMD:

• History and examination

• Amsler grid test

• Measurements of visual acuity

• Fundoscopy

• Fluorescein angiography

• Optical CT angiography

• Ultrasound

• Metabolic profile

1. Treatment of Macular Degeneration

The aim of the management of ARMD is to identify and target the disease in its initial stages. Early diagnosis and treatment can slow down the disease progression and visual impairment as there is no cure for advanced disease. Treatment options depend on the type and severity of macular degeneration.

Studies show that different combinations of vitamins and minerals can slow down the disease's progression. These include vitamin C, vitamin E, zinc, and copper. Your ophthalmologist will advise you as to whether you may benefit from these vitamins. 

There are certain drugs that treat wet ARMD but don't cure it e.g anti-VEGF injections. They stop the production of new blood vessels in the retina and can improve vision in return. Examples of these agents are Bevacizumab and Aflibercept.

Another modality to treat ARMD is photodynamic therapy. During PDT, drugs and lasers are utilized to eliminate new blood vessels.

For wet macular degeneration, laser photocoagulation can also be used in which light is directed to seal the leaking blood vessels.

The sequelae of macular degeneration are not the same in everyone. Vision loss depends upon multiple factors and the stage of the disease. Annual screening and regular follow-up can minimize the complications of ARMD. If you are facing any of the above-mentioned problems, or if you have not had a complete eye exam recently, call Eye Surgeons Associates or schedule a visit online at www.esacares.com.

1. https://my.clevelandclinic.org/health/diseases/15246-macular-degeneration

2. https://www.aao.org/eye-health/diseases/amd-macular-degeneration

3. https://www.medscape.com/viewarticle/848348

Author

Eye Surgeons Associates Drs. Zuhair H. Peracha, Manal H. Peracha-Riyaz, Eric Zuckerman, Matthew Pieters, and Leila Siblani are dedicated to excellence in eye care and service. We utilize the latest treatment methods and procedures, including routine eye care, cataract surgery, glaucoma treatment, retinal disease management, diabetic eye treatment, and eyelid surgery.