Overview:
Macular degeneration or is also known as age-related macular degeneration. Many people are developing this syndrome during the later stages of their life. People who are older than 65 are much likely to affect by this disease. It affects the retina, which is a layer present at the back of the eyeball. Light-sensitive cells present in the layer helps the person to see the world around us.
Your eyes start to work abnormally, as this disease affects the central vision of a person’s eyes. You can’t see the world like before as it appears to start blur, and you tend to see the darker spots than usual. When there is a straight-line present in front of you, they may appear curved or distorted lines before you.
It is very difficult to read something, write something when you are suffering from age-related macular degeneration. You are unable to recognise faces while you are in the phase of this disease. We would advise people to not drive cars, bikes when they are affected by this condition. The good news here is people can continue with their daily activities with the help of peripheral vision. People don’t need to panic for this syndrome, as this one doesn’t lead to total vision loss.
Most of the people who are affected by this disease are between the ages of fifty and over. People may suffer from partial blindness due to macular degeneration. Due to this reason, we would advise people to seek medical attention immediately when the images that used to be clear may start appearing blurred.
Macular degeneration is also considered as the painless eye condition. It affects the central portion of the retina, and result in improper functioning of the eyes.
Kinds of Macular Degeneration
Macular degeneration is categorised into two types.
- Dry macular degeneration
- Wet macular degeneration
- Geographic Macular Degeneration
- Juvenile Macular Degeneration
Dry macular degeneration: No treatment is available for this type. It is considered as a common eye disorder among people who are between the ages of fifty and above. People start seeing things blurred due to the lack of clear vision. People can see images as long as the macula works perfectly and it is an important part of the retina.
Wet macular degeneration: Wet macular degeneration is also called neovascular age-related macular degeneration (AMD). It is commonly considered as a chronic eye disorder that has the capability of causing your eyes blurred vision or blind spots in your visual field. People develop this condition due to the new blood vessels forms under the macula and it results in the leakage of blood and fluid. People should consider this as a very serious problem because it is a dangerous form of age-related macular degeneration. People experience severe vision loss due to this type of macular degeneration. It develops more rapidly and if symptoms appear, we would advise you to consult the respective physician in that field immediately.
Geographic Macular Degeneration: It is simply called as an advanced form of dry macular degeneration. People affected by this condition when there is a larger area of loss of the RPE (Retinal pigment epithelial) cells. The retinal epithelial cells have the capability of nourishing the rods, cones that are known as the photoreceptors of the eye. If anything happens to the retinal epithelial cells, it eventually affects the photoreceptors of the eye in the retina. It is also called as retinal pigment epithelial dropout. People who are suffering from this type of macular degeneration, generally don’t suffer from the symptoms of age-related macular degeneration such as leakage of fluid, and loss of clear vision. But it happens at the later stages of their life. Researchers are developing gene therapy and stem cell transplantation therapy to prevent the disease of the retina.
Juvenile Macular Degeneration: It is also called juvenile macular dystrophy and it affects the people who are below the age of 14 years. People diagnosed with this condition due to their parents or ancestors. Doctors need to check the patient’s family history when it comes to the Juvenile macular degeneration. When your child is suffering from this type of AMD, then we would advise you to take your child to an eye health professional. Parents don’t need to worry about this problem when it affects their child, they don’t become blind and they lose the central vision that means the images that used to clear may start appearing blurred.
Symptoms of Macular Degeneration
Usually, people don’t observe any symptoms during the initial phase of age-related macular degeneration. As the problem becomes severe, people may experience blurry vision, unable to concentrate on the things, seeing black or dark areas in your central vision, unable to see the images in both close and far vision are the common symptoms generally people experience while they are suffering from macular degeneration.
It has been observed that the people who are diagnosed with the age-related macular degeneration syndrome can properly see a number in the clock, but not the hands. There is no clinical evidence that the symptoms of this disease may appear only in one eye, there are chances that these symptoms may appear in both eyes.
People are unable to notice the symptoms of age-related macular degeneration due to their other eye still sees well. There are chances that this disease may affect only one eye but not the other one. Your physician may perform a dilated eye exam when your body shows the symptoms of macular degeneration. In some cases, the disease may not be detected through this test, even though the symptoms appear your test results may show negative. We would advise you to diagnose this condition in the early stage to get your clear vision back to your eyes.
Causes of Macular Degeneration
Advancing age, farsightedness, smoking, female gender, family history, obesity, light eye color, high cholesterol, high blood pressure, cardiovascular disease, and exposing your body to the sun are the risk factors of macular degeneration. The atmosphere present around you can contribute your body to the development of age-related macular degeneration.
People who are over the age of fifty tend to develop this disease. Smoking cigarettes can increase your risk of getting diagnosed with this disease. It has been observed in research that people can develop this condition due to several genes. Cardiovascular diseases may increase your chances of getting diagnosed with age-related macular degeneration such as
- Coronary heart disease
- Deep vein thrombosis and pulmonary embolism
- Cerebrovascular disease
- Congenital heart disease
- Peripheral arterial disease
- Rheumatic heart disease
If you are suffering from the above diseases, then you may develop the symptoms of age-related macular diseases. Still, the definite cause of this syndrome is unknown.
How to Diagnose Macular Degeneration?
It is vital to diagnose your problem in the initial stage, that is why we would advise you to consult an eye health professional, which is commonly known as an optometrist, or an ophthalmologist.
Your eye doctor will examine the retina and macula that is present in the back of your eyes. To confirm your problem, he or she may run a series of tests such as
- Amsler grid
- Fluorescein angiography
- Optical coherence tomography
Amsler grid: An Amsler grid is simply a grid of five millimeters squares with a central fixation dot in the middle. Usually, a normal grid is about ten centimeters wide by ten centimeters high. This test is conducted by the eye health professionals to their patients to detect the distortion or blind spots in the central vision. This is most commonly used to detect a monitor for changes associated with age-related macular degeneration or AMD. The grids should be held at a normal reading distance of approximately thirty centimeters with one eye covered while the other is tested.
The eye doctor asks the patient to look at a special grid. If any part of the grid is either distorted or missing in the patient’s views, then an eye health professional confirms the patient that he is diagnosed with age-related macular degeneration.
Fluorescein angiography: with the help of this special test, your physician may diagnose your condition. The test involves taking special pictures of the inside of the eye. The main objective of this test is to find problems in the retina. This test allows a much more detailed look in your eye and identifies the circulation problems in the eyes. You will need to get dilating drops in your eyes a few minutes before this test. These drops may blur your vision for a few hours, so we would advise you to don’t read and drive after the test. It may lead to accidents.
You will be seated at a special camera and your doctor will inject a small amount of special dye into a vein in your arm with the help of a tiny needle. Then, a series of flash pictures will be taken of both eyes and it provides the information that your doctor is looking for.
Optical coherence tomography: Your retina will be scanned with the help of special light rays and takes a few pictures of it. These images will provide necessary information about your macula.
Treatment
All you need to do is visiting your eye doctor regularly. As there is no treatment to restore your vision, but there are some methods to slow down the process of vision loss.
Anti-VEGF medication: People who are suffering from wet age-related macular degeneration may use the medication of Anti-vascular endothelial growth factor. It is a chemical helps your eyes to the formation of new blood vessels. Lucentis and Avastin are examples of these drugs.
This procedure can be done by medical professionals. Your eye specialist will inject the drug into your eyes with the help of a tiny needle. To get the best results, you should consult your eye health professional every few weeks. There are no side effects associated with this treatment, but you may feel the following the side effects for some time after the injection such as
- Pain
- Blurred vision
- Redness
- Swelling
You don’t need to worry about the above side effects, as these are temporary and not disturb you in the long run. Complications like damage to the retina, lens of the eyes, and infection may occur after the treatment but in very rare scenarios.
Photodynamic therapy: A light-sensitive medication is known as verteporfin is injected into the patient’s arm with the help of a tiny needle. Eye doctors identify abnormal blood vessels in your macula which is present at the back of your eyes with the help of this therapy.
Verteporfin is activated with the help of a laser and it is shone through the eye for about one minute. With the help of laser, verteporfin is activated and destroys the abnormal blood vessels present in the eye. This therapy won’t do any damage to your eye tissue.
We would advise people to opt this method for every few months as this photodynamic therapy prevents the leakage of fluids and blood that can damage the macula. Doctors recommend this therapy to their patients not frequently when compared to anti-vascular endothelial growth factor injections.
Laser therapy: Sometimes, to destroy the abnormal blood vessels in the retina, your eye health professional may recommend laser therapy. This therapy is less commonly used when compared with photodynamic therapy and Anti-vascular endothelial growth factor.
Omega-3 fatty acids: It has been observed in a study that the consumption of omega-3 fatty acids found in the foods and fish oils can reduce your chances of getting diagnosed with age-related macular degeneration (AMD). However, more research needs to be done to prove this point.
Stem-cell therapy: human stem cells have the capability of repairing the retina itself. It has been observed in a study that two people who are suffering from severe wet age-related macular degeneration had recovered their sight after stem-cell therapy.
Implantable telescope: Implantable miniature telescope can improve the vision of the people who are suffering from advanced age-related macular degeneration. But, still, it is difficult for people to drive a car and reading a book.
Conclusion
Age-related macular degeneration may look like a small problem in the beginning stage but can cause greater discomfort to you. you should consult an eye health professional once in a month even though if you don’t have a vision loss.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322741/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816845/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573066/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513889/
Sirisha B