Macular Degeneration: Symptoms, Causes and Treatment

 

Macular degeneration or age-related macular degeneration (AMD) is a condition that affects the macula, the part of the eye responsible for central vision.

Age-related macular degeneration is one of the most common causes of vision loss in people over 60 years old. It is a condition where the macula begins to deteriorate over time due to age and other factors. This results in poor central vision and sometimes even blindness in severe forms.

 

Types of macular degeneration

Macular degeneration appears in two forms: dry and wet.

Dry Macular Degeneration

Dry macular degeneration is the more common and milder form of macular degeneration. Waste deposits called drusen start to collect in the macular area and disturb the normal functioning of the macula. They can be seen as small yellow spots or clusters in the macula area.

Wet Macular Degeneration

Wet macular degeneration is when the blood vessels in the macular area become weak and leaky and causes bleeds at the macula. This is the more severe form of macular degeneration as it can affect your vision more significantly.

 

Symptoms of macular degeneration

Macular degeneration is a progressive disease that deteriorates over time. You may not notice the symptoms in the early stages of macular degeneration. However, typically you may notice blurring or black spots and distortions in your central vision, especially when you read or focus on something. The more severe macular degeneration becomes, the more central vision that will be affected. Peripheral vision is not affected in macular degeneration.

The most common symptoms of dry macular degeneration are:

• Distortions or black spots in your central vision
• Difficulty seeing small details, especially in low lighting
• Blurry vision

Wet macular degeneration can have similar symptoms to dry macular degeneration, but usually more severe and progresses rapidly.

 

Risk factors of macular degeneration

Macular degeneration is a condition that increases in the older population.
Some risk factors associated with macular degeneration include:

• Age, over 65-years old
• A family history of macular degeneration
• Race: Caucasian
• Smoking

 

Diagnosis of macular degeneration

Regular eye tests can detect age-related macular degeneration. Early signs of macular degeneration such as drusen can be picked up when your eye health professional examines the retina, particularly the macula. It is important to monitor any early signs of macular degeneration as it can progress and worsen over time.

An Amsler grid may also be used to monitor any symptoms of macular degeneration. This is a grid of lines that are normally straight, however if you have signs of macular degeneration, the lines may begin to look wavy or missing. This is a useful tool to check your macular health, even at home.

Some additional imaging diagnostic tests that the eye specialist or optometrist may conduct include:

Fluorescein Angiography

This test includes the infusion of dye into a vein in your arm to look at the blood circulation in your eye. Once the dye circulates to the eye blood vessels, the specialists will examine the condition of blood vessels with a camera. They will analyse these photos to search for issues and changes in your retinal blood vessels. This is particularly useful for wet macular degeneration.

Optical coherence tomography

This includes taking cross-sectional pictures of the retina and checks for any unusual deformations, deposits, swelling or growth at the retina. This test is useful for both dry and wet macular degeneration as it can help see into the deeper layers beneath the macula.

 

Treatment for macular degeneration

There is no cure for macular degeneration. However, there are things we can manage to slow down the progression. Wet macular degeneration is treatable to stop the bleeding in the eye.

If you have dry macular degeneration, changes to your diet and lifestyle can help the overall functioning of the eye and particularly the macula. Foods high in lutein and zeaxanthin can help the overall macular health. Dark-green vegetables such as kale, spinach and broccoli are recommended. Specific supplements can help limit the progression of moderate macular degeneration.

If your level of vision is impacted by dry macular degeneration, a low vision specialist may help guide you through alternative magnifiers or lighting to help see in detail.

Treatment for wet macular degeneration

If you have wet macular degeneration, treatment is required to help stop the bleeding and improve the level of vision. An eye specialist will inject a medicine in to your eye that will help stop bleeding. Multiple injections may be required over time as this is a preventative measure, not a cure.

 

Preventive Measures

There is no proven way that can prevent macular degeneration. However, there are some lifestyle changes that can be adopted to reduce the risk.  These include:

• Quit smoking
• Maintain a healthy diet; high in leafy green vegetables and low in processed fats
• Regular eye tests can screen and detect signs of macular degeneration.

 

Early detection of macular degeneration can significantly help maintain the level of progression and its effects on vision.