Macular degeneration, also known as age-related macular degeneration (AMD), is a progressive eye condition that affects the macula, the central part of the retina responsible for sharp, detailed vision. It is a leading cause of vision loss among people aged 50 and older.
Two main types of macular degeneration
- Dry AMD:
This is the most common form, accounting for about 80-90% of cases. It occurs when the macula thins and tiny protein deposits called drusen form beneath the retina. Dry AMD typically progresses slowly over several years.
- Wet AMD:
This less common but more severe form affects about 10-20% of patients. It occurs when abnormal blood vessels grow under the retina and leak fluid or blood, causing rapid and severe vision loss.
The key early signs and symptoms of macular degeneration
- Blurry or fuzzy central vision
- Difficulty seeing in low light conditions
- Colors appearing less bright or vivid
- Increased need for brighter light when reading or doing close-up work
- Difficulty adapting to dim lighting, such as when entering a dimly lit room
- A gradual or sudden change in the quality of vision
- Straight lines appearing wavy or distorted
- Reduced central vision in one or both eyes
- Increased difficulty recognizing faces
- A well-defined blurry spot or blind spot in the center of vision
It’s important to note
Early stages of macular degeneration often do not cause noticeable symptoms. Symptoms can develop gradually and may only be subtle at first, so many people may not realize they have the condition until it progresses.
Regular eye exams are crucial for early detection. Eye doctors can spot signs of macular degeneration before symptoms become apparent. The way it can be diagnosed is through comprehensive dilated eye exams, visual acuity tests, and imaging techniques like optical coherence tomography (OCT).
If you experience any sudden changes in vision, such as increased distortion or new blind spots, you should seek immediate medical attention, as this could indicate progression to wet AMD, which requires prompt treatment.
What are the risk factors?
In addition to those over the age of 50, smoking, a family history, high blood pressure, high cholesterol, obesity, and Caucasian descent are all risk factors.
What can I do to Prevent Macular Degeneration?
Lifestyle Changes
- Quit Smoking:
Smoking significantly increases the risk of macular degeneration and its progression. Quitting smoking is one of the most effective ways to protect your vision.
- Regular Exercise:
Engaging in regular physical activity can help maintain a healthy weight and improve cardiovascular health, which is beneficial for eye health.
- Protect Your Eyes from UV Light:
Wearing sunglasses that block UV rays and wide-brimmed hats can help protect your eyes from sun damage.
Dietary Adjustments
- Eat a Healthy Diet:
A diet rich in fruits, vegetables, and whole grains can lower the risk of macular degeneration. Specifically, dark leafy greens (like kale and spinach), orange and yellow peppers, and other vegetables high in carotenoids are beneficial.
- Include Omega-3 Fatty Acids:
Consuming fish or taking omega-3 supplements can be helpful. Fish such as salmon, mackerel, and sardines are good sources of omega-3 fatty acids.
- Take AREDS2 Supplements:
The Age-Related Eye Disease Study 2 (AREDS2) formula, which includes vitamins C and E, zinc, copper, lutein, and zeaxanthin, has been shown to slow the progression of intermediate to advanced macular degeneration.
What are the treatment options?
There is no cure. Early detection and treatment are crucial for best outcomes. Regular eye exams and prompt attention to any vision changes are recommended, especially for those at higher risk of developing AMD.
For Dry AMD:
- Nutritional supplements:
The AREDS2 formula, containing vitamins C and E, zinc, copper, lutein and zeaxanthin, may help slow progression in intermediate stages.
- New FDA-approved drugs (as of 2023):
– Pegcetacoplan (Syfovre)
– Avacincaptad pegol (Izervay)
These are injected into the eye to slow progression of geographic atrophy.
- Lifestyle changes:
Quitting smoking, eating a healthy diet, exercising, and protecting eyes from UV light.
- Low vision aids and rehabilitation to help adapt to vision changes.
For Wet AMD:
- Anti-VEGF injections:
The primary treatment, including drugs like:
– Bevacizumab (Avastin)
– Ranibizumab (Lucentis)
– Aflibercept (Eylea)
– Brolucizumab (Beovu)
These are injected into the eye to stop abnormal blood vessel growth.
- Photodynamic therapy (PDT):
A light-sensitive drug is injected and activated by a laser to destroy abnormal blood vessels. This is less common now but may be used alongside anti-VEGF injections.
- Laser surgery:
Used in rare cases to destroy abnormal blood vessels.
Other emerging treatments being researched include:
– Gene therapy
– Stem cell treatments
– New drug delivery methods to reduce injection frequency
Conclusion
Although there are no cures, early detection, treatment, and lifestyle adjustments can help those with this condition live a normal life.
