Macular degeneration is a condition affecting the eyes, that causes the gradual loss of the central field of vision. Since it comes on slowly some people don’t notice the earliest stages of macular degeneration. It’s also worth noting, that there are different types of macular degeneration, and possible warning signs to look out for.
Common Symptoms of Macular Degeneration
Macular degeneration’s symptoms can often be hard to notice, but as they develop they can escalate quickly. This includes things like:
- A gradual reduction in the central field of vision.
- The pronounced distortion of straight lines in your field of vision that worsens with time
- An increased need for brighter lighting
- Increasing difficulty adapting to low light conditions
- Blurred vision
- Difficulty recognizing faces
A severe, untreated case of macular degeneration can also cause damage to the retina, which delivers visual messages from the eyes to the brain. Left unchecked the impairment to one of both retinas can eventually lead to blindness.
There are two different types of macular degeneration to be concerned about. Each has underlying causes that may or may not be treatable.
Dry Macular Degeneration
Also known as “Age-Related Macular Degeneration makes up roughly 90% of all cases of macular degeneration. It causes the layers of the macula, which include the photoreceptors as well as the retinal pigment epithelium to become increasingly thinner. As it continues to degenerate or “Atrophy” these components of the eye function progressively poorly.
Dry macular degeneration can also result in changes in the pigment or color of the macula. As time goes on miniscule drusen starts to appear on the retina. These are essentially tiny piles of waste products left with the cells of the eye. As time goes on, significant drusen can also lead to deterioration as well as increasing atrophy of the retina of one or both eyes.
What Is Non-Neovascular Age-Related Macular Degeneration?
This is a type of non-exudative age-related macular degeneration. It doesn’t specifically involve the exuding or leakage of fluids from the blood vessels of the eyes. More severe cases of Non-Neovascular Age-Related Macular Degeneration are often designated as GA or Geographic Atrophy due to the large sections of the retina that become severely demarcated as they gradually cease functioning correctly.
Wet Age-Related Macular Degeneration
Roughly 10% of all Age-related Macular Degeneration cases are classified as “Wet.” These are more pronounced forms of macular degeneration where new blood vessels gradually start to develop in the choroid layer behind the retina. This type of Wet AMD is sometimes referred to as CNV or Choroidal Neovascularization.
The problem with CNV cases of wet age-related macular degeneration is that these new blood vessels in the choroid layer are very weak. This typically causes them to “Exude” or leak fluids, including lipids which play a critical role in the structure of the cells as well as the blood. As it progresses these leaked lipids and other fluids start to saturate the layers of the retina, which also includes the layers of the macula.
As time goes on, this progressively worsening leaking can start to cause scar tissue to form in these critical structures of the eye, which can, in turn, lead to the retinal cells ceasing to function normally. At this point, visual signals cannot get from the eyes to the visual cortex processing center of the brain, resulting in increasing visual loss and eventual blindness.
How Is Macular Degeneration Diagnosed?
An optometrist or an ophthalmologist can detect the earliest signs of both wet and dry macular degeneration as part of a comprehensive eye exam. If they do suspect macular degeneration is affecting one or typically both of the eyes, there are a few different diagnostics they might choose. Most call for first dilating the pupils.
Also known as FAF this is a non-invasive retinal imaging modality used to provide a density map of lipofuscin, in the retinal pigment epithelium, which is common in both forms of age-related macular degeneration.
This test enables the eye doctor, to look at the back of the eye at an area called the fundus, and consists of: retina. optic disc. Changes here and the buildup of waste products or leaked fluids are often a sign of macular degeneration.
Visual Acuity Test
This is a common diagnostic that can help the eye doctor assess how much visual acuity has been lost from the central field of vision.
This is an outpatient medical procedure where the eye doctor injects a special fluorescent dye into the bloodstream. This dye then helps to highlight the blood vessels in the back of the eyes in a way that makes them easy to photograph.
Optical Coherence Tomography
Also known as OCT, this is a non-invasive imaging test that uses light waves to take cross-section pictures of the affected retina. It allows the eye doctor to see each of the retina’s distinctive layers.
How Is Macular Degeneration Treated?
It’s important to note that there currently no known way to reverse the damage caused by either wet or dry macular degeneration. Though modern medicine has made it possible to significantly slow the progression of macular degeneration. In some cases where it is caught early the increasing loss of visual acuity might be completely arrested for years.
Your eye doctor will work with you to create a treatment strategy tailored to your wet or dry macular degeneration as well as other eye health conditions. This typically includes the use of prescription medications such as Bevacizumab (Avastin), Ranibizumab (Lucentis), Aflibercept (Eylea), or Brolucizumab (Beovu).
Can Wet Or Dry Macular Degeneration Be Prevented?
A lot of what causes macular degeneration is related to the natural aging process, as well as certain lifestyle choices. Some of the things you can do to decrease your risk of developing either type of age-related macular degeneration include things like maintaining a healthy weight and eating nutritious foods, especially green leafy vegetables, fish, and whole grains. Try to quit smoking and maintain normal blood pressure, as well as exercise regularly.
Getting a routine eye exam each year will also go a long way toward catching the earliest stages of macular degeneration as well as implementing the most effective treatment strategy for long-term management of this serious eye condition.