Macular degeneration is a form of retinal degeneration, which is also referred to as age-related macular degeneration (AMD), and it comes in two basic forms:
- Dry macular degeneration with drusen, which is also referred to as “atrophic” or non-neovascular macular degeneration
- Wet exudative macular degeneration, also known as neovascular macular degeneration
Dry macular degeneration is by far the most common. In fact, the dry form makes up 90 percent of all cases of macular degeneration, and it’s a common malady for people over 65 years of age. The condition describes the thinning of the retinal pigment epithelial cells (RPE) of your macula. The macula is the oval golden-colored covering at the center of your retina in side your eye.
The retinal pigment epithelial cells sustain the light photosensitive receptor cells fundamental to vision. When you look at something, the photoreceptors (rods and cones) gather the images and send them to your brain, where vision really takes place.
A process of atrophy takes place with the degeneration, or death, of these cells, which is why dry macular degeneration is also referred to as atrophic. The accompanying drusen are tiny bits of yellow crystal deposits that accumulate within the macula. You need your macula to be healthy and clear to allow vision in the center of your field of view.
Macular degeneration may start in a very mild form in just a single eye and then spread to the other. The tendency is for the disease to worsen until it affects your ability to conduct normal daily activities, though it doesn’t necessarily result in a total loss of vision.
The Other Kind
Wet macular degeneration makes up only 10 percent of all the cases of the disease, but it tends to cause more damage than the dry form. The wet form manifests itself through the appearance of abnormal blood vessels beneath the retina.
Choroidal neovascularization (CNV) is the name for this growth of blood vessels, since the choroid is underneath the retina. The leakage of blood from these superfluous vessels is what blurs and obscures your vision. This process is more rapid and dramatic than the drusen in the dry version of the disease.
Symptoms of Macular Degeneration
It’s possible to have the disease in only one eye and not suffer any noticeable loss of vision. As no pain is associated with it, the most common initial symptom of macular degeneration is a shadowy fuzzy spot in the middle of your vision. And this spot grows as the condition worsens. Other common symptoms include:
- Blind spots
- Poor night vision
- Difficulty adapting to low light
- Letters and words tend to look blurry
- Lack color and detail in images
- Difficulty noticing contrasts in texture in the pavement or being able to distinguish the individual stairs in a staircase
- Trouble recognizing faces
- Glare becomes particularly disorienting
With wet macular degeneration, straight lines appear bent. In advanced stages of dry macular degeneration, the central vision loss can lead to depression, and sometimes visual hallucinations can occur. This condition is referred to as Charles Bonnet Syndrome. Dry macular degeneration can then morph into the wet condition, resulting in rapid and dramatic vision loss.
The Causes of AMD
The exact cause of macular degeneration still has not been determined. Nevertheless, extensive research suggests that the disease is a combination of environmental and genetic influences. Factors that may increase the risk of macular degeneration include:
- Age: People over the age of 65 are far more likely to have the disease.
- Genetics: This disease can usually be found in the family history. Though researchers claim to have isolated several genes that are suspected to be the cause of the condition, there is no reliable genetic test for the disease as of 2016 or for predicting who will get it.
- Race: Whites are more likely to get macular degeneration.
- Smoking: Smoking tobacco or being regularly exposed to secondhand smoke significantly increases your risk.
- Obesity: Researchers have determined that obesity increases the probability that early-onset macular degeneration will progress and worsen.
- Heart disease: High blood pressure or other cardiovascular problems are strongly correlated to macular degeneration.
Diagnosis of AMD
Over the age of 50, you should have an annual Eye Exam, and be sure to mention to your doctor if you’ve experienced any of the above symptoms. Macular degeneration can only be verified by a comprehensive eye exam that includes at least some of the following:
- Visual Acuity: This is the standard eye chart exam.
- Dilated eye exam: Your pupils are dilated to widen them, providing your eye doctor a better view of your retina and optic nerves.
- Amsler grid: The grid’s lines appear fuzzy and warped if you have macular degeneration.
- Fluorescein angiogram: This test can only be performed by an ophthalmologist. A fluorescent dye is injected into your arm; from there it’s tracked up to your eye to see if there are leaking blood vessels.
- Optical coherence tomography (OCT): This test is similar to ultrasound, but it uses light waves instead of sound waves to obtain high-quality images.
Treatment for Macular Degeneration
For the early stages no macular degeneration treatment is available. And since there is no measurable vision loss in the beginning, it’s recommended that you undergo annual exams with your eye doctor and make lifestyle adjustments. Quitting smoking, losing weight, and eating better are all advisable.
As the disease enters the intermediate and late stages, you’re urged to take vitamins with verified benefits for macular degeneration. Researchers found that daily use of certain vitamins and minerals can slow the disease’s progress can reduce your risk by about 25 percent. These include:
- Vitamins C and E
In advanced stages of wet macular degeneration, more proactive macular degeneration treatments may be used, such as injecting drugs directly into your eyes. There is also a photodynamic therapy, which involves injecting a drug into your arm and then using a laser macular degeneration treatment on isolated spots of the retina. The least common treatment involves using an intense laser treatment on the abnormal leaking blood vessels in your eye.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.
Do you have any questions about Macular Degeneration or its treatment methods in Midtown NYC? Would like to schedule an appointment with NYC Ophthalmologist, Optometrist Dr. Saba Khodadadian of Manhattan Eye Specialists, please contact our office for consultation with NY eye doctor.
Dr. Saba Khodadadian, Optometrist (NYC Eye Doctor)
New York, NY 10010
(Between Madison Ave & Park Ave)
☎ (212) 533-4821