What is Macular Degeneration (Yellow Spot Disease)? Symptoms, Causes and Treatment

Macular Degeneration

Macular degeneration is one of the main causes of partial vision loss in adults and the elderly. Also referred to as macular degeneration in medicine, it is associated with the deterioration of the macular structure, which controls the sharp vision of the eye with aging. The macula or yellow spot area is a light-sensitive tissue part located in the inner and back part of the eye. In older adults, macular degeneration can disrupt daily life and negatively affect social life. Complete blindness may not occur in macular degeneration, but it can cause blurred vision that makes reading, writing, driving, repairing, and cooking difficult. While it can happen quickly in some individuals, it may develop more slowly in others. Mild vision loss may go unnoticed during this process. Generally, vision losses are directed towards the center of the image. Although the exact cause of the degeneration is not known, risk factors such as aging, smoking, hypertension, and hypercholesterolemia exist. The incidence of macular degeneration in women is higher than in men. You can read the rest of the article for information on the symptoms, causes, diagnosis, and treatment of macular degeneration.

What is Macular Degeneration?

Known as macular degeneration or age-related macular degeneration, it is a health problem that progresses in parallel with aging and affects visual acuity. The macula, which is the center of the retina, is the region where the image falls. Central vision is formed in the macula located at the back of the eye, and the image is transmitted to the brain. As a result of the degeneration of the macula, even if individuals do not go completely blind, reduced visual acuity or blurred vision may occur. Since this medical problem develops depending on age, it is frequently seen in people over 50 years of age. There are two defined forms of age-related macular degeneration:

Dry macular degeneration: It is responsible for approximately 80-90% of macular degeneration cases. It occurs with the thinning and drying of the macula as a result of the accumulation of "Drusen" proteins in the macular region. With dry-type macular degeneration, vision loss is usually slow and gradual.

Wet macular degeneration: The less common wet form can occur as a result of the formation of new and abnormal blood vessels under the retina. These blood vessels can leak fluid along with blood, and the macula can turn into a scar structure. This form is faster and more severe.

Regular eye examinations are important because macular degeneration does not show symptoms in the early period in some individuals.

What Are the Symptoms of Macular Degeneration?

The image sent from the damaged macula cannot be read or understood by the brain. This situation can be understood with the progression of the disease in many people. In addition, the observed symptoms of macular degeneration are generally as follows:

Decreased ability to see clearly (blurred vision),

Decreased ability to see in low/dim light,

Dark spots in the field of vision,

Problems seeing colors,

Straight lines appearing wavy or curved,

Distortions in the shapes of objects,

Difficulty recognizing faces,

Needing more light while reading.

Degeneration can affect one or both eyes. Usually, when one eye is affected, signs and symptoms may not be noticed early. Because the healthy eye has the ability to compensate for the vision.

How Does Macular Degeneration Occur?

The exact cause of back-of-the-eye macular degeneration is not yet known. However, there are a number of risk factors that can trigger macular damage. These factors can support the weakening of the macula and the occurrence of vision loss. The main risk factors for macular eye disease can be:

Aging,

Infections,

Smoking,

Hypertension,

Obesity,

Diabetes,

Family history of macular degeneration,

Atherosclerotic lesions,

Caucasian race,

Malnutrition,

Being physically inactive.

Since lifestyle habits are generally associated with degeneration, it may be possible to prevent or slow down macular damage.

How is Macular Degeneration Diagnosed?

Early and accurate diagnosis supports shaping the appropriate treatment plan. Since most people do not show symptoms in the early period, medical intervention is sought when the degeneration progresses. Tests and methods for macular degeneration used during diagnosis include:

Amsler grid test: You are asked to look at a grid consisting of horizontal and vertical lines with a dot in the center. You are expected to point out wavy, curved, blurred, and empty areas on this grid. As the rate of distortion in the image increases, the progression in macular degeneration can be recorded.

Dilated eye exam: Eye drops are instilled to dilate the pupil. The inner part of the eye can be examined with the help of special lenses.

Fluorescein angiography: A yellow dye called "fluorescein" is injected into the blood vessels from the arm. The movement of the dye in the eye vessels is monitored with special cameras. Thus, possible leaks in the macular region can be detected.

Optical coherence tomography (OCT): Allows scanning of the retina and detailed imaging of the macula. It is a painless and non-invasive procedure.

Optical coherence tomography angiography (OCTA): Used to image blood vessels and blood flow in and under the retina. This application is similar to fluorescein angiography, but laser light reflection is used instead.

In addition, medical history, family history, environmental conditions and drug use, and other existing diseases (diabetes, hypertension, etc.) are evaluated together with the macular eye disease test.

How is Macular Degeneration Treated?

Macular degeneration treatment may vary depending on dry and wet forms. The treatment methods applied for both forms are mainly as follows:

Although there is no definitive option yet for the treatment of dry-type macular degeneration, the progression of the disease can be slowed down. In this context, vitamin- and mineral-heavy nutrition and supplement use are effective in slowing down the development of dry macular degeneration. Vitamins E and C, lutein, zeaxanthin, copper, zinc, and omega-3 fatty acids are recommended nutrients to be included in the diet. These nutrients can also be taken as supplements in some cases.

Wet-type macular degeneration treatment commonly involves anti-VEGF drugs and laser surgery. The anti-VEGF drug is administered to the eye with a very fine needle. This treatment helps stop the development of new abnormal blood vessels in the retina. It can also prevent blood and fluid leakage from abnormal vessels. Drug injection can continue for several months to several years. It is generally a painless procedure and helps reduce vision loss. Laser surgery, another treatment option, is applied less commonly. It can be preferred when leaking abnormal blood vessels are very small, located far from the macula, and in cases such as advanced glaucoma where injections cannot be made into the eye. Laser therapy helps slow the progression of degeneration but cannot reverse the damage. Macular degeneration surgery can be performed in two different ways: Photodynamic therapy and laser photocoagulation.

Frequently Asked Questions

Macular degeneration in the eye can lead to mild or severe vision loss in the central vision. However, retina health may generally not be adversely affected. Difficulty in carrying out social and daily activities, and the disruption of jobs requiring focus are the main negative factors. At the same time, situations such as bumping into objects and falling can be dangerous. It cannot be said that macular degeneration usually leads to total blindness. In case of failure to perform necessary medical interventions and exacerbation of symptoms, complete vision loss rarely occurs. However, most of the time, symptoms can be controlled with different methods and the development of the disease can be slowed down. Important points to consider before and after the diagnosis of macular degeneration are:

Limiting or quitting smoking and tobacco products,

Adhering to a diet rich in antioxidant content,

Reaching and maintaining an ideal weight,

Bringing health problems such as hypertension, cardiovascular diseases, etc. under control

In addition, it is important to have regular eye examinations. There is no definitive cure for macular degeneration. However, degeneration diagnosed in the early stages can have its progression slowed and symptoms alleviated. Age and dry macular degeneration can allow for less frequent symptoms with various treatment methods. Basically, adequate and balanced nutrition, food supplements, drug therapy, and laser surgery are treatment options applied according to the type of disease. According to data, oxidative stress, inflammation, and genes playing a role in the development of angiogenesis in the body can be controlled with vitamin D. Vitamin D can help protect the activities of cells and pigment epithelium in the macular tissue. The direct proportionality between vitamin D deficiency and the risk of macular degeneration supports these data. The health problem known as night blindness is called "night blindness" in medicine. Night blindness is defined as experiencing vision problems in low-light or dim environments. These are symptoms that occur when the eyes have problems perceiving light or react slowly to changes in light. Retina macular degeneration is the condition of deterioration of sharp vision resulting from damage or leaks in the retina. Macular degeneration and night blindness are not the same health problem. Before making a surgical decision, it must be determined whether the vision loss is caused by macular degeneration or cataracts. If vision loss is due to macular degeneration, cataract surgery may not provide a full recovery in vision because the retina is damaged. While cataract surgery helps increase the light entering the eye, macular degeneration can continue to be an obstacle for central vision. Be sure to consult your doctor for the most suitable treatment options for you. Factors triggering macular degeneration mainly include:

Aging,

Incorrect nutritional conditions,

Obesity, hypertension, cardiovascular diseases,

Family history of macular degeneration.

If macular degeneration is not treated, the degree of visual impairment may increase and symptoms may become severe. It may be possible to experience blindness in severe cases that are not treated. Apart from this, it may be difficult to perform daily activities such as reading, writing, cooking, repairing, and driving. Anxiety, stress, and depression may develop in some individuals. The eye with macular degeneration may experience problems in terms of central vision. Vision characteristics such as the center of the field of vision appearing blurred, wavy, and skewed, misinterpretation of colors, loss of the ability to see in dim light, and distortion in the shapes of objects may emerge.

If you have complaints about your vision health, you can consult an ophthalmologist without delay. When macular degeneration is diagnosed early, the rate of progression can be significantly slowed. Take the first step for a professional evaluation by making an appointment from our Hisar Hospital Ophthalmology Department.