Ophthalmos Research and Educational Institute

RETINA

Macular Degeneration

Macular Degeneration is the largest cause of blindness in people over 50 years old in the western world. One in three who are over 75 suffer from this disease, and worldwide approximately 300 million are affected by it. It is a disease of the eyes that needs careful and regular monitoring, however many people ignore it and tragically end up blind.
When somebody suffers from age related Macular Degeneration the macula of the retina does not function properly, resulting in not being able to see detail as before. The peripheral vision is not affected and continues to function as usual. One does not go blind with this type of Macular Degeneration.

The usual types of Macular Degeneration are the dry and wet form. Both can lead to serious loss of vision.

In the dry form, which is the most common, a gradual loss of vision is noticed. It is caused by the destruction or thinning of the macular tissue. Usually the first signs are thick yellow deposits (drusen) under the Macular and do not cause reduction in vision. However if the deposits remain and become enlarged, they cause the destruction of the retinal cells, resulting in gradual reduction of the central vision.

The wet form is rarer than the dry affecting one in ten cases. It is the most serious of the two as there is sudden loss of vision. This type can be likened to a tree’s roots that have grown too big and lifted up the pavement. In a similar manner, for unknown reasons up until now, irregular vessels emerge from under the retina and lift it. These new vessel membranes produce fluid or blood. They are delicate and can be destroyed easily and in advanced cases may create a wound which can cause blindness at that part of the retina.

At first the patient notices that there is a distortion in vision (lines become curved or incised). Because the vision that is lost cannot be restored it is of great importance for the quick diagnosis of any form of Macular Degeneration. Early discovery lessens the percentage of loss to a larger or lesser extent of the central vision. This is why people must be informed of this disease and ophthalmic examinations be carried out regularly.

For the dry form of Macular Degeneration for the time being there is no choice of treatment. Patients at high risk can be helped with nutritional supplements. The use of a high dose of Zinc and antioxidants appears to have positive results. A large study in the United States showed that they can slow down the process of Macular Degeneration by up to 25%. However the type and dosage of Zinc and the combination of the antioxidants has not been determined yet. (Unwanted consequences are the increase of possible cancer of the lungs in smokers and frequent infections of the urinary tract). Recently Omega 3 has proved to be beneficial.

Treatment for the wet type consists of injections into the eye with anti-. The anti-VEGF intraocular injections can reduce the fluid and improve lost vision in patients with neovascularisation. There is ongoing research at the moment for other treatments such as surgery of the macula, transplant of the retina & others.

Many people who have been diagnosed with Macular Degeneration can live an independent life with the aid of appliances that improve poor vision, such as magnifying or telescopic lenses and follow advice for easier management of daily activities.