The macula is a small area located at the back of the eye that allows us to see fine details clearly. When a disease occurs in this region, our central vision deteriorates and we have difficulty doing daily tasks that require detailed vision.
When macular vision fails to perform its function, our central vision may become blurred. Macular degeneration can affects your near and far vision and make some of your visual activities that you have done before ( reading, doing crafts ) impossible. In some patients, it may result in permanent loss of central vision, environmental vision is preserved.
What is Macular Degeneration Risk Factors?
Bu hastalık (makula dejenerasyonu) genellikle kadınlarda daha fazla görülmekle beraber toplumda belirli risk faktörleri işe ilişkilidir. Bu faktörler
• Genetic (Familial ) predisposition
• Being over the age of 50
• Smoking
• Hypertension and the height of cholesterol
Are There Different Types of Macular Degeneration?
There are dry and wet types of the disease.
a-Dry Type Macular Degeneration
It accounts for 90% of cases. It progresses slowly. Usually when they go from a light environment to a dark environment, they need a few minutes to adapt. Dry type macular degeneration turns into an wet type in some of the patients.
b- Wet Type Macular Degeneration
It accounts for 10% of cases. As a result of abnormal vascular development under the retina, there is bleeding and fluid accumulation in the retina. This bleeding and fluid damages the retinal cells and causes vision loss. In this type of disease, vision loss and symptoms occur suddenly and can progress severely.
What are the Symptoms of Age-Related Macular Degeneration?
Age-related macular degeneration affects the central vision of the retina. Patients with advanced macular degeneration disease can see the outlines of the clock they are looking at, but they cannot tell the time because they cannot hour and minute hand of the the clock. In cases where vision is not very affected, the diagnosis is usually made during a routine examination, and in cases where vision is significantly affected, the disease is detected while investigating the patient's complaints. The most common symptoms in patients are
• A dark or empty area in the center of the field of view
• The letters on the paper are blurred.
• Straight lines or shapes of objects can be seen as curved and crooked or rounded.
• Need more light when reading,
• Pale vision of colors.
• There may be complaints such as difficulty recognizing faces
What kind of Tests are Performed to Diagnose Macular Degeneration?
After a routine eye examination, the pupils are dilated with drops and the back of the eye (macula) is examined with special lenses. If macular degeneration is suspected, the diagnosis is confirmed by eye angiography (FFA) and optical coherence tomography (OCT) examination, if deemed necessary by the ophthalmologist. The response of the disease to treatment and its follow-up are also done with OCT examination. In FFA, a substance called fluorescein is administered thoroughly intravenous route. The subtype and stage of the disease are tried to be determined through the films taken while this substance passes through the vessels in our eyes. OCT is a test that shows the layers of our eye in detail. OCT is the most effective method to evaluate whether there is fluid accumulation and the response to treatment.
How is macular dejeneration treated?
Treatment of macular degeneration varies depending on the wet and dry type of the disease.
Today, there is no effective treatment for dry macular degeneration. However, patients diagnosed at an early stage can slow down the progression of the disease with food supplements specially produced for macular degeneration, containing antioxidants, vitamins and omega-3. If there is smoking, which is one of the most important risk factors, it should be stopped. A diet containing healthy green vegetables and fish instead of ready-made, packaged foods has been shown to have a positive effect. Vitamins and nutritional supplements cannot definitively cure this disease, nor can they be helpful in correcting vision loss.
The aim of treating wet macular degeneration is to stop the progression of the disease and maintain the current level of vision. Intraocular drug injection treatments are the most frequently applied treatments today. Intraocular injections shrink the abnormal vascular formation in the retina, reduce vascular permeability and fluid accumulation. The frequency of these injections may vary depending on the severity of the disease, the patient's response to treatment and the medications administered.
How to Follow Up Patients with Macular Degeneration?
Patients are seen at regular intervals according to the applied treatment protocols. If the patient is not examined regularly, the disease may be reactivated. For this reason, eye examinations are performed and, if necessary, drug injections into the eye are repeated at regular intervals. The success of the treatment is closely related to the patient's compliance with the treatment and regular treatment. Patients should look at the Amsler Grid Card, which is given once or twice a week, separately for each eye, until their next doctor's appointment. If they notice lines on the floor or warped or wavy vision around doors and windows, they should immediately contact their doctor.