A simple diagnostic test to detect visual problems caused by changes in the macula is the Amsler grid test.
One of four people over the age of 60 years shows Macula degeneration and is threatened to have a permanent loss of the central vision.
What is the Macula
The macula is the central part of the retina responsible for central vision (detail vision, reading, driving, etc.) and color perception. Damage to the macula causes loss of central vision and color perception.
What is macula degeneration?
Maculopathy is the degeneration of cells of the macula. The age-related macular degeneration is the leading cause of central vision loss in people 60 years of age and is associated with the continued loss and deterioration of cells that occurs with aging. The age-related macular degeneration is the leading cause of severe vision loss in people over 50 years. It is estimated that about 400,000 Greeks suffer from degenerative maculopathy and unfortunately, the numbers are rising rapidly, and the average survival is growing. Within two years from initial diagnosis many of the affected eyes, will have serious vision loss.
What are the forms of maculopathy?
There are two forms of macula degeneration: The dry and the wet form. The dry form is the most frequent, about 85% of cases due to progressive loss of cells of the macula. The wet form of degeneration is characterized by growth of new blood vessels under the macula and the creation of the neovascular membrane, exudation of fluid and blood.
Symptoms of maculopathy
Some people ignore the first symptoms because they believe these are due to the fact they get older. But the sooner the problem is detected the better the chances for a better outcome. Therefore, it is of high value to recognize some early symptoms.
The most common symptoms are:
The blurring of vision for far and near.
The distortion (distortion of straight lines in Amsler gridappear).
The appearance of scotoma (black spots) in the central visual field.
The shades of color, especially gray are not distinguishable and the contrast of the objects decreases.
Pictures with an eye may appear smaller, larger or slightly distorted compared with the other eye.
There are several risk factors for the age-related maculopathy which alone or in combination accelerate the deterioration of the cells. The pathogenesis is not fully clear. Is Considered to be an inflammatory process, which has a genetic predisposition and various environmental influences.
The most common factors are:
Age – over the 60 years.
Heredity – first-degree relatives.
Gender – women have higher rates of degeneration than men.
Nutrition – inadequate nutrition especially for people who live alone and do not have proper nutrition.
Vascular-metabolic diseases such as cardiac hypertension, diabetes etc. affect blood flow in the central region of the eye.
Smoking – the seizure of vessels.
Obesity – the fat-soluble carotenoids such as lutein, zeaxanthin do not accumulate in sufficient quantity in the eye.
The solar radiation – the use of sunglasses reduces risk.
How can macula degeneration be diagnosed
Through an ophthalmologic examination of the fundus(retina). If there are any signs of degeneration, the patient should be further examined with fluoreszenzangiographie, which controls the state of the vessels, and optical coherence tomography (OCT) of the macula for the presence of fluid in the macula, and measuring the thickness of the retina (the retina is thinner in the dry form and thicker in the wet form).
Is there a treatment for the macula degeneration?
In the last 10 years a great progress has being achieved at the treatment of the wet form.
In the dry form, the whole effort is to slow and stabilize the progression of the maculopathy. This is reached by taking multivitamins, minerals and antioxidants that inhibit the accumulation of free radicals which are highly reactive and damaging to the cells of the macula. Good nutrition is an important factor. In situations of advanced dry form the vision is very limited. Low vision aids can improve the central vision.
The last years serious steps have been made to deal with the wet form with encouraging results. Where previously doctors lifted their hands, unable to interfere now not only can stop the deterioration, but also achieve significant improvement of the vision.
New drugs, antineovaskularisations agents, acting directly at the eyes and have rare systemic side effects.
The treatment for the wet form of macula degeneration is to regress-destruct the neovascularization. These drugs help in the absorption of retinal fluid and regression, destruction of abnormal vessels.
The results are satisfactory, improving the status of the macula and vision. But we must examine the patient regularly for possible recurrence.
Regular eye examination with fundus(retina) examination after the age of 50.
Avoidance of unnecessary sun exposure and the use of sunglasses to filter UV rays.
The treatment of vascular-metabolic diseases.
The Attiko Ophthalmologiko Eye Center has the most modern equipment for the proper diagnosis and treatment of the macula degeneration.