Macular degeneration: types, symptoms and treatment

Central vision, which depends on an eye structure called the macula, is what allows us to look at details and perform daily activities such as reading a book, driving, or even recognizing a person’s face. This type of vision is the one that is affected when a disorder called macular degeneration occurs, a condition that affects older people more and eventually leads to vision loss.

In this article, we tell you what macular degeneration isWhat are its two most common forms and the symptoms associated with each. In addition, we explain the main risk factors that lead to the onset and development of this eye disease, as well as the treatments currently available.

    What is Macular Degeneration?

    Macular degeneration, also called age-related macular degeneration, is an inherited neurodegenerative eye disorder that it gradually affects the central vision, which is that which depends on the macula and the one that provides us with the visual acuity needed to perform tasks such as driving, reading, or recognizing a person’s face.

    The macula is a tiny part of the eye, in the form of a yellowish spot (due to the high concentration of two pigments that give it this color), which is located in the central area of ​​the retina. It is made up of the fovea, located inside the macula and responsible for color perception; and the foveola, located inside the fovea, is what allows us to have maximum visual acuity.

    In macular degeneration, as the name suggests, there is a gradual deterioration of the macula, which allows us to perceive details and movementThus, people who suffer from this disease end up suffering from a significant loss of vision, especially related to fine details, near or far.

    This loss of central vision has a number of negative consequences in the daily life of people suffering from this condition, with age generally being advanced in general. Macular degeneration is considered to be one of the main causes of blindness and low vision, and no treatment is currently known.

    Currently, this disease affects 1.5% of the population, And if it only concerns people over 50, the prevalence increases to 5.3%. Next, we will take a look at what the two main forms of macular degeneration are.

      Types and their symptoms

      There are two types of macular degeneration: dry, which is the more common of the two; and wet, less frequent but more severe. Let’s see in more detail what each of them consists of.

      Dry or atrophic macular degeneration

      Dry macular degeneration is the most common type, accounting for 85% of all cases. Photoreceptors in the macula (light-sensitive cells) and retinal pigment epithelium deteriorate gradually, and deposits or extracellular waste called druses form.

      The presence of druses in the retina is relatively normal from the age of 45, and very common in people over 65; however, an increase in the amount and size of it is usually the first sign of possible macular degeneration. The result is blurry or blurry vision and loss of central vision.

      Dry macular degeneration progresses slowly over time and develops in three stages:

      early stage

      Presence of small and medium-sized drus, without loss of vision or symptoms.

      intermediate stage

      The person has medium to large druses and can have vision with spots in the center of the visual field. Sometimes the subject may need more light for tasks that require attention to detail.

      advanced stage

      Presence of multiple deposits of druse, destruction of the retinal pigment epithelium and photoreceptor cells of the macula. At this point, blurred vision occurs and, over time, vision loss.

      Wet or exuding macular degeneration

      Wet or exuding macular degeneration is the least common form (about 15% of cases) but the most severe. This happens when the blood vessels (which make up the neovascular membrane) start to grow abnormally behind the macula, causing a drop of fluid and blood. These exudations end up causing scarring and, therefore, macular damage.

      In this form of macular degeneration, loss of central vision occurs rapidly. It does not develop in stages, as with the dry form, and the damage is more severe. The most common initial symptom is seeing distorted straight liness, as if they had a wavy figure. Vision can become blurry or completely lost in a very short period of time (days or weeks).

      There are two subtypes of wet macular degeneration: Occultism, which occurs due to fluid spills and the growth of new blood vessels under the retina, and causes milder vision loss; and the classic, the severity is greater in terms of vision loss and occurs because the growth of blood vessels and scarring generate large remnants, responsible for the lesion of the macula.

      Risk factors

      The main risk factor for macular degeneration is age, because for people over 50, the likelihood of suffering from this disease increases significantly. Other relevant factors that may increase the risk of developing this disorder are:

      1. Family and genetic background

      Macular degeneration is inherited and several genes have been identified that may be involved in the development of the disease, therefore your risk increases if you have a direct relative who suffers from the disease.

      2. Obesity

      According to research, people who are obese have a higher risk of moving from the early and middle stage to the advanced stage of disease.

      3. Smoke

      Regular exposure to cigarette smoke increases the risk of contracting the disease, and patients who smoke respond less well to treatment.

      4. Race

      Caucasian people are at greater risk for muscle degeneration, compared to other races, such as African Americans.

      5. Cardiovascular disease and hypertension

      There is a relationship between diseases that affect the heart or hypertension and macular degeneration.

      6. Gender

      Women are more likely to suffer from macular degeneration only men.

      treatment

      Currently, there is no treatment to prevent the loss of vision that causes dry macular degeneration when it reaches the most advanced stage. However, yes it is possible to slow down or prevent the disease from moving from an early stage to a more advanced stage using high doses of antioxidants and minerals such as zinc, according to the National Institute of Ophthalmology.

      To treat wet macular degeneration, there are several treatment alternatives: laser surgery, used to destroy blood vessels that cause macular damage; photodynamic therapy, which involves injecting a substance into the body and then activating it with a light that illuminates the blood vessels in the eye; and injections into the eye of anti-VEGF drugs, which eliminate growth factors that promote the development of abnormal blood vessels.

      However, the macular degeneration and vision loss associated with this disease can continue to progress, even if treatment is ongoing. At present, no fully effective cure or treatment is knownBut research continues in this regard.

      References bibliographic:

      • Chávez Pardo, I., González Varona, D., and de Miranda Remeis, DI (2008). Macular degeneration. Revista Arxiu Metge of Camagüey, 12 (2), 0-0.
      • Curcio, CA, Medeiros, NE and Millican, CL (1996). Loss of photoreceptors in age-related macular degeneration. Research in Ophthalmology and Visual Sciences, 37 (7), 1236-1249.
      • Flors-Bru, S., and Bautista-Paloma, J. (2008). Treatment of age-related macular degeneration: a pending topic. Archives of the Spanish Society of Ophthalmology, 83 (7), 405-406.

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