The macula is the central and most sensitive area of the retina. Retina is the inside (back-side) layer of the eye that records the images we see, and sends them to the brain. It controls our ability to read, drive a car, recognize faces or colours, and see objects in fine detail.
Macular Degeneration results in deterioration of the retina and directly affects vision.
When the macula is working properly, it collects highly detailed images at the centre of the field of vision and sends them up the optic nerve to the brain, which interprets them as sight. However, when the cells of the macula deteriorate, images are not received correctly.
Macular Degeneration can be diagnosed and treated to avoid further deterioration.
It is important to diagnose macular degeneration early as its effect cannot be reversed, but treatment may control further progression. At Poona Eye Care, we conduct regular checks to detect macular degeneration and ensure timely treatment.
Macular degeneration, if not treated in time, may result in further deterioration of the retina and gradually be responsible for vision loss.In primary stages, macular degeneration does not affect vision. As the condition aggravates, people experience wavy or blurred vision, and, if the condition continues to worsen, central vision may be completely lost, which can make it hard to recognize faces, drive, read, or perform other activities of daily life. Visual hallucinations may also occur.
There are two types of Macular Degeneration: Dry (atrophic) and Wet (neovascular or exudative).
Mostly, the degeneration starts as the dry type and in a few cases it progresses to the wet type. Macular degeneration is always bilateral (i.e., occurs in both eyes). However, it does not necessarily progress at the same pace for both eyes.
Nutritional therapy: Healthy diet high in antioxidants is the treatment for dry AMD. If dry AMD is further advanced , supplements to add higher quantities of specific vitamins and minerals are recommended to support the cell structure.
Treatments for Wet AMD
Laser treatment
Wet macular degeneration leads to leaking blood vessels. It has traditionally been treated with a laser photocoagulation. In recent times, a therapy called Photodynamic Therapy (PDT) is used. The therapy involves a drug which is photoactivated with laser to bring about selective destruction of the unwanted leaking vessels. Patients need careful monitoring for both these treatments. Laser treatments have limitations, but are an improvement over untreated macular degeneration.
Anti-VEGF Therapy
VEGF is an acronym for vascular endothelial growth factor. Currently, the most common and effective clinical treatment for wet age-related macular degeneration is anti-VEGF therapy – which is periodic intravitreal (into the eye) injection of a chemical called an “anti-VEGF.” In the normal life of the human body, VEGF is a healthy molecule which supports the growth of new blood vessels. However, in the case of macular health, VEGF promotes the growth of new, weak blood vessels in the choroid layer behind the retina, and those vessels leak blood, lipids, and serum into the retinal layers. The leakage (hemorrhaging) causes scarring in the retina and kills macular cells.
An intraocular shot of an anti-VEGF drug inhibits the formation of new blood vessels behind the retina and may keep the retina free of leakage. The injection shot is usually not painful as it is given after administering anaesthesia. The procedure takes about fifteen minutes. And the effect can last for a month or more. This treatment also results in slowing down the progression of the disease. In a few cases,the treatment may give rise to other health concerns such as strokes, hemorrhaging, increased eye-pressure, retinal detachment and vitreous floaters.
There are currently no known preventive methods for macular degeneration, but pursuing a healthy life-style and food rich in anti-oxidants can do to reduce the risk of macular degeneration and possibly slow the progression. Staying away from ultra-violet light can also help.