Macular Degeneration Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Macular degeneration, or in medical terms known as age-related macular degeneration, is a condition associated with decreased central vision. The macula itself is a part of the retina that functions as a receptor for light signals, which will then be delivered to the brain.
Age-related macular degeneration (ARMD) is macular degeneration that occurs at the age of more than 50 years. This disease is characterized by the presence of drusen, hyperpigmentation or hypopigmentation, neovascularization (the emergence of new blood vessels), and sub-retinal bleeding.
There are two types of macular degeneration, namely:
- Dry macular degeneration.
Usually begins with the appearance of a buildup of residual substances under the retina called drusen. More and more drusen buildup will affect vision. If left unchecked, it can cause degeneration and depletion of cells that are in the outer layer of the retina.
- Wet macular degeneration.
Generally related to lowering the condition of the outer layer of the retina. This is due to the growth of new, fragile blood vessels behind the macular lining. These fragile blood vessels tend to leak easily and leak blood or fluid which causes scarring of the macula. Wet macular degeneration can affect central vision more quickly than dry macular degeneration, ie within weeks to months.
Reason
The cause of macular degeneration is still not known with certainty. However, there are two hypotheses that try to explain the process of this disease, namely the theory of aging and the theory of oxidative damage.
Along with the aging process, there is an accumulation of lipofuscin in the pigment epithelium. This lipofuscin inhibits the degradation of macromolecules such as proteins and fats, and the end result is the death of retinal pigment epithelial cells.
In addition, the theory of oxidative damage also plays a role in this disease. Free radicals play a role in the occurrence of oxidative stress and cause cell damage.
Risk factors for macular degeneration are:
- Age
The older you get, the greater the risk of a person suffering from macular degeneration. The risk of this disease at the age of 75-85 years is 28%, while there are only 11% for those aged 64-74 years.
- Gender
Women are more at risk of developing macular degeneration than men.
- Hereditary factors
As many as 10–20% of people with macular degeneration have a family history of loss of central vision.
- Race
Macular degeneration is more common among whites than blacks.
- Smoking
Women who smoke 25 cigarettes per day have a greater risk of macular degeneration than women who stop smoking.
- Exposure to sunlight
Exposure to UVA and UVB rays increases the risk of macular degeneration.
- Nutrition
There are several nutritional risk factors associated with macular degeneration. Diets high in carotenoids can reduce the risk of neovascular macular degeneration by up to 43%.
Symptoms
Patients with macular degeneration will usually complain of mild symptoms. For example, there is a decrease in the central visual field and contrast visual disturbances. These complaints usually do not cause symptoms of pain. In addition, the sufferer may also complain of various visual disturbances which can be ascertained through funduscopic examination or eye binoculars.
Dry macular degeneration will show symptoms of less bright vision, difficulty adapting to dim light, and blurry or unclear vision. Whereas in wet macular degeneration, sufferers may complain of a number of additional symptoms such as an increasingly wider blind spot, and there are visual distortions of the lines.
Diagnosis
There are several ways to determine the diagnosis of macular degeneration –such as fundoscopy, Amsler card, fundus fluorescein angiography (FFA), Indocyanine green angiography (ICGA). The doctor will use a special tool to see the patient’s retina, blood vessels, and optic nerve.
Treatment
There are several treatment options for macular degeneration – such as laser surgery and photodynamic therapy. Both of these therapies cannot fully restore vision but can slow the rate of vision loss.
Dry macular degeneration cannot be cured, but can be slowed down with vitamin and antioxidant supplementation. A healthy diet and quitting smoking are also recommended. In addition, several other therapies are vision rehabilitation, where sufferers are taught to adapt to changes in their central vision, and the installation of telescopic lenses.
Wet macular degeneration can be treated with injections of anti-VEGF ( anti-vascular endothelial growth factor ) to stop or delay vision loss. Giving this drug aims to block the formation of new blood vessels in the macular area.
Prevention
There are several things that can be done to reduce the risk of macular degeneration, such as:
- Stop smoking.
- Avoid direct eye exposure to ultraviolet rays by using sunglasses.
- Routine eye tests can detect symptoms of eye disorders earlier.
- A healthy diet with high antioxidant content and rich in vitamins.