Macular Degeneration – Symptoms, Causes, And Treatments

Macular degeneration is a medical condition that affects about 8.7% of the world’s population (1). It is the leading cause of blindness among older adults in industrialized countries. The number of people with age-related macular degeneration is projected to be around 196 million in 2020! Alarming, isn’t it?

Macular degeneration is associated with progressive vision loss that advances with age. Wondering what treatment options are available for this condition? We have it all covered in this post. Keep reading.

What Is Macular Degeneration?

Macular degeneration is a medical condition that affects the retina – a layer at the back of your eyeball that is made up of cells sensitive to light. This condition is also referred to as age-related macular degeneration (AMD) and is known to affect a person’s central vision.

Images or visions that were previously clear may appear blurred as a result of this condition. Some individuals may also see dark spots that tend to get bigger progressively. Although macular degeneration can make it harder to perform certain activities, total vision loss is quite unlikely.

This visual condition usually affects older adults and is one of the most common causes of partial blindness in those who are 60 years or older (1).

There are mainly two types of macular degeneration.

Types Of Macular Degeneration

Macular degeneration is classified into two types – dry macular degeneration and wet macular degeneration (2).

• Dry Macular Degeneration

This type often develops gradually, and there is no cure for it. However, an individual can try to cope with it. Dry macular degeneration accounts for 85-90% of the cases.

• Wet Macular Degeneration

It is also known as neovascular AMD and usually occurs when new blood cells develop under the macula. This development can cause blood and fluid to leak under the macula. Wet AMD has more severe consequences than dry AMD as it can also result in severe vision loss. Once the symptoms begin surfacing, immediate treatment is required to prevent complications.

Macular degeneration can also be classified into different stages.

Stages Of Macular Degeneration

There are mainly three stages of age-related macular degeneration (AMD) (2). They include:

• Early AMD – Most individuals do not exhibit any symptoms in the early stages of AMD. This is why regular eye exams are important, especially if you are at risk of developing the condition. The presence of medium-sized drusen, which are yellow deposits beneath the retina, confirms early AMD.
• Intermediate AMD – In this stage, there could be some vision loss, but there may still not be any noticeable symptoms. Some individuals may see a blurred spot in the center of their vision. It is diagnosed by the presence of many medium-sized or one or more large drusen.
• Late AMD – Vision loss becomes evident once your condition enters this stage. This stage is also referred to as geographic atrophy, and it most often affects the center of one’s vision. Large areas of damaged tissues resulting in central blind spots characterize this stage.

The symptoms of macular degeneration may vary depending on the type of the condition.

Signs And Symptoms

Dry AMD

The common symptoms of dry AMD are:

• Requirement for brighter light while reading
• Blurry vision
• Slow visual recovery post-exposure to bright light
• Colors seemingly look less vibrant
• Increased difficulty in recognizing different faces
• Hazy or less defined vision

Wet AMD

Those with wet macular degeneration may exhibit all the above symptoms including:

• Metamorphopsia – A condition that causes straight lines to appear wavy or crooked.
• Central scotoma or a blind spot in the center of one’s vision. This spot may get bigger if not treated.

The symptoms of wet AMD often progress much faster than those of dry AMD and are more severe.

The exact cause of this condition has not yet been found. However, the following factors have been linked to increasing the risk of developing macular degeneration.

Causes And Risk Factors

Factors that can increase your risk of developing macular degeneration include (3):

• Advancing age – The risk of developing macular degeneration increases after 60 years of age.
• Ethnicity – Caucasians are at a higher risk of developing AMD than the others.
• Family history/Genetics – A family history of the condition puts you at a higher risk of developing it.
• Smoking tobacco
• Obesity
• Medical conditions like diabetes, high blood pressure, and high cholesterol levels
• Consuming too much of dietary fat
• Exposure to sunlight

Macular degeneration can be quite difficult to diagnose in its early stages. Hence, it is always better to get your eyes checked regularly, especially if you are at risk of developing AMD. The following are the common diagnostic tests used to confirm macular degeneration.

Diagnosis

Your doctor or eye specialist will begin by testing the back of your eyes, where your retina and macula are located. This will be followed by a series of tests like (2):

• Amsler Grid – You will be asked to look at a special grid that has vertical and horizontal lines. If the lines look distorted, broken, or faded to you, the diagnosis is positive.
• Fluorescein Angiography – The doctor injects fluorescein dye in a vein in your arm. They then inspect your eye with a magnifying glass and take pictures of the eye. These pictures will help them find out if the blood vessels behind the macula are leaking. Leakage confirms wet AMD.
• Optical Coherence Tomography – Special light rays are used to scan the retina and take an image of it. The image provides more details about the macula and helps to check for any alterations in it.

Once your condition is diagnosed, your doctor may prescribe treatment based on the type of AMD you are suffering from.

Treatment Methods

Treatment is usually aimed at slowing vision loss as the lost vision cannot be restored.

Treatment for dry AMD may include lifestyle modifications and support like:

• Using a magnifying glass to read
• Reading books with larger prints
• Using intensive lights for reading
• Clinical trials are also currently being conducted for treating dry AMD with the help of stem cell transplants.

Common treatment options for wet AMD are (4):

• Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Medications – The vascular endothelial growth factor is the chemical that contributes to the development of new blood vessels in the eyes of those suffering from wet AMD. Anti-VEGF medications like ranibizumab (Lucentis) and bevacizumab (Avastin) block this chemical.
• Photodynamic Therapy – This therapy involves injecting a light-sensitive medication called Verteporfin into the affected person’s arm to help detect abnormal blood vessels in the eyes. Then, a laser is shone through the eye for a minute, which activates Verteporfin and destroys the abnormal blood vessels in the macula.
• Laser Surgery – It uses laser rays to treat the abnormal blood vessels in the retina.

When it comes to managing macular degeneration or AMD, your diet plays quite a significant role. The following is a list of foods that you should include and/or avoid in your diet if you are suffering from macular degeneration.

Diet Tips For Macular Degeneration

What To Eat

• Antioxidant-rich foods like broccoli, squash, spinach, kale, and collard greens (5).
• Eggs, spinach, kale, parsley, Brussels sprouts, lettuce, squash, and other foods that are rich in lutein and zeaxanthin, which help improve macular health (6).
• Vitamin-C rich fruits like berries and citrus fruits (5).

What To Avoid

Foods that can have a negative impact on macular degeneration that you need to avoid are (7):

• Sugar
• High-fat meats
• Fried and junk foods
• Artificial sweeteners
• Refined foods like white rice, white pasta, and sugary cereals
• Saturated fats

Exercising and maintaining a healthy weight are also important to deal with macular degeneration.

Role Of Exercise

Obesity is one of the many factors that increase one’s risk of developing macular degeneration. Losing weight if you are obese and maintaining it is a great way to help with the condition. Exercising helps to lose weight and also improves the circulation of oxygen throughout your body. This can help slow down the progression of vision loss (7).

Here are a few tips to prevent your macula from degenerating further.

Prevention Tips

• Get your eyes checked regularly.
• Quit smoking.
• Avoid increased exposure to the sun.
• Avoid looking directly at bright lights.
• Wear sunglasses or hats when outdoors, especially during the day.
• Manage your weight.
• Keep a check on your blood pressure and cholesterol levels.
• Exercise regularly to improve oxygen circulation throughout your body.
• Follow a nutritious diet.

Macular degeneration can take quite a toll on the mental and physical well-being of individuals, especially in adverse cases where significant vision loss is recorded. Getting your eyes checked regularly and beginning treatment promptly (in the case of wet AMD) is indeed your best bet to deal with this condition.

For any further doubts or queries, feel free to get in touch with us via the comments section below.

Frequently Asked Questions

What foods should be avoided with macular degeneration?

Avoid sugar, high-fat meats, fried and junk food, saturated fats, and refined foods like white rice and pasta.

Do glasses help with macular degeneration?

Yes, glasses made of special lenses and/or magnifiers can help those suffering from blurred vision as a result of macular degeneration.

What vitamin helps with macular degeneration?

Antioxidant vitamins like C and E can help slow down the progression of macular degeneration.

Why do the blind wear dark glasses?

Most visually impacted individuals wear dark glasses to protect their eyes from sensitivity to light. Direct exposure to light can cause dizziness and discomfort in some blind individuals.

Which is worse – dry or wet macular degeneration?

Wet macular degeneration accounts for almost all cases of vision loss from macular degeneration and is, thus, much more severe than dry AMD.

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Author

Shaheen NaserHealth & Wellness Writer

 

Shaheen holds a postgraduate degree in Human Genetics and Molecular Biology from Bharathiar University. She is a Geneticist with proficiency in Biotechnology, Immunology, Medical Genetics, Biochemistry, Microbiology, and Genetic Counseling.

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