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What is Macular Degeneration?


MACULAR DEGENERATION DEFINED

Macular degeneration or age-related macular degeneration is a medical condition where blurred vision or loss of vision occurs within the center of the visual field. In the early stages, no symptoms are found. However, with time, most individuals experience worsening of symptoms affecting one or both eyes. The loss of vision is limited to the central vision and does not result in total blindness but affects your everyday activities like reading, writing, driving, recognizing faces and others.

Macular degeneration is one of the leading sources of irreversible vision loss especially in the elderly. The condition occurs when the central portion of the retina known as the macula gets damaged. As this condition occurs in older individuals it is called age-related macular degeneration.



TYPES OF MACULAR DEGENERATION:

The two most common forms of macular degeneration include:

Dry form and wet form

In its dry or atrophic form, yellow deposits known as drusen accumulate within the central retina or macula. The increase in number and/or size of those drusens lead to the severity of the condition. Eventually, left untreated, it results in loss of vision. In its wet form, there is an abnormal proliferation of blood vessels in the macula known as neovascularization.


RISK FACTORS FOR MACULAR DEGENERATION:

The risk factors which increase your chance of suffering from macular degeneration include:

Age: It is more common in people over the age of 50.

Family history: this condition also has a genetic component so family history matters.

Race: macular degeneration is more commonly found in white people.

Lifestyle: smoking cigarettes increases the risk of developing macular degeneration. Systemic health: obesity is a risk factor for progression of macular degeneration. High cholesterol levels can also increase the risk of developing AMD. Increased consumption of fatty foods can also increase the risk of AMD. Excessive exposure to UV light can also increase your chance of developing macular degeneration. Cardiovascular diseases increase your chance of suffering from macular degeneration. Lastly, we now know that there is an inflammation component in this pathology.




NATURAL HISTORY OF MACULAR DEGENERATION:

In the early stage of AMD, small drusen (deposits) which are rich in lipids are found underneath the retina. Thickening of Bruch’s membrane starts along with abnormalities of the retinal pigmented epithelium. As the disease progresses, more and larger drusens are noted on examination. Mediation of inflammation by macrophages, RPE destruction, and complement activation result in the advancement of macular degeneration leading eventually to geographic atrophy and choroidal neovascularization.


HOW TO PREVENT MACULAR DEGENERATION?

Take the following measures to reduce the risk of suffering from macular degeneration:

Manage your general health i.e. medical conditions like high blood pressure or cardiovascular disorders. Control such medical conditions under the supervision of your doctor and take medicines as recommended to avoid damage . Avoid smoking as this is one of the strongest risk factors to develop macular degeneration. Regular exercise and a healthy, balanced diet will not only help you stay healthy but also prevent macular degeneration from progressing fast. Include green leafy vegetables, fruits, food rich in omega-3 fatty acids such as salmon and nuts.



TREATMENT OPTIONS FOR MACULAR DEGENERATION:

Treatment options for macular degeneration include the following:


NUTRITION & VITAMIN SUPPLEMENTS:

People suffering from age-related macular degeneration might benefit from the consumption of nutritional supplements for AMD. The specific mix of minerals and vitamins can help in slowing down the progression of macular degeneration. Most individuals suffer from the dry form of age-related macular degeneration. People with dry AMD have yellow, tiny deposits underneath the retina known as drusen. In certain situations, the macula becomes severely thin leading to serious visual consequences.

Most individuals with AMD have drusen but it does not result in loss of vision. The increase in number or size of the drusens is an early sign of progression to moderate stage age-related macular degeneration. People with early AMD usually do not show symptoms and do not observe a blurred spot within the central vision. In the more advanced stage of AMD, more drastic changes in normal macula anatomy lead to the loss of normal central vision function.

The age-related eye disease study (AREDS) which was conducted by the National Eye Institute (NEI) of the National Institute of Health (NIH) in order to evaluate the benefits of minerals and vitamins on daily basis for AMD, concluded that nutritional supplements help people who have increased drusen size or people who already suffered from eyesight loss in one eye from AMD. Supplement did not show any benefit in the early stages of the disease. However, using the AREDS supplement formula, patients with moderate stage AMD saw the progression of the disease slow down. Consumption of the following vitamin supplements can slow down the progression of macular degeneration and avoid late-stage AMD or the wet form of age-related macular degeneration:

Vitamin E (400 IU)Vitamin C (500 mg)Zinc (80 mg)Zeaxanthin (2 mg)Lutein (10 mg)Copper (2 mg)

With time, other additions were also made in the study formulation which improved the course of AMD. The use of omega-3 fatty acids i.e. fish oil also helped in slowing down the progression.

Bear in mind that nutritional supplements do not cure age-related macular degeneration. However, they help in slowing down the progression of the disease in the moderate stage of macular degeneration. Consult your optometrist or ophthalmologist and ask whether nutritional supplements can be beneficial for you. Studies also show that consumption of healthy foods is essential to slow down the progression of AMD and delay its advanced stage. Consume dark leafy vegetables with healthy fruits to slow down the disease. Nutritional supplements, in certain situations, can be highly beneficial but they also pose some health risks. It is therefore essential to consult your eye doctor before taking nutritional supplements.


ANTI-ANGIOGENESIS DRUGS:

These drugs block the leakage or formation of blood vessels resulting in wet macular degeneration. (Anti-VEGF)


LOW VISION AIDS:

These devices help people suffering from macular degeneration by producing enlarged pictures of close objects. They allow patients to perform better their daily activities.


Other treatments being looked at focus on the inflammatory aspect of the disease, targeting the complement activation in macular degeneration.


BOTTOM LINE:

Macular degeneration is a very serious condition . There is no cure for treating macular degeneration but there are preventive measures which you should consider. It is essential for people suffering from macular degeneration to get examined regularly by their eye doctor.


Sources:

https://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-overview

https://en.wikipedia.org/wiki/Macular_degeneration

https://www.allaboutvision.com/conditions/amd.htm

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