What is Macular Degeneration?

Commonly known as "macular degeneration," age-related macular degeneration (AMD) is a problem related to the retina of the eye. Anadolu Health Center Ophthalmology Specialist Op. Dr. Yusuf Avni Yılmaz points out that macular degeneration can lead to blindness in advanced age, stating, “The risk factors for macular degeneration include old age, smoking, a family history of macular degeneration, high blood pressure, obesity, lack of physical activity, having light-colored eyes, excessive exposure to sunlight, high-fat consumption, and the side effects of certain medications.” Op. Dr. Yusuf Avni Yılmaz answered questions regarding macular degeneration...

The health of the macula area of the retina determines the ability to perform visual functions such as reading, recognizing, driving, watching television, using a computer, and seeing fine details. When the macula, a part of the retina, becomes damaged for various reasons, macular degeneration, or age-related macular degeneration, occurs. With macular degeneration, central vision is lost depending on the severity of the disease. Details cannot be seen when looking at a near or distant object. However, peripheral (side) vision may still be normal. For example, while the numbers on a watch can be seen on the wrist, the hour and minute hands may not be visible. In very early stages, straight lines or squares may appear slanted or distorted when viewed.

The Only Way to Prevent Macular Degeneration is Good Nutrition and Wearing Sunglasses

According to a study conducted in the U.S. in 2010, there are 9.1 million cases of early macular degeneration worldwide. This number is expected to rise to 17.8 million by 2050. Macular degeneration has two types: “dry” and “wet.” Dry macular degeneration accounts for about 90% of cases. It progresses slowly, and there is no specific medication for its treatment. The dry type is an early stage of the disease and may result from the aging and thinning of macular tissues or from a combination of both processes. Dry macular degeneration can be diagnosed when yellowish spots known as drusen start to accumulate in and around the macula. These spots are believed to be deposits or residues resulting from tissue degradation. The only way to prevent dry macular degeneration or slow its progression is through good nutrition and wearing sunglasses that protect against harmful sun rays.

What Causes Macular Degeneration?

In approximately 10% of cases of dry macular degeneration, the eye disease can progress to a more advanced and harmful form. In wet (neovascular) macular degeneration, new blood vessels grow beneath the retina, leading to leakage of blood and fluid. This leakage causes permanent damage to the light-sensitive retinal cells, creating blind spots in central vision. Fluid leakage from the newly formed vessels causes edema in the retina, resulting in significant vision loss.

Symptoms of Macular Degeneration: Blurry and Distorted Vision

Age-related macular degeneration typically causes slow and painless vision loss. However, in rare cases, vision loss can be sudden. Early signs of age-related macular degeneration include shadowy areas in central vision and unusually blurry or distorted vision. The diagnosis of the disease is made during a detailed eye examination using a grid test known as the "Amsler grid," which consists of numerous squares. If the lines on this card appear distorted, it should raise suspicion of macular degeneration. Additionally, during the examination, the pupil must be dilated with drops to allow for a detailed examination of the retina. If necessary, optical coherence tomography (OCT) and ocular angiography are important for confirming the diagnosis and determining the type of possible macular degeneration.

Genetic Predisposition Can Cause Macular Degeneration

While age-related, studies also indicate that macular degeneration has a genetic component. Researchers have noted a strong correlation between the development of age-related macular degeneration and gene variants. This genetic deficiency is associated with nearly half of potentially blinding cases of macular degeneration. Specific variants of one or more of these genes, which play a role in the body’s immune responses, have been found in 74% of the studied patients with macular degeneration. Other studies have shown that hypoxic cells in the retina produce a protein called vascular endothelial growth factor, which triggers the growth of new blood vessels in the retina.

Treatment of Macular Degeneration: More Common in Women

In addition to affecting older populations, macular degeneration is particularly more prevalent among whites compared to blacks and in women compared to men. There is currently no definitive treatment for age-related macular degeneration, but some treatments can delay its progression or even improve vision. The treatment for macular degeneration depends on whether the disease is in the early stage of the dry form or the more severe wet form, which can lead to significant vision loss. There is currently no treatment for dry macular degeneration, but dietary adjustments and various vitamins are believed to help prevent progression to the wet form. For the wet type, treatments aimed at stopping the abnormal growth of blood vessels have shown improvement in vision, including photodynamic therapy (a light treatment administered through the bloodstream) and injections administered into the eye.