Macular Degeneration: Symptoms, Causes & Treatment

Macular degeneration is an eye disease that happens when the macula starts to lose function or degenerate. The macula is the central part of the retina and is responsible for sharp central vision.

Macular degeneration can cause symptoms such as gradual loss of central vision, reduced sharpness, and blurred or distorted central vision. It is more common in adults over 50 and is often related to age-related changes in the eye, which is why it is also called age-related macular degeneration (AMD).

However, macular degeneration can also occur in younger people due to factors such as genetics, smoking, vitamin deficiencies, or high blood pressure. Treatment for macular degeneration should be guided by an ophthalmologist and may involve eye injections or laser treatment.

Macular degeneration symptoms

The main symptoms of macular degeneration are:

• Gradual loss of central vision in one or both eyes

• Distorted vision, in which straight lines may appear bent

• Seeing a dark or blurry spot in the center of vision

• Difficulty seeing objects clearly

• Blurry vision, especially when seeing up close

• Seeing colors as less bright or less intense

• Difficulty seeing in dimly lit places

• Needing brighter, more intense light to read

Although it can severely affect vision, according to the National Eye Institute, age-related macular degeneration affects sharp central vision and does not cause complete blindness.

Confirming a diagnosis

Macular degeneration is diagnosed by an ophthalmologist (eye doctor) based on personal and family health history, age, lifestyle habits, a visual acuity test, and an eye exam, also called fundoscopy. These evaluations allow the doctor to examine the macula and identify the form and type of macular degeneration.

The doctor may also order other tests, such as fluorescein angiography, indocyanine green angiography, or optical coherence tomography. These tests help assess the blood vessels inside the eyes and provide detailed images of the retina.

Main types

Macular degeneration is classified according to the stage of the disease and the severity of symptoms. The main types are:

1. Age-related macular degeneration (AMD)

This is the early stage of the disease and may not cause symptoms. At this stage, the ophthalmologist may see drusen, which are waste deposits that build up under the retinal tissue.

Although drusen buildup does not always cause vision loss, it can affect the health of the macula and progress to a more advanced stage if it is not detected and treated early.

2. Dry macular degeneration

This is the most common form of the disease and happens when cells in the retina die, leading to gradual vision loss. If left untreated, this degeneration can worsen and develop into a more aggressive form in the future.

3. Wet macular degeneration

Wet macular degeneration, also called neovascular degeneration, is the most severe stage of the disease. In this stage, new blood vessels may form between the retina and the sclera, which is the white layer of the eye.

These new blood vessels can leak fluid and blood under the retina. This can lead to scarring and vision loss.

Possible causes

The exact cause of macular degeneration is not fully understood. However, it is known to result from a combination of genetic and environmental factors that affect the macula, leading to a gradual loss of vision.

Some factors that can increase the risk of developing macular degeneration are:

• Age greater than 50

• Family history of macular degeneration

• Smoking

• Overweight or obesity

• High blood pressure

• High cholesterol

In addition, cardiovascular diseases, which affect the heart and blood vessels, can increase the risk of macular degeneration.

Macular degeneration treatment

The main treatments that may be recommended by a doctor are:

• Dietary supplements containing vitamin C, vitamin E, zinc oxide, copper oxide, lutein, zeaxanthin, and omega-3

• Anti-angiogenic therapy, with medicines injected into the eye, such as ranibizumab or aflibercept, which help prevent the formation of new blood vessels

• Photodynamic therapy, with medicine injected directly into a vein, such as verteporfin, followed by laser treatment in the eye to close blood vessels and prevent fluid and blood from leaking inside the eye

• Photocoagulation, which uses a high-energy laser to destroy abnormal blood vessels in the eye, stop bleeding, and prevent damage to the macula

In some cases, the doctor may also perform surgery to remove the eye lens and replace it with a telescopic intraocular lens to help improve the field of vision.

Treatment for macular degeneration should be done under the guidance of an ophthalmologist, with regular follow-up and monitoring. According to the American Academy of Ophthalmology, early detection and prompt treatment of active neovascular AMD can help improve visual outcomes.

Natural treatments

Natural treatments should not replace the medicines recommended by an ophthalmologist. However, they may help prevent macular degeneration and slow its progression.

A diet rich in omega-3, found in fish and shellfish, as well as antioxidants, vitamin C, vitamin E, beta-carotene, zinc, and copper, found in fruits and vegetables, is recommended. These nutrients are important for retinal health.

If diet alone does not provide enough of these nutrients, supplements may be used, following the dosage recommended by the ophthalmologist.

To help prevent and manage the disease, it is also important to avoid smoking and alcohol, and to protect your eyes from strong sunlight and ultraviolet (UV) radiation by wearing appropriate sunglasses.