Macular degeneration (AMD)

Specialty of Optometry

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What is macular degeneration?

The macula is the part of the eye that provides us with clear vision. As we grow, its function loses its abilities, causing macular degeneration, also known as AMD.

It is a fairly common ailment from the age of 60 onwards and can occur at various levels, sometimes it is imperceptible. On the contrary, it can also be developed in a much more virulent way, causing a total and progressive loss of sight. There are two types of AMD; wet macular degeneration and dry macular degeneration.

Wet macular degeneration:

  • New blood vessels grow under the retina, causing bleeding and fluid leakage.
  • New vessels form neovascular membranes.
  • The evolution of this AMD is fast and can damage the central vision in a very important way.
  • Wet macular degeneration can be hidden or classic.

Dry macular degeneration:

  • This type of AMD evolves slowly over time (years).
  • It occurs when spots begin to accumulate in and around the macula.
  • It is a much more common type of AMD. More than 85 percent of all people with intermediate or advanced macular degeneration have the dry form.

Prognosis:

Early diagnosis is key to starting a treatment as soon as possible. If it is not treated quickly, the prognosis can be poor.

Symptoms of macular degeneration:

Macular degeneration does not cause pain, but may present a number of visual symptoms that the patient should recognise:

  • Straight lines that may appear wavy or broken
  • Distance and height estimation alteration
  • Increased sensitivity to light
  • Needing more light to read
  • Blurred vision

When the disease is in a more advanced stage, a black spot can be seen in the central area of vision, which gets darker as the condition progresses.

Medical tests for macular degeneration:

A complete diagnosis is usually made with:

  • Visual acuity test
  • Ophthalmologic examination , paying special attention to the condition of the macula
  • Optical coherence tomography : It is a scan of the macula, which aims to show the presence or absence of a neovascular membrane.

What causes macular degeneration?

Macular degeneration is related to ageing. Although age-related macular degeneration can occur in middle-aged people, studies indicate that people over the age of 60 are at a higher risk.

Other risk factors include:

  • Smoking
  • Obesity
  • Family history: People with directly related family members who have age-related macular degeneration are at increased risk of developing this disease.
  • Gender: More women develop AMD than men.

Can macular degeneration be prevented?

Whilst it cannot be prevented, once it is diagnosed, it is important to regularly and closely monitor these patients so that its progress can be observed and treatment applied.

Treatments for macular degeneration:

Although there is no definitive treatment to repair the effects of age-related macular degeneration, early diagnosis is important to slow its progression. It has also been shown that consumption of antioxidant vitamins and zinc may contribute to the reduction of advanced macular degeneration (dry macular degeneration) and associated vision loss.

The treatments available for wet macular degeneration are:

  • Laser surgery: Laser thermal photocoagulation surgery is the only proven surgical treatment option available for people with wet macular degeneration.
  • Injections into the eye with new medications, such as vascular endothelial growth factor antagonist therapy (VEGF) .

Which specialist treats macular degeneration?

Ophthalmologists are responsible for preventing, diagnosing and treating diseases that affect the patient's eyes and visual capacity, such as macular degeneration.

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