Macular Degeneration: Types, Symptoms and Treatment

A relatively common disorder affecting vision.

Central vision, which depends on an eye structure called the macula, is what allows us to focus on details and perform daily activities such as reading a book, driving or even recognizing a person's face. It is this type of vision that is affected when a disorder known as macular degeneration occurs, a disease that affects older people more and ends up causing a loss of vision.

In this article we explain what macular degeneration is, what are the two most common forms of macular degeneration and what are the most common forms.What are the two most common forms of macular degeneration and the symptoms associated with each of them. In addition, we tell you about the main risk factors that lead to the appearance and development of this eye disease, as well as the treatments currently available.

What is macular degeneration?

Macular degeneration, also called age-related macular degeneration, is a hereditary, neurodegenerative eye disorder that gradually affects the central vision, which depends on the macula. gradually affects central vision, which is the vision that depends on the macula and provides sharpness of vision. and which provides us with the visual acuity necessary to perform tasks such as driving, reading or recognizing a person's face.

The macula is a tiny part of the eye, in the form of a yellowish spot (due to the high concentration of two pigments that give it that color), which is located in the central area of the retina. It is composed of the fovea, located inside the macula and responsible for color perception; and the foveola, located inside the fovea, which allows us to have maximum visual acuity.

In macular degeneration, as its name suggests, the foveola, located inside the fovea, is the one that allows us to have maximum visual acuity, progressive deterioration of the macula, which is the one that allows us to perceive details and movement, is produced, so that people suffering from this condition end up suffering a significant loss of vision, especially related to fine details, either near or far.As a result, people suffering from this condition end up suffering a significant loss of vision, especially in fine details, both near and far.

This loss of central vision leads to a series of negative consequences in the daily life of people suffering from this condition, whose age is usually advanced, in general. Macular degeneration is considered to be one of the main causes of blindness and low vision, and there is currently no known cure.

At present, the disease affects 1.5% of the population, and if only the elderly are considered, macular degeneration is a major cause of blindness and low vision.If only people over 50 years of age are considered, the prevalence rises to 5.3%. We will now take a look at the two main forms of macular degeneration.

Types and their symptoms

There are two types of macular degeneration: dry macular degeneration, which is the more common of the two; and wet macular degeneration, which is less frequent but more serious. Let's take a closer look at what each one consists of.

Dry or atrophic macular degeneration

Dry macular degeneration is the most common type, accounting for 85% of all cases. The photoreceptors of the macula (the light-sensitive cells) and the pigment epithelium of the retina progressively deteriorate, and deposits form on the retina. progressively deteriorate, and deposits or extracellular waste products called drusen are formed.

The presence of drusen in the retina is relatively normal after the age of 45, and very common in people over 65; however, an increase in the number and size of drusen is usually the first sign of possible macular degeneration. The result is blurred or mottled vision and loss of central vision.

Dry macular degeneration evolves slowly over time and develops in three stages. and develops in three stages:

Early stage

Presence of small to medium-sized drusen, without loss of vision or symptoms..

Middle stage

The person presents medium and large drusen, and vision with spots in the center of the visual field may appear. in the center of the visual field. Occasionally, the subject may need more light for tasks that require focusing on details.

Advanced stage

Presence of multiple drusen deposits, destruction of the retinal pigment epithelium and photoreceptor cells of the macula. At this stage, blurred vision and, eventually, loss of vision occurs.

Wet or exudative macular degeneration

Wet or exudative macular degeneration is the less frequent (about 15% of cases) but more severe form. It occurs when Blood vessels (which form the neovascular membrane) begin to grow abnormally behind the macula, causing them to leak fluid and blood. These exudations eventually lead to scarring and, consequently, macular damage. and, consequently, macular damage.

In this form of macular degeneration, loss of central vision occurs rapidly. It does not develop in stages, as in the dry form, and the damage is more severe. The most common initial symptom is to see straight lines deformed, as if they had a silhouette.as if they had a wavy silhouette. Vision may become blurred or completely lost in a very short period of time (days or weeks).

There are two subtypes of wet macular degenerationThe two main risk factors are: occult, which occurs due to fluid leakage and the growth of new blood vessels under the retina, and causes a milder loss of vision; and classic, which is more severe in terms of vision loss and occurs because the growth of blood vessels and scarring generates large debris, responsible for the macular lesion.

Risk factors

The main risk factor for macular degeneration is age, since for people over 50 years of age the probability of suffering from this disease increases considerably. Other relevant factors that may increase the risk of developing this disorder are the following:

Family and genetic history 2.

Macular degeneration is hereditary and several genes have been identified that could be involved in the development of the disorder. the risk increases if you have a family member with a direct relative suffering from the disease..

2. Obesity

According to research, people who suffer from obesity have a higher risk of moving from the early and middle stage to the advanced stage of the disease. of the disease. disease.

3. Smoking

Exposure to cigarette smoke on a regular basis increases the risk of developing the disease, and patients who smoke respond less well to treatment..

4. Race

Caucasians are at higher risk of muscle degeneration compared to other races, such as African-Americans.

5. Cardiovascular disease and hypertension

There is a relationship between diseases affecting the heart or hypertension and macular degeneration.

6. Sex

Women are more prone to macular degeneration than men. than men.

Treatment

Currently, there is no treatment that can prevent the vision loss caused by dry macular degeneration when it reaches the most advanced stage. However, it is possible to However, it is possible to slow down or prevent the disease from progressing from the early to more advanced stages through the use of high doses of antioxidants and minerals such as zinc, as indicated by the National Institute of Ophthalmology.

To treat wet macular degeneration there are several therapeutic alternatives: laser surgery, used to destroy the blood vessels that cause macular damage; photodynamic therapy, which consists of injecting a substance into the body and then activating it by means of a light that illuminates the eye's blood vessels; and injections into the eye with anti-VEGF drugs, which eliminate the growth factors that promote the development of abnormal blood vessels.

However, the macular degeneration and vision loss associated with this disease can continue to progress, even when receiving treatment. At present, there is no known cure or fully effective treatment for macular degeneration, no cure or fully effective treatment is known, but research is ongoing.However, research in this direction is ongoing.

Bibliographic references:

• Chávez Pardo, I., González Varona, D., & de Miranda Remedios, D. I. (2008). Age-related macular degeneration. Revista Archivo Médico de Camagüey, 12(2), 0-0.
• Curcio, C. A., Medeiros, N. E., & Millican, C. L. (1996). Photoreceptor loss in age-related macular degeneration. Investigative ophthalmology & visual science, 37(7), 1236-1249.
• Flores-Moreno, S., & Bautista-Paloma, J. (2008). Treatment of age-related macular degeneration: a pending subject. Archivos de la Sociedad Española de Oftalmología, 83(7), 405-406.