Age-related Macular Degeneration (Dry)
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Dry macular degeneration is one of the two common forms of age-related macular degeneration, a condition that affects individuals aged 50 and above. It results in a decline in central vision clarity due to the deterioration of the inner layers of the macula, a critical part of the retina. It’s important to note that having this condition does not necessarily lead to complete vision loss.
People with dry macular degeneration typically retain their peripheral vision while experiencing varying degrees of central vision loss, which can range from mild to severe. Over time, there is a possibility of worsening vision, impacting activities such as reading, driving, and recognizing faces.
Dry macular degeneration can initially affect one eye before progressing to the other, or it may develop simultaneously in both eyes. Early detection and the adoption of self-care measures can potentially slow down the progression of vision loss associated with this condition.
Symptoms
Dry macular degeneration has the potential to advance into wet macular degeneration, characterized by the growth and leakage of blood vessels beneath the retina. While the dry variant is more prevalent, its progression typically occurs gradually over an extended period.
Since this condition does not impact peripheral vision, it does not result in complete blindness. When only one eye is affected, changes in vision might go unnoticed, as the unaffected eye can compensate for the impacted one. Symptoms may occur slowly. This include:
- Having more trouble adjusting to low light conditions, like in the case of entering a poorly lit room
- Needing to use more light when reading or conducting close-up work
- Visual distortions, like the appearance of bent straight lines
- Presence of a distinct blurry spot or blind spot within the field of vision
- Diminished clarity in the central vision of one eye or both eyes.
- Augmented blurriness when reading printed words.
- Challenges in recognizing faces
If alterations in the central vision, such as distortion or blind spots, or experience a decline in the ability to perceive fine details, it is advisable to consult with a healthcare provider for proper diagnosis or treatment. Regular eye checkups is also beneficial in early detection of any vision changes.
Causes
Dry macular degeneration specifically affects the macula, a critical area of the retina responsible for sharp central vision. Over time, the macular tissue tends to thin out, resulting in the loss of essential cells needed for maintaining clear and focused vision.
This condition is closely linked to the aging process of the eye. Ongoing research indicates that a combination of genetic factors within families and environmental factors like smoking, obesity, and dietary choices may play a role in its development. However, the exact cause of dry macular degeneration remains unidentified.
Risk factors
Individuals 60 years old and above, as well as those in the white population or racial groups has a higher prevalence of macular degeneration. Other risk factors include:
- Family history and genetics: Researchers have determined a number of specific genes that are associated with the occurrence of this condition. Individuals with a family history of macular degeneration are at a higher risk of having one.
- Smoking: The risk of macular degeneration is significantly increased when one consume cigarettes or are frequently around cigarette smoke.
- Being overweight: Being overweight or obese, according to studies, may elevate the risk of the more severe form of macular degeneration developing from the early or intermediate stages of the disease.
- Cardiovascular illness: One could be more susceptible to macular degeneration if they have blood vessel or cardiac conditions.
Diagnosis
The diagnosis of age-related macular degeneration usually involves assessment of one’s symptoms, evaluation of medical and family history, conduct of a comprehensive eye examination, and several tests.
Tests that may be required include:
- Examination of the back of the eye: In this test, the healthcare provider searches for drusen, or yellow deposits that grow behind the retina and give the impression of mottling. Macular degeneration patients frequently have a large number of drusen. A specialized instrument is used to inspect the rear part of the eye after putting drops in the eyes to dilate them.
- Amsler grid: This is a tool utilized during an eye examination to assess changes in the central vision. If an individual has macular degeneration, they may observe fading, breakage, or distortion in some of the straight lines within the grid.
- Fluorescein angiography: Wet macular degeneration is indicated by changes in blood vessels or the retina, which can be seen in the photographs produced in this test. In the procedure, a dye is injected into a vein in the arm. The eye’s blood vessels are highlighted by the dye as it gets inside. Multiple images are captured by a specialized camera while the dye passes through the blood vessels.
- Optical coherence tomography: This test shows potential areas of retinal thickness, thinning, or edema. Fluid accumulation from leaking blood vessels in and under the retina may be the source of these. The detailed cross-sectional images of the retina are displayed by this noninvasive imaging examination.
- Indocyanine green angiography: This test can be used to distinguish between different kinds of macular degeneration in conjunction with a fluorescein angiography.
Treatment
Numerous clinical trials are currently underway in the quest to discover treatments for dry macular degeneration. While it is important to note that the damage caused by this condition cannot be reversed, early detection and the adoption of certain strategies can potentially help mitigate its progression.
Strategic options for dry macular degeneration include:
- Vitamin supplements: The formulation, known to be potentially beneficial in reducing the risk of vision loss, based on research from the Age-Related Eye Disease Study 2 (AREDS2), includes specific amounts of vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper.
Although this supplementation has not demonstrated the same benefits for people in the early stages of dry macular degeneration, a high-dose combination of these antioxidant vitamins and minerals may be beneficial for individuals with intermediate or advanced macular degeneration. - Low vision rehabilitation: Receiving therapy from healthcare specialists and other low vision rehabilitation-trained professionals may be beneficial in figuring out how to adjust to the shifting vision.
Age-related macular degeneration typically does not result in total blindness and does not impair side vision. However, it may lessen or completely erase the central vision. Reading, driving, and recognizing faces all require central vision. - Telescopic lens implantation surgery: The telescopic lens has lenses that enlarge the field of vision. It resembles a small plastic tube. Although the telescopic lens implant has a relatively limited field of vision, it may help with both close-up and distance vision.
Implantation of a telescopic lens in one eye may be a viable alternative for improving vision for certain individuals with advanced dry macular degeneration in both eyes. It might be especially helpful in an urban setting to help recognize street signs.
