Dry macular degeneration
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Dry macular degeneration is one of the two forms of age-related macular degeneration, a condition that commonly affects individuals aged 50 and above. It results in a blurry vision or a decline in central vision due to the deterioration of the inner layers of the macula, a part of the retina. The macula plays a crucial role in providing clear vision in the direct line of sight.
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 total 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:
- Visual distortions, like the appearance of bent straight lines
- Decreasedcentral vision in one or both eyes
- 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
- Presence of a well-definedblurry spot or blind spot within the field of vision
- Increased 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
The macula is the region of the retina responsible for maintaining clear vision in the direct line of sight. Over time, the macular tissue may undergo thinning and the loss of cells essential for 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 likelihood of developing macular degeneration is higher among active smokers and those exposed to secondhand smoke.
- Being obese: Being 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.
- Underlying cardiovascular issues: An increased risk of developing macular degeneration is possible in individuals with conditions impacting their heart and blood vessels.
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 form under the retina and give the mottled appearance. 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.
- An examination to check for changes in the central vision: Using Amsler grid, alterations in the central vision is assessed. For individuals with macular degeneration, certain straight lines within the grid may appear faded, fragmented, or distorted.
- Fluorescein angiography: Dry 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 identify the certain kinds of macular degeneration in conjunction with a fluorescein angiography.
Treatment
Currently, there is no known method to reverse the damage caused by dry macular degeneration. But numerous clinical trials are underway to explore potential treatments and interventions. 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.
Treatment options for dry macular degeneration include:
- Vitamin supplements: The high-dose formulation of antioxidant vitamins and minerals, known to be potentially beneficial in reducing the risk of vision loss, based on research from the Age-Related Eye Disease Study 2 (AREDS2). The formulation 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: Age-related macular degeneration typically does not result in total blindness and does not impair side vision. However, it may lessen or eliminate the central vision. Reading, driving, and recognizing faces all depend on the essential function of central vision.
Receiving therapy from healthcare specialists and other low vision rehabilitation-trained professionals may be beneficial in figuring out how to adjust to the changing vision. - Telescopic lens implantation surgery: The telescopic lens, resembling a small plastic tube, is fitted with lenses that enhance and magnify the field of vision. Although the telescopic lens implant has a relatively narrow 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.
