Macular Degeneration

How to detect Macula Degeneration and what we at EuroEyes can do about it.

Take care of your mum and dad! Early diagnosis of AMD can save their eyes to become blind.

Age-related macular degeneration (AMD) is the leading cause of blindness in persons older than 50 years in the United States and worldwide, accounting for 8.7 % of all legal blindness worldwide. A main cause of severe vision loss in Macular Degeneration is the development of new blood weasels (choroidal neovascularization = CNV), leading to the exudative or “wet” form of AMD. In patients presenting with Wet Macula Degeneration - treatment with intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents may improve visual acuity (VA) by three lines or more in 30–40 % of patients and may prevent blindness.

Early diagnosis and treatment of Macula Degeneration - is crucial in order to preserve vision and the quality of life of patients. Studies revealed that the more early or immature wet Macula Degeneration is detected, the better final Visual outcome is expected following (antiangiogenic) treatment.

You can help to detect early retinal changes or early macula degenerations by you mum and your dad ( or grandparents) at home in front of you computer or smartphone.

The Amsler grid is one easy way to be used for detection of macular disease (AMD) at an early stage. It is a macular degeneration test that checks for any distortion or wavy lines, which are symptoms of AMD. A person with normal vision will see all straight lines. A person with wet macular degeneration sees something like this illustration - the lines are wavy and distorted.

They may also see a "hole" in the middle of the macular degeneration grid.

If any changes are noticed, take contact with your doctor right away.

Nowadays patients can make use of webpage test or smartphone applications which show Amsler grids, making them even more accessible.
A patient diagnosed with dry or wet macular degeneration should have an Amsler grid at home to monitor their vision.

OCT Spectral or optical coherence tomography is the gold standard in the management, diagnosis and follow up of patients with AMD. It provides detailed cross-sectional images of the retina and an ideal follow up and treatment of macula degenerations is possible. The development of OCT has changed the management of AMD patients.

I recommend you to make use of our euroeyes link to the The Amsler grid - an easy methods for the detection of early AMD. You should also test it on you parents or grandparents. If ant distortion or the straits lines takes please - you are welcome to contact us on euroeyes.cn

What Is Macular Degeneration?

Macular degeneration is a deterioration or breakdown of the macula. The macula is a small area in the retina at the back of the eye that allows you to see fine details clearly and perform activities such as reading and driving. When the macula does not function correctly, your central vision can be affected by blurriness, dark areas or distortion. Macular degeneration affects your ability to see near and far, and can make some activities—like threading a needle or reading—difficult or impossible. Although macular degeneration reduces vision in the central part of the retina, it usually does not affect the eye’s side, or peripheral, vision. For example, you could see the outline of a clock but not be able to tell what time it is. Macular degeneration alone does not result in total blindness.  Even in more advanced cases, people continue to have some useful vision and are often able to take care of themselves.  In many cases, macular degeneration’s impact on your vision can be minimal.

What Causes Macular Degeneration?

Many older people develop macular degeneration as part of the body’s natural aging process. There are different kinds of macular problems, but the most common is age-related macular degeneration (AMD).  Exactly why it develops is not known, and no treatment has been uniformly effective.  Macular degeneration is a leading cause of severe vision loss in patients over 65. 

The two most common types of AMD are “dry” atrophic and “wet” (exudative):

 

"Dry" Macular Degeneration (Atrophic): Most people have the “dry” form of AMD.  It is caused by aging and thinning of the tissues of the macula.  Vision loss is usually gradual.

 

"Wet" Macular Degeneration (Exudative): The “wet” form of macular degeneration accounts for about 10 percent of all AMD cases, but a high percentage of those cases develop significant vision loss.  Wet AMD results when abnormal blood vessels form underneath the retina at the back of the eye.  These new blood vessels leak fluid or blood and blur central vision. Vision loss may be rapid and severe.

Deposits under the retina called drusen are a common feature of macular degeneration.  Drusen alone usually do not cause vision loss, but when they increase in size or number, this generally indicates an increased risk of developing advanced “wet” AMD.  People at risk for developing advanced AMD have significant drusen, prominent dry AMD, or abnormal blood vessels under the macula in the fellow eye (“wet” form). 

What Are the Symptoms of Macular Degeneration?

Macular degeneration can cause different symptoms in different people. This condition may be hardly noticeable in its early stages. Sometimes only one eye loses vision while the other eye continues to see well for many years. But when both eyes are affected, the loss of central vision may be noticed more quickly.

 

See a EuroEyes doctor if you notice these symptoms:

  • Words on a page look blurred.
  • A dark or empty area appears in the center of vision.

Detecting Macular Degeneration

One warning sign of macular degeneration is when words on a page look blurred or straight lines look distorted.  You can check your vision daily by using an Amsler Grid.

To Use this grid:

  1. Wear your reading glasses and hold this grid 12 to 15 inches away from your face in good light.
  2. Cover one eye.
  3. Look directly at the center dot with the uncovered eye.
  4. While looking at the dot, see if any of the lines appear wavy, blurred or dark.
  5. Repeat with the other eye.

 

If these lines appear wavy, you should make an appointment with one of our doctors.  A medical eye examination will be performed that includes specialized photography that finds abnormal blood vessels, fluid or blood under the retina.

How Is Macular Degeneration Diagnosed?

Many people do not realize that they have a macular problem until blurred vision becomes obvious.  Our eye doctors can detect early stages of AMD during a medical eye examination that includes the following:

  • Amsler Grid
  • Viewing the macula with special lenses;
  • Taking special photographs of the eye, called fluorescein angiography and optical coherence tomography (OCT), to find abnormal blood vessels, fluids, or blood under the retina.

How Is Macular Degeneration Treated?

Laser Surgery, PDT and Anti-VEGF Treatments

Certain types of “wet” macular degeneration can be treated with laser surgery, a brief outpatient procedure that uses a focused beam of light to slow or stop leaking blood vessels that damage the macula.  A treatment called photodynamic therapy (PDT) uses a combination of a special drug and laser treatment to slow or stop leaking blood vessels.

Another form of treatment targets a specific chemical in your body that is critical in causing abnormal blood vessels to grow under the retina.  That chemical is called vascular endothelial growth factor (VEGF).  Anti-VEGF drugs block the trouble-causing VEGF, reducing the growth of abnormal blood vessels and slowing their leakage.

These procedures may preserve more sight overall, though they are not cures that restore vision to normal.  Despite advanced medical treatment, many people with macular degeneration still experience some vision loss.

 

Adapting to Low Vision

To help you adapt to lower vision levels, your EuroEyes ophthalmologist can prescribe optical devices or refer you to a low-vision specialist or center.  A wide range of support services and rehabilitation programs are also available to help people with macular degeneration maintain a satisfying lifestyle.  Because side vision is usually not affected, a person’s remaining sight is very useful.  Often, people can continue with many of their favorite activities by using low-vision optical devices such as magnifying devices, closed circuit television, large-print reading materials and talking or computerized devices.

If you or someone you know is experiencing symptoms of macular degeneration contact Euroeyes at Jin Mao

 

 

 
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