What causes the disease?
The macula lutea, also known as the yellow spot, is a very important part of the eye’s nerve membrane, as it is the area of sharp vision. It helps us to see objects clearly and to read. If something is wrong with it, our central vision is damaged. In this disease, the cells of the nerve membrane in the area of sharp vision start to die. Unfortunately, the exact cause of this is not known, but there are a few observable risk groups in whom it is more common.
Genetics plays a very important role in eye disease. Therefore, we should pay more attention if there is a family history of macular degeneration. As mentioned above, the chances of developing the problem increase with age. In addition, lifestyle factors such as smoking and stress are risk factors, but frequent exposure to increased exposure to light and UV light can also contribute to the disease. In addition, people with diabetes, high blood pressure and vitamin deficiencies are at higher risk.
Two types of macular degeneration
n 80-90% of cases, this is known as dry macular degeneration. In this type of macular degeneration, abnormal metabolites accumulate in the layers of the retina, resulting in yellowish deposits and pigments. Later, this leads to functional disturbances that result in thinning of the macular tissue and partial, patchy neuronal cell death. In this type, slow deterioration is seen and usable vision is preserved for longer. Rarely, however, the dry type may become wet type and sudden deterioration may be seen.
The wet type is a very rapidly worsening form of macular degeneration, which causes severe visual impairment. In this case, the disease affects the layers of the retina beneath the retina, from where abnormal blood vessel formation starts, causing oedema and haemorrhage in the area of the macula. This process leads to serious problems with central vision.
Symptoms of macular degeneration
One of the most striking changes is the appearance of a small or large grey or black blur in the centre of the visual field. Facial recognition is also impaired, but other symptoms may also indicate macular degeneration. For example, ‘curvature’ or distortion of straight lines, or when objects are seen with less contrast. We may find that there are simply no glasses that are right for us. Whichever of these we notice, we should go for a complex eye examination immediately. It is also worth checking at home every month, for example with a square grid, that the lines are straight.
In many cases, macular degeneration does not initially present any obvious symptoms that can be noticed, but can be detected by the eye doctor, for example, during a simple spectacle fitting. This is why it is worth having regular eye check-ups after the age of 60, but preferably after the age of 50, to avoid more unpleasant symptoms.
What help can we get?
Macular degeneration can usually be detected by a dilated fundus examination, and of course the symptoms that the patient presents with are a good indication. Further tests may then be needed to give a more accurate picture of the extent and type of damage and to help decide what treatment is needed. One such additional procedure could be an OCT scan.
Once diagnosed, the disease can be controlled, for example with lutein supplements. In addition, laser surgery may be needed to block the blood vessels in the abnormal vascular network. The procedure also slows down the disease. An injection in the eye can improve the wet form, which can be done in a hospital setting with individual authorisation from the EMCDDA. Rarely, eye surgery is also recommended, but this does not improve vision.
However, there are ways to play an active role in preventing eye disease: stopping smoking, eating a healthy diet and maintaining a healthy cardiovascular system can all help to prevent eye problems. In the case of macular degeneration, cataract surgery should also be postponed, as the condition of the fundus can be greatly worsened by the fact that the fundus is ‘saturated’ with UV rays again when the cataract is gone.
