| • | What is the macula? |
| • | What is macular degeneration? |
| • | Treatment of macular degeneration |
| • | Conclusion |
What is the macula?
The thin inner layer of eye is called the retina. It is like the "camera film" of the eye. The central portion of the retina that gives allows us to see detail vision such as reading and recognizing peoples faces is called the macula. The rest of the retina allows for "side vision" but is not able to distinguish fine detail. A person without good macular function is able to walk around without bumping into things as well as take care of their daily needs such as bathing, cooking, and eating. Therefore, patients do not go blind from macular degeneration. However, they are unable to read a newspaper or highway signs while driving.
What is macular degeneration?
Macular degeneration is a deterioration of the deepest layers of the retina in the area of the macula. The actual cause of macular degeneration is under intense study but it is usually associated with the aging process. However, genetic or hereditary tendencies can cause macular degeneration in childhood or make it much more likely to develop in patients over 55. The deterioration appears to be related to a build up of oxidents and other metabolic waste products in the pigmented layer of the retina.
Over time this layer begins to degenerate and form what are called drusen. As more drusen form, macular function decreases and vision begins to blur. In some cases the pigmented layer undergoes atrophy. Small gaps (scotomas) in vision develop and eventually enlarge to cause more severe vision loss. Drusen development and/or atrophy of the pigmented layer of the macular is called Dry Macular Degeneration.
In the most severe form of macular degeneration small breaks in the layer between retina and the vascular middle layer of the eye (choroid) can develop. These breaks allow abnormal blood vessels to develop and grow underneath the retina. These vessels (subretinal neovascular membranes) hemorrhage and scar causing fairly rapid and severe loss of macular function and central vision. This is called Wet Macular Degeneration.
Treatment of macular degeneration:
Unfortunately, the dry form of macular degeneration is not curable, but there are steps you can take to slow down progression or the conversion of the dry form of macular degeneration to the wet form. Specific formulations of antioxidant vitamins have been statistically proven to help slow down the progression of macular degeneration. 85% of all patients who are legally blind from macular degeneration have the "wet" form. Up until 2006, our treatments were geared toward slowing down the loss of vision, but since then, the development of new pharmaceuticals has enabled us to successfully stop the loss of vision in 90% of our patients, with 60% actually getting better, and 30-40% achieving 20/40 or better. The “VEGF” inhibitors are pharmaceuticals that are directly injected into the eye. Sometimes a combination of PDT laser and intraocular injections are used depending on the situation. Our retina doctor can help you decide what treatment is right for you. All state-of –the-art treatments for macular degeneration are performed here at the Omaha Eye and Laser Institute (Lincoln Eye and Laser Institute for their site). Along with regular check ups and current treatments, patients with macular degeneration can hope to keep as much vision as possible for as long as possible.
Conclusion
Macular degeneration is a difficult disease but with motivation and patience its effects can be significantly reduced. Early treatment and preventative measures can help slow down the condition and low vision rehabilitation can help people to lead an independent life style.