Macular degeneration: treatment

Macular degeneration is a painless eye condition that leads to the gradual loss of central vision and occurs when the macula, or yellow spot, (the part of the eye that is responsible for central vision) is unable to function as effectively as it used to. In most cases, peripheral vision is not affected.

There is no treatment for this condition, whether for the dry or the wet form. Fortunately, there is a treatment that can stabilise it.

Early detection of macular degeneration is essential if the treatment is to be started in good time.

  • Stabilisation

What is macular degeneration?

Macular degeneration is an eye condition that damages the macula, or yellow spot, making it unable to function as effectively as it used to, leading to a gradual loss of central vision. In most cases, peripheral vision is not affected.

The most important types of macular degeneration are juvenile macular degeneration and age-related macular degeneration. Juvenile macular degeneration manifests itself at a young age and, though hereditary, it is relatively rare. In most cases, both eyes will be affected.

Age-related macular degeneration

Age-related macular degeneration starts around the age of 50. Heredity is not a factor here. The two most forms of age-related macular degeneration are the dry and wet forms:

Dry macular degeneration

Dry macular degeneration, also known as atrophic degeneration, is the most common, though the least serious, form of age-related macular degeneration (80 %). It is age-related and caused by a thinning of the macular tissues, a natural part of ageing. Usually both eyes are affected to some degree and vision will deteriorate gradually. Peripheral vision remains intact.

Wet macular degeneration

Wet macular degeneration, also known as exudative or haemorrhagic macular degeneration, is a more unfavourable form though fortunately less common (20 %). The lack of nutrients and oxygen in the retina causes new blood vessels to form under the yellow spot which are fragile and do not function properly. These abnormal blood vessels leak fluid and, sometimes, blood. This accumulation of fluid in the macula (= macula oedema) distorts central vision. The loss of visual acuity can be fast and pronounced. The other eye may remain reasonably good for a while but, sooner or later, both eyes may be affected. This condition can lead to severe scarring in the macula. In some cases, also peripheral vision may be affected to a certain extent.

Macular degeneration

  • Macular degeneration: symptoms
  • Macular degeneration: causes

Macular degeneration: treatment

  • Treatment

    Macular degeneration

    • There is no cure for this condition, whether for the dry or the wet form. Fortunately, there is a treatment that can stabilise it.

      Early detection of macular degeneration is essential if the treatment is to be started in good time.

    • Diagnoses

      • Direct and indirect ophthalmoscopy (examination of the back of the eye)
      • Fluorescein angiography (examination of the retina using fluorescent dye)
      • Optical Coherence Tomography (OCT) (laser-assisted examination of the retina)
    • Dry macular degeneration: treatment

      Addition of specific food supplements to the diet such as vitamins, antioxidants and certain oligo-elements (pure trace elements).

    • Wet macular degeneration: treatment

      Currently, injections of vascular growth inhibitors are considered to be the best treatment for wet macular degeneration. These injections reduce the formation of new, abnormal blood vessels and thus prevent further vessel leakage. The medicine is injected into the vitreous cavity of the eye (= intravitreal injection) and this injection must be administered several times. Interim checks are performed via OCT.

      Because macular degeneration often worsens without treatment, the objective of this treatment is to maintain (and potentially improve) visual acuity.

      Other possible treatments are conventional (thermal) laser, Photo Dynamic Therapy (PDT), and ‘low vision’ optical aids (loupe, magnifying bar, loupe glasses, better lighting etcetera).

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