Macular Degeneration

What Is the Macula?

The macula is the most important part of the eye's nerve layer, the retina. It allows sharp vision of the point being looked at directly. There are dozens of conditions that can affect the macula. In everyday use, however, when we say “macular degeneration”, we usually mean age-related macular degeneration, since it is the most common cause of irreversible vision loss in people over 60.

What Is Age-Related Macular Degeneration?

This is when, due to aging, the visual cells of the macula lose their vitality and become unable to function.

Who Develops Macular Degeneration?

We cannot say with certainty that a given person will or will not develop macular degeneration. However, there are certain risk factors that increase the likelihood of developing this disease. The most important risk factor for macular degeneration is age. It is generally seen after age 60, and the risk increases with age. Macular degeneration is more common in people who have a family history of the disease, who smoke, who have high blood pressure and cholesterol, and who have an unbalanced diet.

What Are the Symptoms of Macular Degeneration?

The most common symptom is decreased vision. Patients complain particularly of not being able to see the exact point they are looking at. For example, when looking at another person's face, the patient may see that person's body clearly while their eyes and nose appear blurred and distorted. Another important symptom is difficulty reading despite wearing reading glasses. Because patients cannot see the point they are looking at directly, they try to see by looking slightly to the side.

Does Macular Degeneration Progress? What Happens in the End?

How macular degeneration will progress, and to what extent the patient's vision will be affected, depends on the type of the disease. There are two types: dry and wet. Which type a patient has is determined by an OCT scan.

1. Dry Macular Degeneration: 90% of patients have the dry type of macular degeneration. In the dry type, the disease progresses more slowly. Of patients with dry macular degeneration, 10% progress to the end stage of the disease, and another 10% convert to the wet type. Patients who reach the end stage or convert to the wet type experience serious vision problems. The remaining patients continue their daily lives despite experiencing some vision problems.

2. Wet Macular Degeneration: 10% of patients have the wet type of macular degeneration. In the wet type, abnormal blood vessels also form in the macula, so the disease progresses more rapidly. If left untreated, the macula completely loses its function in most patients, resulting in permanent vision loss.

What Is the Treatment for Macular Degeneration?

Treatment for macular degeneration varies according to the type of the disease. The main goal of treatment is to preserve existing vision and prevent it from getting worse. However, some patients with wet macular degeneration can experience partial improvement. A patient quitting smoking, lowering their blood pressure, blood sugar, and cholesterol, and exercising regularly will have a positive effect on macular degeneration.

Patients with dry macular degeneration are primarily advised to eat a diet rich in leafy green vegetables and to eat fish at least twice a week. Vitamin supplements may be recommended. Regular follow-up is very important for these patients, because if the disease converts to the wet type, injection treatment must be started immediately.

Patients with wet macular degeneration receive injection treatment into the eye. Initially, 3 injections are given, one month apart. This treatment is sufficient for 80% of patients. Patients for whom three doses are not sufficient require additional injections.

For patients who have reached the final stage and have experienced severe vision loss, special eyeglasses are prescribed to make daily life easier, particularly for reading text.