Macular degeneration: everything you need to know

Macular degeneration is a common eye condition that affects millions of people worldwide, particularly in older age groups. It is a progressive eye disease that can have a significant impact on an individual's quality of life. Revered consultant ophthalmic surgeon Dr Meg Das illustrates the various types of macular degeneration, risk factors and treatment options.

What is macular degeneration?

Macular degeneration, also known as age-related macular degeneration (AMD), is an eye disorder that primarily affects the macula, a small but crucial part of the retina responsible for central vision. It is the leading cause of vision loss among individuals over the age of 50 in developed countries. AMD gradually damages the macula, leading to a loss of central vision while preserving peripheral vision. This can severely impact daily tasks such as reading, driving, and recognising faces.

Types of macular degeneration

There are two main types of macular degeneration:

• Dry AMD (Non-Neovascular): Dry AMD is the most common form, accounting for about 80-90% of cases. It develops when small deposits called drusen accumulate beneath the macula, causing it to thin and deteriorate over time.

• Wet AMD (Neovascular): Wet AMD, though less common, is more severe and usually results in more rapid vision loss. It occurs when abnormal blood vessels grow beneath the macula and leak blood and fluid, causing damage to the macula and surrounding tissue.

What are the most common risk factors for macular degeneration?

Several factors increase the risk of developing macular degeneration, including:

• Age: the risk of developing macular degeneration increases with age, particularly after 50.
• Genetics: a family history of AMD can increase the likelihood of developing the condition.
• Smoking: smoking is a significant modifiable risk factor for AMD.
• Race: Caucasian people are more susceptible to AMD than other racial groups.
• Cardiovascular health: hypertension and high cholesterol levels may contribute.
• Sunlight exposure: prolonged exposure to UV light may be a risk factor.
• Obesity: excess body weight can increase the risk of AMD.

What are the principal symptoms of macular degeneration?

Macular degeneration often presents with the following symptoms:

• Blurred or distorted central vision.
• Difficulty recognising faces or reading.
• Straight lines appearing wavy or distorted.
• Reduced brightness and colour perception.
• Dark or empty areas in the central field of vision.

What are the current treatment options for macular degeneration?

Currently, there is no cure for macular degeneration, but several treatment options can help manage the condition:

• Anti-VEGF injections: for wet AMD, anti-VEGF drugs can be injected into the eye to inhibit the growth of abnormal blood vessels and reduce leaking.
• Laser therapy: in some cases of wet AMD, laser therapy may be used to destroy abnormal blood vessels.
• Low vision aids: devices like magnifiers, telescopes, and special glasses can help people with macular degeneration make the most of their remaining vision.
• Nutritional supplements: some studies suggest that specific dietary supplements can slow the progression of dry AMD, particularly those containing vitamins C and E, zinc, copper, and antioxidants.

Can I make any lifestyle changes to prevent the onset of macular degeneration?

While it's not always possible to prevent macular degeneration, certain lifestyle changes can reduce the risk or slow its progression:

• Quit smoking: smoking is a significant risk factor, so quitting can help protect your vision.
• Eat a healthy diet: a diet rich in fruits, vegetables, and fish may reduce the risk of AMD.
• Protect your eyes from UV rays: wear sunglasses and a wide-brimmed hat when outdoors.
• Manage cardiovascular health: control blood pressure and cholesterol levels.
• Exercise regularly: maintaining a healthy weight and staying physically active can be beneficial in reducing the risk of macular degeneration.

The Age-Related Eye Disease Study (AREDS) found that a specific combination of vitamins and minerals can slow the progression of dry AMD. This formulation includes vitamin C, vitamin E, zinc, copper, and antioxidants. However, it's essential to consult with an eye care professional before starting any supplements.

Can macular degeneration lead to blindness?

Macular degeneration can cause severe vision loss, but it typically does not lead to complete blindness. Most individuals with AMD retain some peripheral vision, allowing them to perform daily tasks. Early detection and prompt treatment for wet AMD can help preserve more vision.

If you would like to book a consultation with Dr Das, simply visit her Top Doctors profile today.