Age-related macular degeneration, or more commonly known as “macular disease,” is a frequent cause of vision loss, especially in older adults. In Turkey, it is the second most common eye disease, with diabetes-related damage being the first.
Therefore, as it affects the quality of vision and can lead to vision loss, it holds a significant place among retinal diseases. The macula is a specific region of the retina, and disorders in this area are termed macular diseases. Age-related macular diseases are the most common, with incidence increasing usually over the age of 55-65. Various risk factors exist, with age being the most significant one; the older the age, the higher the incidence rate.
The “macula” is a specialized area of the retina that provides color and detailed vision. It can deteriorate with aging, while more rarely, it can be affected by congenital factors, trauma, excessive sunlight exposure, or other retinal diseases at an earlier age. Other influencing factors include alcohol and smoking. In patients with high blood lipid levels, like triglycerides or cholesterol, the risk can increase. In macular disease, the primary complaint is difficulty seeing the center of vision or complete loss of the image. In the early stages of the disease, seeing straight lines as broken or curved is a common patient complaint. Age-related macular degeneration occurs in two types: wet and dry. The "dry type" is more commonly encountered and has been shown to potentially have a genetic transmission. The "wet type," though less common, progresses with a faster vision loss. In the wet type, fluid and/or bleeding are present in the retina where the macula is located, causing rapid and severe vision loss. Over time, dry macular disease can convert into the wet type. The dry type occurs in about 80% of patients and is less severe because it progresses slowly by drying the tissue.
The wet type is named as such when new vessels form. When it converts to the wet type, complaints of distorted and irregular vision notably increase. Breaks in straight lines become noticeably discernible. Complaints of seeing curvy, concave, convex images arise, along with complaints of seeing small or large images. More rapid progression can be seen once it turns into the wet type; fortunately, it is observed in about only 20% of patients.
"Optical Coherence Tomography (OCT)" and especially "fluorescein angiography" in wet type cases are commonly used tests in the diagnosis and follow-up of macular disease. A self-administered grid test is a highly beneficial method of follow-up. Macular disease requires long-term regular monitoring. In dry macular disease, dietary supplements rich in vitamins and minerals (such as lutein, zeaxanthin, omega-3, zinc) are considered beneficial. In wet type cases, intraocular injections can slow the disease's course, halt it in some cases, and even provide vision improvement.
How is Optical Coherence Tomography (OCT) performed?
It is performed using an OCT device. The OCT allows for the examination of the retina and the vascular layer beneath it by scanning in fine sections. It is conducted quickly without using any harmful radiation or medications. OCT is used for diagnosing and monitoring retinal diseases reliably.
OCT is used in macular disease, diabetes-induced retinal damage, and the diagnosis and monitoring of all retinal diseases arising from congenital or acquired vascular diseases primarily. It is also quite useful in diagnosing and monitoring the progression of glaucoma. Known side effects of OCT do not exist.
Monitoring and Importance of Age-Related Macular Degeneration
Since macular degeneration is a progressive disease, regular monitoring and early intervention are crucial. Particularly to prevent dry macular degeneration from turning into the wet type, periodic eye doctor consultations are necessary. During these consultations, a macular degeneration test is conducted. While the most common test is Optical Coherence Tomography (OCT), more detailed imaging methods like fluorescein angiography may be employed in some cases. Tests determine how fast the disease progresses, and a treatment plan is developed accordingly.
How is the Macular Degeneration Test Performed?
The macular degeneration test, especially at the onset of the disease, helps in fully understanding the patient's complaints and properly staging the disease. This test carried out with an OCT device examines the back of the eye, i.e., the retina, in detail, detecting fluid accumulation or abnormal vessel formation in the retina. During the test, the patient's pupil may be dilated, and short-term light sensitivity can develop after the procedure.
Macular Degeneration and Disability Report
In advanced-stage macular degeneration patients, vision loss can reach serious levels. Determining the percentage of vision loss is important for patients to benefit from social rights. In this context, for patients identified with a certain rate of vision loss, a macular degeneration disability report can be prepared. This report allows individuals to access various social and economic rights. To obtain a disability report, visual acuity is measured through detailed examinations and tests conducted by an ophthalmologist and is evaluated by the relevant health board.
What is Macular Degeneration?
So, what exactly is macular degeneration? Macular degeneration is a disease characterized by damage to the macular region located at the back of the eye. This condition leads to the inability to see objects clearly when looking directly at them, seeing lines as curved, or having dark spots in the central vision. As the disease progresses, significant limitations in daily life activities like reading, driving, and recognizing faces can occur.
Macular Degeneration and Vitamin Supplements
Particularly in dry macular degeneration, certain vitamin and mineral supplements are recommended to slow the disease's progression. When it comes to macular degeneration vitamin support, lutein, zeaxanthin, Vitamin E, Vitamin C, omega-3 fatty acids, and zinc come to mind. These supplements are thought to protect retinal cells by reducing oxidative damage caused by free radicals. Since each patient's needs may differ, medical advice should be sought before starting vitamin use.
Frequently Asked Questions
How long does a macular degeneration test take?
Tests used in the diagnosis of macular degeneration are generally completed in a short time. These tests, averaging 10 to 15 minutes, assess the patient's central vision. The eye doctor initially performs a visual acuity test. Then, a special grid table called the Amsler Grid is used to detect distortions in the patient's central field of vision. A fundus examination, using drops that dilate the pupil, allows for a detailed examination of the retina and especially the macular region. During this examination, findings such as damage to the retinal layer, pigment changes, or fluid accumulation can be evaluated. For some patients, more detailed information may be obtained using advanced imaging methods such as optical coherence tomography (OCT) or fundus photography. After the test, the patient can easily return to daily life, but it is advisable not to drive during the few hours of potential blurred vision that may occur due to the effects of the drops used.
What are the conditions for obtaining a disability report for macular degeneration?
Obtaining a disability report due to macular degeneration is possible, but this process is based on certain official and medical evaluations. Initially, the degree of a patient's vision loss is determined. This rate is identified through comprehensive examinations and vision function tests conducted by expert ophthalmologists. Generally, a vision loss of 40% or more is sought for a disability report. However, not only numerical percentages but also the impact of vision loss on daily life is significant. Individuals wishing to obtain a report must apply to health boards at state hospitals. These boards evaluate the patient's complete medical documents and test results regarding the eye disease to determine a disability rate. Following the board's approval, the report provides access to various social rights and legal advantages. This report is particularly important for tax deductions, early retirement, or access to public services.
Is macular degeneration treatable?
Macular degeneration, especially its age-related type, is not a completely treatable disease. However, with early diagnosis and the application of appropriate treatment methods, the progression of the disease can be slowed. Macular degeneration is fundamentally divided into two main types: dry type and wet type. Dry macular degeneration progresses more slowly and usually manifests with cellular losses. In this type, lifestyle changes, regular eye examinations, and some special vitamin supplements can delay the disease's progression. Wet macular degeneration is a more rapidly progressing form characterized by abnormal vascular growth beneath the retina. In this type, anti-VEGF (vascular endothelial growth factor inhibitors) injections administered into the eye can halt vision loss and even partially improve vision in some patients. During the treatment process, it is crucial for patients to have regular check-ups, comply with medical recommendations, and adjust their lifestyle accordingly. Therefore, although the disease cannot be completely eradicated, the existing vision capacity can be maintained, and quality of life can be significantly improved.
Which vitamins are beneficial for macular degeneration?
When detected at an early stage, macular degeneration can have its progression rate slowed with certain vitamin and mineral supplements. Especially carotenoids like lutein and zeaxanthin are naturally found in the macular region of the eye and act as protective barriers against harmful rays. These substances prevent free radicals from damaging retinal cells, thereby preserving cell structure. Additionally, strong antioxidants like Vitamin C and Vitamin E combat oxidative stress and contribute to retinal health. The mineral zinc aids in the more effective use of Vitamin A on the retina, supporting visual function. Omega-3 fatty acids, especially in DHA and EPA forms, help strengthen the retinal structure and are known for their anti-inflammatory effects. All these substances are typically combined in special formulas developed to support eye health. As each individual's health status varies, these kinds of supplements should not be used without a doctor's advice. Professional medical support is crucial for determining the appropriate dose, evaluating interactions with existing conditions, and integrating into the treatment process.