Macular Degeneration

It is currently one of the primary causes of irreversible vision loss. It is estimated to affect approximately 30-50 million people in the global population. The disease is divided into two groups. The wet type accounts for 10% of all cases, while 90% is made up of the dry type, where vision gradually declines over many years. About 10-20% of those with dry age-related macular degeneration may progress to the wet type over time.

The hereditary genetic occurrence rate is as high as 71%, while 29% is known to be influenced by environmental factors. Advanced age, smoking, obesity, systemic diseases, and the inability to obtain necessary nutrients from the diet are some of the risk factors. A deficiency of essential minerals that must be obtained through diet, such as Vitamins C, D, E, selenium, zinc, copper, and magnesium, alongside antioxidants like A and β-carotene, cryptoxanthin, lutein, and zeaxanthin, plays a role in the manifestation of macular degeneration. Healthy individuals over the age of fifty-five should be advised on measures to protect against this condition, including protection from sunlight, quitting smoking, regular exercise, maintaining weight, controlling blood pressure and cholesterol, reducing fats and sugar intake, and consuming dark leafy greens, walnuts, fruits, and fish 1-2 times a week. In advanced dry macular degeneration, a high level of antioxidant support as identified in AREDS studies is required.

The primary complaint of patients with macular degeneration is difficulty seeing the center of their visual field or a complete loss of that image. Early stage symptoms often include the perception of straight lines appearing broken or distorted, seeing dark spots, and a decrease in image quality.

Age-related macular degeneration has two types: the wet type and the dry type. The "dry type" is the more commonly encountered form, and it has been shown to have genetic transmission potential. The "wet type," while less common, is characterized by a more rapid vision loss.

In the wet type, there is fluid and/or bleeding present within the retina where macular degeneration occurs, which can lead to rapid and severe vision loss. The possibility of the dry type progressing to the wet type over time is a concern. The dry form is seen in approximately 80% of patients and is generally benign because it progresses slowly by drying out the tissue. The term wet type refers to the formation of new blood vessels. When it progresses to the wet type, patients may experience a noticeable increase in complaints of distorted and wavy vision. Breaks in straight lines can become distinctly noticeable, resulting in perceptions that are wavy, sunken, or bulging. There can be reports of both small and large vision complaints.

When it progresses to the wet type, faster progression may be seen. Fortunately, this occurs in only a small portion of patients, about 20%. Does dry macular degeneration turn into wet type? The possibility of dry macular degeneration gradually transforming into the wet type is a concern. The term wet type refers to when new blood vessels form. When it progresses to the wet type, patients experience a significant increase in complaints about distorted and wavy vision. Breaks in straight lines can become glaringly obvious. Complaints of wavy, sunken, or bulging vision can occur. Patients may report varying degrees of vision complaints when it switches to the wet type.

The most common treatment for wet macular degeneration in recent years has been the injection of anti-VEGF (Vascular Endothelial Growth Factor) medications into the eye. These medications prevent the formation of new blood vessels that lead to bleeding and fluid accumulation. Achieving good results from treatment is possible with early diagnosis, adherence to treatment, and regular check-ups.

The Amsler grid consists of a square approximately 10 cm x 10 cm, featuring equally spaced horizontal and vertical lines arranged perpendicularly to each other. While one eye is being tested, the other is covered, and the grid is held at reading distance (30-35 cm) directly in front of the open eye, focusing steadily on the center point of the paper. Distortions, curvatures, or areas of blurriness in the horizontal and vertical lines indicate a potential issue with the macula. Patients can repeat this test periodically at home to monitor for any progression in their condition.

Macular degeneration can occur in both eyes at once or only in one eye. If it occurs in just one eye, it is termed unilateral; if it is present in both, it is referred to as bilateral.