What is the macula and what is its function?
The retina is the innermost layer of the back of the eye (we can see it through the fundus), it is a nervous tissue responsible for capturing the light that reaches it focused and transmitting it in the form of a nerve signal to the brain, which analyzes it and forms the image we see. It can be divided into two main areas:
- The central one called macula, in charge of central vision, fine vision with details and colors.
- Peripheral retina, in charge of the more peripheral visual field and helping a lot in night vision.
What is macular degeneration and what types are there?
AMD (age-related macular degeneration) is the leading cause of blindness in the western world. It is a pathological aging of the macula.
There are two main types of AMD:
- Dry or atrophic AMD: This is the most frequent type. It is a progressive atrophy of the macula. The evolution is slow (years) and in most cases will not reach very advanced stages.
- Wet or exudative AMD: This is the appearance of neovascular tissue in the macula that causes edema and hemorrhages. It may appear on a previously dry AMD. It is of rapid evolution (weeks or months) with rapid and severe vision loss. Over time and without treatment it causes irreversible scarring.
What are the symptoms of AMD?
The initial symptoms of this disease are distortion of images and difficulty in reading. With the progression of the disease these symptoms worsen and in the final stages there is a complete loss of central vision, with the impossibility of reading, recognizing faces and great difficulties in daily activities, although peripheral vision is never lost, which allows these patients mobility and a certain degree of independence.
Are there risk factors that make a person prone to AMD and can it be prevented?
The exact origin of the disease is currently unknown; the only established risk factor is age; it does not appear before the age of 50. There are other known risk factors that can increase the possibility of suffering from this disease, such as family history, smoking, high blood pressure, hyperlipidemia and intense exposure to the sun, mainly in people with light eyes. There is no treatment or preventive action that completely avoids the onset of the disease, but we can act on the known and avoidable risk factors, such as avoiding smoking, eating a healthy diet rich in vitamins B, C and E, antioxidants, omega 3 acids, lutein and zeaxanthin (oily fish, vegetables, fruits, nuts, olive oil, etc.), avoiding obesity, blood pressure control, etc.
In any case, the main preventive measure we can take is to go to the ophthalmologist for regular check-ups and promptly in case of symptoms such as spots in the central vision or distortion of images.
How is it treated? What are the results?
For treatment, we must differentiate between the two main groups of AMD:
- Dry or atrophic AMD: Nowadays there is no effective treatment to stop the progression and improve vision, although there are several drugs under study with very encouraging results. However, it is recommended to take specific vitamin complexes which, according to studies, seem to slow down the progression.
- Wet or exudative AMD: In this case we do have very effective treatments to stop the progression and in cases with little evolution to improve vision. These are antiangiogenic drugs that are injected directly into the interior of the eye by means of intravitreal injection. For this reason, early diagnosis and treatment is very important. The results to date have been very good, halting progression and allowing vision to be maintained, but it is not a curative treatment that definitively stops the disease, so in most cases it is necessary to continue with periodic intravitreal injections for years.