Macular degeneration

The retina (Retina) is a very thin layer of tissue, a sheath that covers the posterior inner surface of the eyeball. It consists of more than 100 million photoreceptor cells (called rods and cones) that respond to light. These photoreceptor cells transmit the image of the outside world that has arisen on the retina through the optic nerve to the brain. The highest density of these cells is observed in the center of the retina, which is called the macula. All objects that we can clearly and distinctly recognize when looking straight ahead are copied in the eye to the macula.

The macula is the most valuable segment of the retina, the segment that can do more than all the other components of the eye, but must also do more than all. The macula is not least the part of the retina that is most exposed to light during a person's life. Its high productivity is possible only thanks to the extraordinarily complex “device” and the extraordinarily intensive metabolism of the eye.

Causes

Thus, the macula is particularly susceptible to damaging influences, metabolic disorders, inflammatory processes, circulatory disorders and age-related aging of the retina.

Any damage inflicted on the macula means the loss of photoreceptor cells in it and, thus, a defect in the picture seen. This defect almost always makes itself known through one or more warning symptoms (see symptoms).

Macular degeneration (or degeneration) is the most common disease of the central segment of the retina (mint yellow) and, after cataracts, the second most common eye disease in old age. Usually (in more than 70% cases) it appears in a "dry" form. This form occurs either as a result of a slow process of increasing thinning of the retinal membranes in the macula itself, or due to age-related changes in adjacent tissues that play an important role in the nutrition of the macula.

The consequence of this process is a slow decrease in intact photoreceptor cells in the macula, resulting in a deterioration in visual acuity in the affected eye.

“Wet” macular degeneration is much less common. It occurs if, due to age-related changes, the retina ceases to be sufficiently demarcated from the deeper layers of tissue rich in blood vessels. Vessels can break through to the macula and cause retinal swelling or bleeding, which eventually leads to scarring. Visual impairment occurs in this case sharply and on a large scale, and therefore, as a rule, it is detected by the patient better and faster than in a situation with "dry" dystrophy.

Symptoms

The most important early symptom of wet macular degeneration is a distorted (curved) image in its shape or size, perceived by the eye.

Distinguishing a dark spot before the eyes;
distorted image perception;
perception of the image, as if changed in size;
reduced visual acuity.

Objects and processes that are outside the center of the perceived image are not projected onto the macula and therefore, despite the defects of the macula, they are not subject to changes and distortions.

Fluorescein angiography is sometimes necessary to be able to distinguish between dry or wet macular degeneration and to determine whether laser treatment will give the desired results. For this study, a special dye is injected intravenously, with which you can see all the capillaries of the retina and assess their condition.

Diagnostics

Treatment

For the dry form of macular degeneration, unfortunately, there is still no targeted treatment. But often quite tolerable visual acuity is maintained. Rapid evaluation by an ophthalmologist is critical, as early recognition of wet macular degeneration can in some cases be prevented by laser treatment.

True, laser treatment will not be able to restore lost visual acuity, but by obliterating vessels that have sprouted into the macula, good residual vision can be preserved. Laser treatment thereby transforms the aggressive wet macular degeneration into a much less dangerous dry form.

The most important rules for macular degeneration:

The visual fields and the ability to orientate in patients with macular degeneration remain intact. Macular degeneration does not lead to blindness!
Macular degeneration in one eye does not automatically mean damage to the other eye, but requires regular monitoring of both eyes.
Each patient suffering from macular degeneration should individually examine the underlying mesh (square pattern) with each eye at least once a week. Each newly appeared change in the pattern of the picture should be examined by a doctor.
In dry macular degeneration, limited reading ability can in many cases be achieved with magnifying optical devices to improve vision.

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