ARMD

What is The Macula?

The macula is a small area at the center of the retina that allows us to see fine details such as central vision, activities such as reading and writing and appreciating colour vision.

What Causes Macular Degeneration?

Sometimes the delicate cells of the macula are damaged and stop functioning. The exact cause is not known although it tends to happen as people get older. This is called age-related macular degeneration. The most common types of macular degeneration are the dry [atrophic] and the wet [exudative].

The dry type is caused by aging and thinning of the tissues of the macula. The wet type results from the formation of abnormal blood vessels under the macula which leak fluid or blood and blur the central vision. Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy, which can sometimes affect several members from the same family

Symptoms of macular degeneration:-

  • Blurred or distorted central vision
  • Colours look dim
  • Words on a page look blurred
  • Straight lines appear distorted
  • Dark or empty areas appear in the center of vision

 

This makes activities like reading, writing and recognizing small objects or faces very difficult

How is Macular Degeneration Diagnosed

Viewing the maculas with dilated pupils. Amsler charting.
Fluorescein angiography to find abnormal blood vessels under the macula. Indocyanine green angiography is done in certain cases.

How is Macular Degeneration Treated?

he dry form is treated by focusing on helping the person improve his central vision using low-vision aids like magnifying glasses, telescopic spectacles or closed-circuit televisions.

The wet form is treated with laser photocoagulation to seal the leaking blood vessels that damage the macula. A special type of dye laser is also used wherever indicated.

In wet ARMD, since there are leakages which have to be sealed, it needs to be treated.
Earlier the recommendation was ARGON laser treatment or PDT (Photodynamic therapy) which did not give desired results. Now the recent treatment is with anti-VEGF factors like Injection Avastin / Lucentis.

Anti-VEGF drugs block the trouble-causing VEGF, reducing the growth of abnormal blood vessels and slowing their leakage.

The recent development of anti-VEGF medications have become a path breaking advance in the treatment of wet AMD.
Bevacizumab (Avastin) and Ranibizumab (Lucentis) are two very useful drugs. Most patients will retain the vision they have and some will regain some of the lost vision after these treatments.

These procedures may preserve more sight overall, though they are not cures that restore vision to normal. Despite advanced medical treatment, most people with macular degeneration still experience some vision loss.

Many older people develop macular degeneration as part of the body’s natural aging process. Exactly why it develops is not known, and no treatment has been uniformly effective.