Dry macular degeneration… Gradual central macular atrophy over many years
Wet macular degeneration… Symptoms progress rapidly over days to weeks
Clipart Korea image
Macular degeneration is a dangerous disease that is considered one of the three major blindness diseases in Korea, along with diabetic retinopathy and glaucoma.
According to statistics from the National Health Insurance Corporation, in the last five years, macular degeneration patients have more than doubled from 166,000 in 2017 to 380,000 in 2021. This increasing trend is expected to further increase in the future due to a rapid increase in the elderly population and a westernized living environment.
In the case of macular degeneration, there are few symptoms in the early stages, so it is important to pay attention to your eyesight and receive regular eye examinations after the age of 50. In particular, if you have symptoms such as blurred or curved central vision, you should visit an ophthalmologist as soon as possible and receive treatment.
What is macular degeneration?
The small dot-like area located in the center of the retina is called the macula. The macula is a small area, less than 2% of the total area of the retina. Most of the photoreceptor cells are concentrated here, and it accounts for most of the visual function.
Macular degeneration is when the macula is damaged for various reasons and causes vision loss, which is generally referred to as age-related macular degeneration.
In macular degeneration, there is atrophic (dry) macular degeneration in which visual acuity deteriorates as the macular area gradually dries and shrinks due to accumulation of waste products or inflammation depending on the form of the disease. In addition, there is exudative (wet) macular degeneration, which causes hemorrhage or swelling in the macula due to the occurrence of abnormal blood vessels called choroidal neovascularization. These two lesions often occur together.
Causes of macular degeneration
Most typically, age-related macular degeneration due to aging accounts for most of the cases, which occur according to the aging process of the retina. As we age, waste products called drusen gradually accumulate in the retina, or the choroidal blood vessels swell, causing retinal degeneration.
Park Han-sang, professor of ophthalmology at Chilgok Kyungpook National University Hospital, explained, “Some of these changes occur in the elderly, but in the case of patients with macular degeneration, risk factors such as genetic causes, family history, hyperlipidemia, and smoking combine to cause more severe degeneration.” did.
“Macular degeneration progresses slowly in most cases, but 10 to 15 percent of all patients with macular degeneration develop wet macular degeneration, which causes rapid vision loss, so early appropriate diagnosis and active treatment are essential,” he said.
In addition, macular degeneration due to myopia, which can occur even at a young age, and macular degeneration caused by inflammatory diseases such as uveitis can also be cited as causes.
Symptoms of macular degeneration
Macular degeneration has various symptoms depending on the type of disease and the degree of damage, whether dry or wet.
Early dry macular degeneration is often asymptomatic and is discovered incidentally during an ophthalmologic examination.
In dry macular degeneration, blurred vision usually progresses gradually, and central macular atrophy gradually worsens over several years. Then, the middle part becomes difficult to see and leads to severe visual impairment.
In wet macular degeneration, bleeding or edema due to choroidal neovascularization occurs in the central macula, and symptoms progress rapidly over several days to several weeks. When the middle part looks bent, deformation may occur, and part of it may appear black due to bleeding.
Treatment of macular degeneration
In the case of wet macular degeneration, intraocular injection is mainly performed as the first treatment, and laser treatment is performed in a limited way for some patients.
In the case of patients with wet macular degeneration, high levels of vascular endothelial growth factor in the eye cause the development and proliferation of new blood vessels, so treatment should be performed to suppress the growth of new blood vessels by injecting an antibody injection of vascular endothelial growth factor.
Representative drugs include Avastin, Lucentis, and Eylea. In the first treatment, injection treatment is usually performed three times in a row at intervals of one month, which may vary depending on the type of drug and the condition of the patient.
In the injection, the drug is directly injected into the eye through a syringe with a needle slightly thicker than a hair after administering eye drop anesthetic. For several days after the injection, you should check to make sure there is no infection or inflammation.
How to prevent macular degeneration
It is difficult to completely prevent macular degeneration because genetic predisposition and aging are the most important risk factors, but it is important to avoid correctable risk factors as much as possible.
In particular, in the case of dry macular degeneration, management of risk factors should take precedence over the concept of treatment. According to a study conducted by the National Eye Research Center in the United States, high-dose vitamins and minerals, lutein and zeaxanthin, have been shown to inhibit the progression of macular degeneration in the middle or older stages.
It is also necessary to properly consume vegetables, fruits, nuts, fish, etc. that can reduce oxidative stress, and to take nutritional supplements such as antioxidants regularly so that the symptoms do not worsen. In addition, proper aerobic exercise, smoking, and excessive UV exposure are avoided to prevent the progression of macular degeneration.
In addition, opinions about ultraviolet rays are divided, but there are so many studies that blue light is a factor that causes damage to the retina, so it is helpful to protect your eyes with UV-blocking glasses whenever possible.
Professor Park emphasized that “a management method that is as important as treatment is prevention through regular eye examinations, and regular eye examinations should be performed every six months to a year to check the progress of the disease.”
How to self-diagnose macular degeneration
When you see a checkerboard pattern called ‘Amsler grid’, you can suspect macular degeneration if there are symptoms that look hidden or look curved.
Macular degeneration self-test. Provided by Chilgok Kyungpook National University Hospital
Hansang Park, professor of ophthalmology, Chilgok Kyungpook National University Hospital
Park Han-sang, professor of ophthalmology, Chilgok Kyungpook National University Hospital