Macular degeneration, specifically its atrophic variety: Exploring causes, symptoms, and additional insights
Age-related Macular Degeneration (AMD) is a common eye condition that primarily affects individuals aged 50 and older. This condition affects the macula, a small area in the centre of the retina responsible for sharp, central vision.
Stages of AMD
AMD progresses through three stages: early, intermediate, and advanced (late). Each stage is characterized by progressively worsening damage to the macula with corresponding symptoms and treatment approaches.
Early Stage
In the early stage of AMD, small drusen (tiny yellow deposits) appear under the macula, causing little or no vision loss. Usually, there are no noticeable vision changes, but individuals may require more light for reading. The focus at this stage is on monitoring, healthy lifestyle choices, and regular eye checkups.
Intermediate Stage
During the intermediate stage, larger and more numerous drusen form, and macular thinning begins. Symptoms may include mild blurriness, possible blind spots (scotomas), difficulty distinguishing similar colours, and a greater need for bright light. Nutritional supplements, such as those in the AREDS formulation, become more important at this stage to slow down progression.
Advanced Stage (Geographic Atrophy)
In the advanced stage, significant death of macular cells leads to geographic atrophy, areas of retina loss. This stage is characterized by noticeable central vision loss, blind spots, difficulty with daily tasks such as reading and recognizing faces. No cure exists for this stage, but low vision aids, rehabilitation, and ongoing monitoring can help maximize remaining vision.
Risk Factors and Prevention
The most significant risk factor for developing atrophic macular degeneration is aging. However, other risk factors include light-colored eyes, smoking, diabetes, heart disease, family history of atrophic macular degeneration, high blood pressure, obesity, high cholesterol, eating a diet low in fruits and vegetables, and high exposure to sunlight throughout one's lifespan.
To reduce the risk of developing atrophic macular degeneration, one can quit or avoid smoking, regularly practice physical activity, eat a healthy and balanced diet, maintain optimal cholesterol and blood pressure levels, and have regular eye checkups with a doctor.
Diagnosis and Treatment
When doctors suspect atrophic macular degeneration, they may recommend a series of tests such as a fundus photograph, optical coherence tomography, and visual function tests.
Recently, the Food and Drug Administration (FDA) approved the first-ever treatments for atrophic macular degeneration. These treatments include Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol).
Regular eye checkups with a doctor may help diagnose any eye conditions in their early stages so a person can take the relevant precautions. People with dry AMD should have regular checkups with a doctor to assess the progression of their condition.
In late wet or dry age-related macular degeneration, people may notice black spots in their vision, reduced colour brightness, and blurred vision. These symptoms can also include a dark or dim spot in the centre or near the centre of vision, reduced sharpness or clarity of vision, difficulty seeing in the centre of vision, difficulty seeing in dim light, difficulty seeing when doing activities such as driving, reading, or cooking, washed-out or dull colours, and needing extra light to read.
While no cure exists for dry AMD, lifestyle modifications, including not smoking, eating a diet rich in leafy greens, and controlling cardiovascular risk factors, are vital management strategies. AREDS vitamin supplements containing antioxidants, zinc, and other nutrients are commonly recommended to slow progression in intermediate and advanced stages.
Sources:
- National Eye Institute
- Mayo Clinic
- American Academy of Ophthalmology
- American Optometric Association
- FDA
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