Macular Degeneration: The two forms of the disease and the damage they cause to the eyesight
Retinopathies cannot be described as a single disease as the initial conditions that caused them differ greatly.
Macular degeneration creates represents the most common type of retinopathy. This is the definition given to certain diseases that affect a particular part of the retina resulting in serious disorders of central vision.
Macula: When vision loss is instantly noticed
From an anatomical point of view, macula is an elliptical yellow formation about 1.5 mm in diameter at the center of the retina, which is histologically structured from ganglionic layers containing ganglion cells. At its center lies the central well with a large concentration of cones responsible for central vision. Because the visual stimuli captured by the macula occupy a significant proportion of the brain’s ability to perceive vision, some forms of visual field loss can occur without the macula being affected.
Although the loss of peripheral vision can go unnoticed for a significant period of time, macula’s damage which results in the loss of central vision becomes readily apparent.
The causes of macular degeneration
The two main types of macular degeneration is the one caused by aging and the early one or juvenile.
- The age / dry type
Age-related Macular degeneration usually occurs after the age of 60 (also known as ARMD – Age-related Macular Degeneration) and hereditary involvement is undetermined. Dry type Age-related macular degeneration is the most common (90%) and is characterized as atrophic (drusenoid). The main clinical manifestation is the deformity of vision which is particularly perceptible during reading with manifestation in one eye. The incidence of ARMD in the Western world starts at 2.5% after 60 and can reach 15% after 75 years. It is the most common cause of retinal disease in non-diabetic patients. Dry ARMD develops very slowly and the majority of patients maintain peripheral vision at tolerable levels for several years.
- Early / wet type
Early macular degeneration is genetic and inherited. Wet type (10%), is a condition known as choroidal neovascularization characterized by the development of abnormal vessels under the macula and manifested by serious eyesight loss for the individual.
Genetic reasons that lead to macular degeneration
Main causes for Macular Degeneration are the following:
- Best disease with significant variations of clinical symptoms from one patient to another. It occurs at a very young age, between 4 and 10 years but the diagnosis is very slow.
- Dominant Drusen which appears around the age of 30 but vision loss takes up to a decade to become evident.
- Sorby’s macular dystrophy that is extremely rare.
- Pigment Pattern Dystrophy.
- Stargardt’s disease is the most common form of hereditary macular degeneration. It occurs around the age of twenty. It shows a reduction in central vision to 20/200 as far as central vision is concerned and progressively affects color vision too.
Ophthalmologist’s scan of the retina can provide an early diagnosis. Special imaging methods and techniques are used for diagnosis. The fundus of the eye and the colored photograph of the eye fundus will show some lesions, centrally and in the periphery of the fundus of the eye. Optical coherence tomography (OCT) also allows the analysis of all structures and layers in the macular area.
- Dry type
There is no cure for dry type macular degeneration. It is therefore essential to monitor any changes in vision and to take preventive measures. There is a 30% chance – at any time – of turning into α wet type. Α balanced diet (both for cholesterol and blood pressure control), special dietary supplements and multivitamins (always with the advice of an ophthalmologist), the use of special sunglasses to protect against UV radiation, non-smoking, are factors which slow down disease progression. To detect changes in vision, there is also self-control, using Amsler panel.
- Wet type
Unfortunately, up to this day, there are no particular therapeutic developments that can give hope to patients. Stargardt disease in particular has virtually no special treatment. It is recommended to avoid vitamin A and to stop/abstain smoking.
The only way to reverse the progression of this incurable disease is by acupuncture. Acupuncture practiced by qualified doctors and healthcare professionals (acupuncturists) has not only been proved successful in reversing its progression but also in improving the visual acuity by acting primarily in the macula of the eye and to lesser extent in the rest of the retina of the eye.