Regardless of the eye color we have, a one and a half millimeter dot on the retina, directly opposite the pupil, will always be yellow. For this reason, it is called a macula. And no matter how expensive anti-wrinkle creams are used by ladies and how long men are compared to Jack Nicholson, we’ll all get old anyway. Age is one of the main factors causing macular degeneration.
Yellow spot, black spot
Within the macula, there is the largest concentration of light-responsive photoreceptors in the retina, mainly cones, responsible for sharp color vision in daylight. Some of them have a direct connection with the ganglion cells of the optic nerve, so their full efficiency cannot be overestimated in providing us with a sharp and clear perception of objects in the center of the field of vision, e.g. letters in the text being read, human faces or road signs.
With age, the metabolic process in cells is disturbed, e.g. those in the macula. Cells are unable to get rid of harmful molecules and chemical compounds, with free radicals at the forefront and “poisoned” cells die. As a result, we lose our visual acuity.
The acronym for this disease – AMD – comes from the English age ralated macular degeneration, which indicates the relationship between the disease and the patient’s age. Without playing with euphemisms: with age. We should undergo preventive ophthalmological examinations after the age of 50. AMD is one of the most common causes of pattern loss, and the AMD Association data shows that over 30% of people over the age of 70 worldwide suffer from macular degeneration.
Dr. Katarzyna Mozolewska-Piotrowska, an ophthalmologist who runs the Laser and Angiographic Clinic at the Ophthalmology Clinic of the Medical University of Warsaw in Szczecin and a member of the Scientific and Clinical Council and medical consultant of the Age-related Macular Degeneration Association, describes the first symptoms of degeneration:
– First of all, your vision is worsened, especially in front of you: the image is blurry, unclear, less contrast than before, and the colors appear faded. The patient may complain of distorted image, the impression of wavy lines and a gray or black spot in front of the eye that always appears in the same position. Initially, the symptoms are very subtle, and more importantly, they can only be picked up by looking at each eye separately. Therefore, it is very important to check your eyesight regularly, but always with the companion eye covered.
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Dry or wet
AMD comes in two forms: dry and wet. The dry form is more common, and fortunately, 90% of all AMD patients who suffer from it experience a milder, slower-progressing form of the disease. It is also called atrophy because it is characterized by the dying of photoreceptors, which gradually leads to deterioration in central vision, or even loss of it.
The wet form, or exudative form, is less frequent, more invasive and more serious. It is caused by undesirable, additional, but very fragile blood vessels that arise in the retina. Theoretically, they are formed for its good, but in practice they are harmful, because they break, lead to micro-infusions and, over time, to scarring. Severe vision loss in this variant of AMD can occur over a period of days or weeks. However, what is very important, Dr. Mozolewska-Piotrowska points out, in the case of AMD, one never becomes completely blind. Even when lesions are not treated, poor peripheral vision will remain. Contrary to popular belief, the doctor continues, and there is no conclusive scientific evidence that women suffer from AMD more often than men. The fact that there are more women in the group of patients over 60 years of age may be related to the statistical life expectancy: in this age group, women are the majority. Thus, the older the age group, the greater the risk of developing AMD, and thus the greater the number of women.
However, it was confirmed that the factors increasing the risk of developing the disease include a diet low in antioxidants, obesity, a lifestyle requiring frequent exposure to sunlight, hypertension and smoking.
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Prevention and treatment
– If AMD is detected early, the progress of the disease can be inhibited, but not all patients can improve their already damaged eyesight – says Katarzyna Mozolewska-Piotrowska, MD, PhD. – The currently known methods of prophylaxis do not prevent the formation of degenerative changes in 100%, but they significantly reduce the risk of their advanced forms. The most important role is played by the prevention of atherosclerotic lesions (a healthy diet with limitation of animal fats, reasonable exercise), protection of the eyes from strong light and not smoking. People who already have degenerative changes in the retina of the eye, it is recommended to supplement the diet with substances protecting the macula, most often in the form of tablets or capsules.
Treatment methods are still being improved, specialists expect the introduction of special steroids into AMD therapy in the near future. The development of a milder dry form is stabilized by bringing the patient’s circulation into order; in the wet form, several methods of treatment are used, e.g. photodynamic therapy, the so-called PDT and intravitreal drugs to inhibit disease progression, and in rare cases, laser therapy or subretinal surgery.
People have the sad quality of not being able to appreciate what they got just like that, effortlessly. However, the sight received as a gift from nature can be taken from us “just like that”. As long as there is time, let’s take care of diet, blood pressure and a healthy lifestyle, and before the existence of the mysterious yellow spot reminds us of a large black spot that obscures the sun and the faces of our loved ones, let’s visit the doctor regularly, because there is a lot to lose.
Text: Julia Wolin
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