Wet Macular Degeneration

Overview

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Wet Macular Degeneration is less common than the dry form of AMD but is more severe and can lead to rapid vision loss. It typically occurs in individuals over the age of 50 and can significantly impact daily activities, such as reading, driving, and recognizing faces.

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Symptoms

Symptoms of wet macular degeneration can develop suddenly and may include

  • Vision Loss: Rapid decline in central vision, making it difficult to see fine details.
  • Distorted Vision: Straight lines may appear wavy or distorted due to changes in the macula.
  • Dark or Empty Spot: A central blind spot or scotoma may develop in the field of vision.
  • Decreased Color Vision: Difficulty distinguishing colors or seeing them as less vivid.
  • Visual Hallucinations: In rare cases, individuals may experience visual hallucinations or see unusual patterns due to changes in the retina.
Complications
  • Abnormal Blood Vessel Growth: Wet AMD is primarily caused by the growth of abnormal blood vessels under the retina. These vessels leak fluid and blood, causing damage to the macula.
  • Genetics: Genetic factors can predispose individuals to wet AMD. Variants in genes related to inflammation and blood vessel formation are associated with increased risk.
  • Age: The risk of developing wet AMD increases with age, particularly after 50.
  • Chronic Inflammation: Chronic inflammation and oxidative stress are believed to play a role in the development of wet AMD.
Causes
  • Healthy Lifestyle: Maintaining a diet rich in antioxidants, vitamins, and minerals may help reduce the risk. Foods high in vitamins C and E, zinc, and lutein are beneficial.
  • Regular Eye Exams: Early detection through regular eye exams can help manage and treat AMD before significant vision loss occurs.
  • Smoking Cessation: Quitting smoking can reduce the risk of developing AMD and slow its progression.
  • Sun Protection: Wearing sunglasses that block UV light can help protect the eyes from potential damage.
Prevention
  • Healthy Lifestyle: Maintaining a diet rich in antioxidants, vitamins, and minerals may help reduce the risk. Foods high in vitamins C and E, zinc, and lutein are beneficial.
  • Regular Eye Exams: Early detection through regular eye exams can help manage and treat AMD before significant vision loss occurs.
  • Smoking Cessation: Quitting smoking can reduce the risk of developing AMD and slow its progression.
  • Sun Protection: Wearing sunglasses that block UV light can help protect the eyes from potential damage.
Risk Factors
  • Age: Risk increases significantly with age, particularly after 50.
  • Family History: A family history of AMD can increase the risk of developing wet AMD.
  • Smoking: Smoking is a major risk factor and can accelerate the progression of AMD.
  • Genetics: Certain genetic variations are associated with a higher risk of AMD.
  • Race: Caucasians are at higher risk compared to other racial groups.
  • Diet: Low intake of certain nutrients, such as antioxidants and omega-3 fatty acids, may increase the risk.
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How is it treated?

Anti-VEGF Therapy

  • Injections: Medications such as ranibizumab (Lucentis), aflibercept (Eylea), and bevacizumab (Avastin) are injected into the eye to inhibit the growth of abnormal blood vessels and reduce fluid leakage.

Photodynamic Therapy

  • Laser Treatment: A photosensitive drug (verteporfin) is injected into the bloodstream and activated by a laser to destroy abnormal blood vessels under the retina.

Laser Therapy

  • Hot Laser Treatment: Direct laser treatment can be used to destroy abnormal blood vessels, though this is less common due to the advent of anti-VEGF therapies.

Nutritional Supplements

  • AREDS Formula: Supplements containing a specific combination of vitamins and minerals (vitamins C and E, zinc, copper, and lutein) may help slow the progression of AMD.

Low Vision Aids

  • Assistive Devices: Devices such as magnifying glasses, special lighting, and electronic reading aids can help individuals with vision loss perform daily tasks.

Monitoring and Follow-Up

  • Regular Eye Exams: Continuous monitoring is essential to assess treatment efficacy and make necessary adjustments.
  • Early intervention and ongoing management are crucial in slowing the progression of wet macular degeneration and preserving vision. Regular eye exams and adherence to treatment plans can significantly impact the outcome and quality of life for individuals with this condition.
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How is it Diagnosed?

Wet macular degeneration, or neovascular age-related macular degeneration (AMD), is diagnosed through a comprehensive ophthalmologic evaluation, as it affects the central retina (macula) and causes rapid vision loss. The diagnosis process begins with a detailed history and symptoms review, often including complaints of blurred vision, central blind spots, or visual distortion (metamorphopsia).

The first step in diagnosis involves a dilated eye exam using ophthalmoscopy. The ophthalmologist looks for signs such as fluid accumulation, retinal swelling, or hemorrhages in the macular area. One of the key diagnostic tools is Optical Coherence Tomography (OCT), a non-invasive imaging test that provides cross-sectional views of the retina, helping detect fluid or blood beneath the macula.

Fluorescein angiography is another essential diagnostic method. In this procedure, a fluorescent dye is injected into a vein, and a special camera tracks its circulation through the retinal blood vessels. The images help detect abnormal blood vessel growth (choroidal neovascularization) and leakage, which are hallmark signs of wet AMD.

Indocyanine green angiography (ICG) may be used in some cases to visualize deeper layers of choroidal blood vessels when fluorescein results are inconclusive.

Visual acuity tests and Amsler grid assessments are also employed to monitor and document central vision changes.

Prompt and accurate diagnosis is crucial for initiating anti-VEGF (vascular endothelial growth factor) therapy, which can slow or halt the progression of wet AMD and preserve vision.

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