Retina

By: Bhavesh Rathod

Macular Degeneration
Macular degeneration: A disease that progressively destroys the macula, the central portion of the retina, impairing central vision. Macular degeneration rarely causes blindness because only the center of vision is affected. However, injury to the macula in the center of the retina can impair the ability to see straight ahead clearly and sometimes make it difficult to read, drive, or perform other daily activities that require fine central vision.

Macular Degeneration
The macula is in the center of the retina at the back of the eye. As we read, light is focused onto the macula where millions of cells change the light into nerve signals that travel to the brain and tell it what we are seeing.

This is our central vision.

With normal central vision, we are able to read, drive, and perform other activities that require fine, sharp, straight-ahead vision. Macular Degeneration is of two types Dry and Wet Macular Degeneration.

Dry Macular Degeneration

The dry form of degeneration results from atrophy to the retinal pigment epithelial layer below the retina, which causes vision loss through loss of photoreceptors (rods and cones) in the central part of the eye. No medical or surgical treatment is available for this condition. Vitamin supplements with high doses of antioxidants, lutein and zeaxanthin, have been suggested by the National Eye Institute to slow the progression of dry macular degeneration. Higher beta-Carotene intake was associated with an increased risk of Dry Macular Degeneration.

Dry Retina

Wet Macular Degeneration

The wet form of Degeneration, causes vision loss due to abnormal blood vessel growth in the choriocapillaris, through Bruch's membrane, ultimately leading to blood and protein leakage below the macula. Bleeding, leaking, and scarring from these blood vessels eventually cause irreversible damage to the photoreceptors and rapid vision loss if left untreated. Only about 10% of patients suffering from macular degeneration have the wet type. Macular degeneration is not painful, and this may allow it to go unnoticed for some time.

Wet Retina

Signs and symptoms

Pigmentary alterations Exudative changes: hemorrhages in the eye Visual acuity drastically decreasing Blurred vision Central scotomas (shadows or missing areas of vision)

Signs and symptoms

Distorted vision (i.e., metamorphopsia) - A grid of straight lines appears wavy and parts of the grid may appear blank. Trouble discerning colors; specifically dark ones from dark ones and light ones from light ones. Slow recovery of visual function after exposure to bright light A loss in contrast sensitivity.

Causes and risk factors

Aging: Approximately 10% of patients 66 to 74 years of age will have findings of macular degeneration. Family history: The lifetime risk of developing late-stage macular degeneration. Smoking: Smoking tobacco increases the risk of macular degeneration by two to three times that of someone who has never smoked.

Causes and risk factors

Cardiovascular status: High cholesterol, obesity. Hypertension: High blood pressure. High fat intake is associated with an increased risk of macular degeneration in both women and men. Exposure to sunlight especially blue light: There is conflicting evidence as to whether exposure to sunlight contributes to the development of macular degeneration.

Diagnosis
Fluorescein angiography allows for the identification and localization of abnormal vascular processes.
Optical coherence tomography is now used by most ophthalmologists in the diagnosis.

Treatment
Treatment is by using either Avastin or Lucentis, which are injected into the vitreous of the eye at various intervals.

Thank You