Age-related macular degeneration, known as “yellow spot disease”, is a problem with the retina of the eye. Stating that yellow spot disease can go as far as advanced age blindness, Op. Dr. Yusuf Avni Yilmaz, an ophthalmologist at Anadolu Medical Center, said “old age, smoking, the presence of a person with macular degeneration in the family, high blood pressure, obesity and inactivity, light eye color, excessive exposure to sunlight, excessive fat consumption and side effects of some drugs are among the risk factors for macular degeneration”. Op. Dr. Yusuf Avni Yilmaz answered the questions about yellow spot disease.
The health of the macular region of the retina determines the abilities to read, recognize, drive, watch television, use computers, and perform other visual functions that require seeing fine details. When the macular region of the retina is damaged for various reasons, macular degeneration, namely yellow spot disease occurs. Depending on the degree of macular degeneration, central vision is lost. Details cannot be seen when looking at a near or distance object. However, peripheral (side) vision may still be normal. For example, when looking at the wristwatch, the hour and minute hands may not be visible, although the numbers are visible. In the very early stage, lines and shapes appear bent and twisted.
The only way to prevent yellow spot disease is to eat well and wear sunglasses
According to a study conducted in the USA in 2010, there are 9.1 million cases of early macular degeneration in the world. This number is expected to rise to 17.8 million by 2050. There are two types of macular degeneration as ‘dry-type’ and ‘wet-type’. Dry-type macular degeneration covers about 90 percent of cases. Yellow spot disease progresses slowly and there is no medicine specific to this disease. The dry-type is an early stage of the disease and can result from aging and thinning of the macular tissues, depositing pigment in the macula, or a combination of these two processes. Dry macular degeneration can be diagnosed when yellowish spots known as drusen begin to accumulate in and around the macula. These spots are thought to be deposits or debris from the deterioration of tissues. The only way to protect from or prevent the progression of dry-type macular degeneration is to eat well and wear sunglasses that protect from the sun's harmful rays.
Why does Yellow Spot Disease Occur?
In about 10 percent of dry-type macular degeneration cases, the eye disease can progress to a more advanced and harmful form. In wet macular degeneration, new blood vessels emerge under the retina and cause blood and fluid leakages. These leakages cause permanent damage to light-sensitive retinal cells and create blind spots in central vision. Retinal edema and severe vision loss occur as a result of fluid leakage from newly emerging vessels.
Symptoms of Yellow Spot Disease: Blurred and distorted vision are symptoms of macular degeneration
Age-related macular degeneration usually causes slow and painless vision loss. However, there may rarely be sudden vision loss. Shadows in central vision and unusually blurred or distorted vision are among the early signs of age-related macular degeneration. The diagnosis of the disease is made during a detailed eye examination with a card test with many squares known as the “Amsler grid card”. Seeing the lines on this card bent should raise suspicion for macular degeneration. In addition, the pupil should be dilated with drops and a detailed retinal examination should be made. When needed, OCT and eye angiography are important to confirm the diagnosis and identify the type of possible macular degeneration.
Genetic predisposition can cause macular degeneration
Although macular degeneration is age-related, studies indicate that the disease has a genetic component. Researchers have reported a strong relationship between the development of age-related macular degeneration and a gene variant. This gene deficiency is associated with almost half of the potentially blinding cases of macular degeneration. Specific variants of one or more of the genes involved in the body's immune responses were found in 74 percent of the patients with macular degeneration studied. Further researches have shown that oxygen-deprived cells in the retina produce a protein called vascular endothelial growth factor, which triggers the emergence of new blood vessels in the retina.
Treatment of Yellow Spot Disease: It is more common in females
In addition to affecting older populations, macular degeneration is more common in whites than in blacks and in women than men. There is no definitive cure for age-related macular degeneration yet, however, some treatments can delay its progression or improve vision. Treatment of macular degeneration depends on whether the disease is of the early dry-type or the more severe wet-type that can lead to severe vision loss. There is no cure yet for dry-type macular degeneration, but the prevailing opinion is that dietary regulation and various vitamins can help prevent wet-type progression of the disease. For the wet type, intraocular radiation therapy, known as photodynamic therapy and intraocular injections are among the treatments aimed at stopping the emergence of abnormal blood vessels, and vision has been shown to improve after these treatments.