Dry ARMD: retinal photography and angiography
Normal retina and retina with wet ARMD
There are hard risk factors (e.g. genetics and ocular conditions) which cannot be changed, however there are certain things, which can be done to reduce the risk of macular degeneration (ARMD) and can be taken charge of ARMD. Research with large populations of people around the world has revealed a whole list of daily risk factors. Adjusting your life style and your nutrition can make a difference. The effect of excessive lifelong light exposure is still discussed controversially: in some studies, there is epidemiologic evidence for a relationship betweenARMD and excessive sunlight exposure, and other studies fail to show such a relationship. If you decide to protect your eyes, the following movie might give you some insights.
ARMD. Nutrition can make a difference
Sunlight-related ocular changes
During the course of a wet AMD, the eye produces large amounts of a protein called VEGF. This protein is one of the main causes of abnormal, leaking blood vessels. These produce excess fluid that may cause swelling of the retina. In the past years, several medications have been developed that may block VEGF. This may reduce the swelling and (partly) restore vision, or stabilize the course of the disease.
These medications are administered by an intravitreal injection.
Deposits of protein drifting in the vitreous (the clear, jelly-like substance that fills the middle of the eye) are called floaters. They are usually benign, occasionally resulting from a separation of the vitreous gel from the retina, called posterior vitreous detachment (PVD). This condition is more common among people over 50 and is not serious. Floaters could cause shadows on the retina and are often described by patients as spots, strands, or little flies.
Floaters can be removed by a vitrectomy surgery, but the procedure increases the risk of developing early cataract: therefore, a floaterectomy is only performed when the floaters are massive and very centrally located, making it sometimes hard to read or work.
Epiretinal membrane is a disease of the eye in response to changes in the vitreous or more rarely, caused by an inflammation, diabetes or a trauma. It is also called macular pucker. Sometimes, as a response of immune system to protect the retina, cells converge in the macular area as a result of the vitreous aging and pulling away in posterior vitreous detachment (PVD). PVD can create minor damage to the retina, stimulating exudate and/or inflammation. Cells like leucocytes can gradually form a transparent layer and, like all scar tissue, tightens to create tension on the retina which may create bulge and pucker (e.g., macular pucker), or even cause swellings or macular edema.
This often results in distortion of the vision which is clearly noticeable such as bowing of lines, or distortions. The distortions can make objects look different in size (usually larger), especially in the central portion of the visual field.
During the process of ageing, the vitreous may liquify and shrink. Later on, it detaches from the underlying retina – a this is the normal process called posterior vitreous detachment.
Sometimes, the vitreous stays attached at the retina at certain places, and pulls on it. A tear may occur, and when fluid from the vitreous cavity enters the hole created by the tear, it may peel off the retina, creating a retinal detachment.
A retinal detachment represents an ophthalmological emergency and must be operated rapidly, often by performing a vitrectomy.