NOW THAT WE KNOW……what the Macula is (from our last discussion), we need to know what happens when that Macula becomes diseased. And that “disease” is called AGE-RELATED MACULAR DEGENERATION. Actually, there are two main categories of Macular Degeneration – EARLY and LATE.
EARLY Macular Degeneration is diagnosed by the presence of small deposits in the Macula called “DRUSEN.” You, as a patient, will not be aware of these ‘drusen.’ They can only be detected through a careful, dilated examination of your Retina by a capable medical eye doctor. You, as a patient, will usually NOT be able to tell that they are there in this early stage. But, this ‘early stage’ is the stage when early detection will result in a much reduced chance of these “Drusen” developing into ‘full-blown’ Macular Degeneration. Long term studies have shown that when treatment is begun in this early stage, there is a 54% REDUCTION in your chances of these Drusen developing into more advanced stages of Macular Degeneration. That, alone, should be ample reason to make your appointment to have your Macula evaluated for the presence of Drusen!
LATE Macular Degeneration itself is further divided into two additional classifications – a so-called “DRY” type and a so-called “WET” type of Macular r Degeneration. In the DRY type, there is NO development of new blood vessels in the Macula area. As the Macula begins to deteriorate, the body, in all of its wonders, recognizes that the Macula is not doing well. There is a deterioration of the pigment and vision cells in the Macula creating a slow but progressive loss of Central Vision. So, recognizing this process, the body begins to ‘grow’ new blood vessels into the Macula in an attempt to revitalize it. These ‘new vessels’ (so-called NEOVASCULARIZATION) are, however, weak and thus begin to ‘leak’ not only blood but fluid as well. As this process continues to go on, eventually the normal elements in the Macula will become replaced by scar tissue thus causing a “blind spot” in the central vision.
The “DRY” type of late Macular Degeneration is far more frequent that the “WET” type. However, Wet Macular Degeneration is responsible for most of the severe loss of central vision in patients with late Age-Related Macular Degeneration. Again, all the more reason to encourage all patients over the age of 45 to be sure to have their Retinas examined regularly with special attention to the Macula. There is no cure for Macular Degeneration…..much better to try to prevent it or, at the very least, make a really early diagnosis!
Naturally, the next question that comes up is, “Well, what causes Macular Degeneration in the first place?” That will be the subject of my next discussion….stay tuned!
John Colombo, M.D.
