Age - Related Macular Degeneration (Yellow Spot Disease)
Just like the rest of the world, yellow spot disease is one of the top problems which creates vision defect at the ages over 55-60 in Turkey. The problems like reading, driving, recognizing faces, watching tv are mostly caused by the yellow spot disease. The later stages of this disease don’t cause total blindness and the individual can go on the daily life.
What is the Yellow Spot Disease?
Retinal layer of the eye consists of nerve cells which transmits the light coming from outside to the brain. If the eye is like a camera, retina is the film. Macular area is just in the middle of this section. In the middle of the macula, there is the fovea which is at the size of a pinhead where the light focuses. Foveo, also known as the yellow spot, gives the retina layer the abilities of central vision and detailed vision. Distortion of the shapes and vision defect is mostly observed in the patients.
Yellow Spot / Fovea is the most important part of the function of seeing.
Even though the retinal layer contains some veins, it also nourishes from the other rich veins which are located just beneath it
There is a thin membrane between those layers and acts a duty of a barrier. The waste material which is collected in this yellow spot due to light are cleaned from this are and forwarded to the veins and disposed further from the eye by blood.
The yellow spot disease might start with the patients over 55-60 years old when those wastes cannot be disposed from the eye and the reason is unknown.
There are two types of yellow spot disease: wet & dry. In dry type, there is a certain amount of loss of vision due to collected waste. In wet type, unwanted vein buds are formed right beneath the yellow spot. Those buds create leaks and bleedings which triggers the loss of vision. %90 of the macular degenerations are dry type yellow spot diseases however 90% percent of the visual losses which is triggered by yellow spot disease are the wet type. It is recommended to have regular controls because a dry type of yellow spot disease can turn into wet type by time.
What are the indications of the Yellow Spot Disease?
The early indications are distortion in straight lines and decrease in vision if the disease turned into wet type.
A card with squares is given to the patients for self-assessment of distortion in the lines. This card is called Amsler Card. The patient should close one eye with hand (with glasses if he/she uses) and looks at the middle of the card and check if there is a distortion in the lines.
In wet type yellow spot disease, the distortion can be understood by this method. A retinal check is recommended in the event of any unusual sight
Is the Other Eye Affected from Yellow Spot Disease?
It is a disease the affects both eyes. However, mostly the situation of the one eye is worse than the other.
What are the precautions?
Some changes in lifestyle and nutrition type can prevent the disease to move on to more serious stages even though it is impossible to prevent the change from dry type to wet type.
Smoking also plays a role in this disease and it is proved. It is recommended to stop smoking and it is proven that consuming dark green, fibre-rich fruits and vegetables decreases the risk.
Some studies also show us that various antioxidant vitamin and mineral rich medicines can prevent the risk of dry to wet transaction which also decreasing the risk of vision loss.
Some recommended vitamins are as it follows:
• 500 Mg Vitamin
• C 400 IU Vitamin E
• 150 Mg Beta Carotene
• 80 Mg Zinc Oxide
• 2 Mg Copper Oxide
It is highly recommended to consult your physician before consuming these vitamin supports. You might receive additional nutrition tips.
Risk Factors of Age-Related Macular Degeneration (Yellow Spot Disease)
Yellow Spot Disease in family
High blood pressure and high lipid-cholesterol
Which Precautions Can We Take?
1. Stop smoking.
2. Consume fibrous foods and consume fish at least 1-2 times per week.
3. Stay away from fried foods which contains trans fats, consume more olive oil.
4. The Blood pressure and lipid-cholesterol should be kept stable.
5. The weight should be controlled.
6. Exercise is important.
7. If the dry type of yellow spot disease has started the above-mentioned vitamin and mineral combinations should be started with the recommendation of your physician.
8. Regular retinal checks should be done if there is yellow spot disease in family history.
Treatment of the Yellow Spot Disease
The transition from dry type de wet type of yellow type is an urgent condition. Thanks to the technologic improvements and modern treatment methods, the success rates of the treatment nowadays are very high.
The aim of the treatment of the wet type of yellow spot disease is to dry the leakages, bleedings and undesirable vein buds which are formed between the layers. There are alternative treatment methods.
Laser Treatment of Yellow Spot Disease
It is the oldest treatment method of the wet type of yellow spot disease. The treatable occasions with this method are limited. Only %15 of the wet type of yellow spot diseases can be treated standard laser method. Undesirable vein buds might relapse in %50 of the patients which are treated by laser.
Photodynamic Treatment (PDT)
PDT has been developed after the standard laser treatment, and it has been applied for 10 years. A material called Verteporfin (Visudyne®), which adheres to the damaged tissue in the eye, is injected intravenously. After that a laser treatment of 83 seconds is applied. It is beneficial in some types of wet type yellow spot disease. It doesn’t increase the vision however keeps the vision %50-60 within the 1-year treatment period. It’s rarely used as a solo treatment method in the suitable cases. Other than that, it is used combined with the injectable medications.
Anti - VEGF Treatment
It’s the latest developed and most popular treatment method for the wet type of yellow spot disease. It consists of Bevacizumab (Avastin, Altuzan), Ranibizumab alike active substances.
Undesirable vein buds form between the layers at the posterior eye wall in the wet type of yellow spot disease. This treatment prevents the formation of those vein buds and neutralizes the growth factors; stops bleedings and leakages. This treatment is repeated monthly and directly injected in the eye.
Success rate of the protection of the vision is over %90 in 1 year period. Success rate of the improvement of the vision is around %30.
How is the Follow - Up?
Both wet and dry type yellow spot diseases need follow ups. In the stage of diagnosis, a FFA – Fundus Fluorescein Angiography and Retinal Topography (OCT – Optic Coherence Tomography) should be performed.