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Treatment Of Yellow Spot Disease

Treatment Of Yellow Spot Disease

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
Smoking Cigarettes
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.


He graduated from the Faculty of Medicine at Hacettepe University (Medium of education: English) in 1997. He completed his specialty in Ophthalmology at Ege University Medical School, at the Ophthalmology Department. He became an Assistant Professor in 2006, and an Associate Professor, in 2010 and received the Professorship title in 2016. In 2003, he received a training on retinal and vitreoretinal surgery at the University of Helsinki's Cornea and Refractive Surgery and in 2017 as a visiting physician at the retinal section of George Washington University in the USA. His main areas of interest are Cataract, Retinal Diseases (Diabetes, Yellowhead Disease, Retinal Vein Diseases etc.), Corneal Diseases (Keratoconus, Dry Eye, Conjunctival Surface Diseases), Uvea (Behçet's Disease) Diseases. He scored over 6000 surgical cases in these areas. He has 36 scientific articles which have been published in international scientific indexes. He has over 80 presentations in various congresses. He has worked as a chapter writer and book editor in Turkish ophthalmology books. He has attended many national and international scientific meetings as a lecturer and panel speaker. He is an active member of the Turkish Ophthalmology Association (TOD) Cataract and Refractive Surgery Unit (2010), Turkish Ophthalmology Association (TOD) Cornea and Ocular Surface Unit (2010), TOD Uvea Unit (2010). Prof. Dr. Sinan EMRE can speak English. He is married and has one child.
He was born in Ankara in 1945. He attended TED Ankara College, İzmir Bornova Anatolian High School and Ege University, Faculty of Medicine between 1963 and 1969, respectively. Upon his graduation, he started his specialization at Ege University, Faculty of Medicine, Eye Diseases Department and assumed the title of Eye Diseases Specialist in 1971. Between 1974 and 1975, he performed his military service as an ophthalmologist in Hatay Military Hospital in İzmir. After that, he was educated on Retinal Diseases and Lasers in Ophthalmology Clinic of the Faculty of Medicine at University of Gant, Belgium for 1 year. In 1977, he assumed the title of Associate Professor of Ophthalmology, and he founded and operated Retina and Contact Lenses units in Ege University, Faculty of Medicine, Department of Eye Diseases. In 1982 he became a Professor of Eye Diseases. Between 1992 and 2000, he served as the Head of Department of Eye Diseases, Faculty of Medicine, Ege University. In the meantime, he published 3 books and more than 150 domestic and foreign scientific papers, and about 170 papers in national and international congresses. He is married to Dr. Nigar Erbakan and has two sons.
Dr Esat Çınar was born in Diyarbakır in 1976. He started İstanbul University, Faculty of Medicine in 1997 and graduated in 2003. He completed his speciality degree between 2003 and 2009 at İzmir Ege University, Faculty of Medicine, Ophthalmology Department. He was in charge of Glaucoma and Cornea Departments as a Deputy Associate Professor in İzmir University Hospital Faculty of Medicine, Department of Ophthalmology. He studied “Keratoplasty” in Ege University, Faculty of Medicine for 6 months (also known as “eye transplant”). He also was in charge of the controls of the premature babies’ in İzmir University Ophthalmology Department. He attended the course for vivisection both in clinical and laboratory fields for one month. His special interests are; Cataract surgery (multifocal, trifocal and thoric intraocular lenses), Cataract surgery with laser (Femtosecond Cataract), Keratoplasty, glaucoma surgery (non-penetrant surgeries such as viscocanalostomy, deep sclerotomy), Excimer Laser Surgeries (Lasik, Lasek, PRK), medical retinal diseases. He has many published articles in international indexes. He has many verbal and written presentations in national and international scientific meetings. He is an active member of the Turkish Association for Ophthalmology. He speaks fluent English and has one child.
He was born in Izmir, in 1971. He attended summer school at Mids School of English, Eastbourn, England for learning a foreign language while he was in Bornova Anatolian High School and graduated with a high degree. He started his medical education at Ege University and continued with his specialization at JL Uni-Giessen, Germany, where he had the chance of working peer to peer with names such as Prof. Dr. Karl W. Jacobi, Prof Dr. Herbert Kaufmann, Prof. Dr. S. Pavlovic. Then, he found the opportunity to further his education in the field of refractive surgery by working with the most important names, such as Prof. Dr. T. Kohnen, JWG Uni-Frankfurt, Prof. Dr. I. Pallikaris, University of Crete, Prof Dr. Mahmut Kaşkaloğlu, Ege University Faculty of Medicine and Kaşkaloğlu Eye Hospital. Besides, he did scientific studies about medical glaucoma treatment, which is his other field of interest, with Ass. Prof. Dr. Karl Georg Schmidt, CGC Uni-Dresden. He is a member of DOG, ESCRS, ISRS of the AAO and TOD. He is married and has one child.
He graduated from Hacettepe University Faculty of Medicine in 1998. He completed his speciality in İzmir Dokuz Eylül University Faculty of Medicine Department of Eye Diseases between 1998 and 2002. He studied Retinal Surgeries in Munich Ludwig – Maximillian University Faculty of Medicine, Department of Eye Diseases. Special Interests: Cataract Surgeries (Multifocal, Trifocal, Toric Intraocular Lenses), Laser Cataract Surgeries (Femtosecond, Laser Cataract), Excimer Laser Surgeries (Lasik, Lasek, PRK) and Medical & Surgical Retinal Surgeries, Eyelid Surgeries. He has many articles published which were also scientifically indexed. He has oral and poster presentations in national & international science meetings. He is an active member of Turkish Society of Ophthalmology. He speaks English & German well, and married with 2 children.
He graduated from Istanbul University, Faculty of Medicine and completed his specialty training in S.S.K Istanbul Hospital in 1984. He worked at Çanakkale State Hospital between 1984 and 2007. After 2007, he worked in private sector health units. He is an active member of The Turkish Ophthalmology Association and American Cataract and Refractive Association. Anterior segment (cataract) medical retina, glaucoma and contact lens are his areas of interest. He has a good command of English.
He was born in 1977. He graduated from Ege University. Fields of Interest: Cataract Surgery (Monofocal, Multifocal, Trifocal, EDOF, Toric Lenses) Excimer Laser (Femtosecond LASIK, PRK, No-Touch) ICL Keratoconus - Crosslink, Hard Contact Lens Application, Intrastromal Corneal Ring Strabismus Surgery Oculoplastic Surgery (Eyelid Aesthetic Surgery, Ectropium, Entropium, Ptosis, Probing, Tear Duct Obstruction) Pterygium Surgery (with Autograft) Glaucoma Medical and Laser Therapy Retinal Diseases (Intraocular Drug Injections, Diabetic Retinopathy, Yellow Spot Disease, Retinal Tears) Soft Contact Lens Inspection and Application He is a member of Turkish Association of Ophthalmology. He is married.
Dr. Kaan Okan Erdem was born in İzmir, in 1968. He finished middle school in Private İzmir Türk College and high school in Atatürk High School. He studied medicine in Selçuk University Faculty of Medicine. He is an active member of European Association of Cataract and Refractive Surgery, European Association of Ophthalmic Plastic and Reconstructive Surgery. He is interested in cataract, refractive surgery, oculoplastic and reconstructive surgery (upper and lower eyelids, tumour removals around the eye, entropium, ectropium ptosis, blepharoplasty), eye ultrasound, medical retinal and glaucoma. He speaks fluent English and married with 2 children.
He graduated from Dokuz September University Faculty of Medicine in 1996. He completed his specialized education in the Department of Ophthalmology of the Faculty of Medicine of the Aegean University between 1996-2001 and earned the title of ophthalmologist Dec. He has published numerous scientific articles that fall into international scientific indexes. There are numerous oral and poster presentations to national and international scientific meetings. He is an active member of the Turkish Ophthalmology Association (Tod). He speaks good English, Opr. Dr. Uğur Karagöz is the father of 2 children. Special interests: Cataract surgery (multifocal, trifocal, Toric intraocular lenses) Cataract surgery with laser (Femtosecond Laser Cataract) Excimer laser surgeries (Lasik, Lasek, PRK) Medical and surgical Retina Eyelid Surgeries
Born in Cyprus Serdarlı, he graduated from Nicosia Turkish High School. He graduated from Dokuz Eylul University Faculty of Medicine. He completed his specialization in Atatürk Health Site Yeşilyurt State Hospital with his thesis on the comparison of the rear camera lens application and the front camera lenses, which was started to be applied for the first time in the clinic under the management of Zühal Çakırca, the clinical chief. She worked as a contact lens center in İzmir for three years and then as chief physician at Karşıyaka Kızılay Fatma Kutluay Dispensary. He continued to work in Karşıyaka by establishing the Private Yalı Polyclinic in 2005 and the Private Yalı Eye Health Branch Center in 2007, his special interests are refraction and contact lenses. He is a member of the Turkish Ophthalmology Association.
He graduated from Ege University Faculty of Medicine in 1989. Specialization he completed his education in Izmir Education and Research between 1991-1994. He completed his Ophthalmology Department at the Hospital. International A large number of scientific articles included in scientific indexes have been published. Numerous oral and poster presentations to national and international scientific meetings has a presentation. He is an active member of the Turkish Ophthalmology Association (TOD). Fluent in English, Opr. Dr. Gazi Duman is married and has two children. Special interests: Cataract Surgery (multifocal, trifocal, toric intraocular lenses) Cataract Surgery with Laser (Femtosecond Laser Cataract) Excimer Laser Surgery (Lasik, Lasek, PRK) Medical and Surgical Retina Eyelid Surgery Strabismus Surgery