Age-related macular degeneration is a degenerative eye condition that affects approximately 10 million Americans. In most cases, this causes vision loss in those over 40. Learn the difference between wet and dry macular degeneration in this article. Visit our clinic or you can check our website at https://www.ophthalmologybrooklyn.com to see all our offered services that can help you manage your eye conditions.

Wet vs. Dry macular degeneration

Diagnosis

For diagnosis of these conditions, the same tests are used. Your eye doctor first reviews your medical and family history and conducts a complete eye exam. To rule out the exact cause of the problem, your doctor may order some tests, like:

• Examination of the back of the eye: Your doctor may put some drops in your eyes to dilate them and use a special instrument to examine the back of your eye. Doctors try to detect a mottled appearance caused by yellow deposits (called drusen) under the retina. It is present in people with macular degeneration.
• A test for changes in the center of your vision: In this test, your doctor may use an Amsler grid to test for changes in the center of your vision. If you have macular degeneration, some of the straight lines in the grid may look faded, broken, or distorted.
• Fluorescein angiography: In this test, your doctor injects a dye into a vein in your arm. The dye travels and highlights the blood vessels in your eye. A special camera is used to take pictures of dye travelling through the blood vessels. The images can show whether your retinal or blood vessel changes, which can be the signs of wet macular degeneration.
• Indocyanine green angiography: Similar to fluorescein angiography, this test also uses an injected dye. It may be used alongside the fluorescein angiogram to identify specific types of macular degeneration.
• Optical coherence tomography: It is a non-invasive imaging test that shows detailed cross-sectional images of the retina. It identifies areas where the retina may be thinning, thickening, or swelling. These symptoms can be caused due to fluid buildup from leaking blood vessels in and under your retina.

Treatment

Currently, there is no treatment available to reverse the damage done by macular degeneration. However, many clinical trials are in progress. If your condition is diagnosed early, different steps are taken to slow down its progression based on the type of macular degeneration you develop.

For dry macular degeneration, these treatment options may be used:

• Vitamin supplements:

For people with intermediate or advanced disease, taking a high-dose formulation of antioxidants, vitamins, and minerals may help to lower their risk of vision loss. Research from the Age-related Eye Disease Study 2 (AREDS2) found benefits in a formulation that includes:

• 500 mg of vitamin C
• 400 IU of vitamin E
• 10 mg of lutein
• 2 mg of zeaxanthin
• 80 mg of zinc
• 2 mg of copper

While it doesn’t show any benefit of taking these supplements for people with early-disease macular degeneration, you still ask your doctor what supplements are right for you.

• Low vision rehabilitation:

Age-related macular degeneration doesn’t affect your side vision, so you’re not blind. However, it reduces or eliminates your central vision, which is required for reading, driving, and recognizing people’s faces. This therapy helps you find ways to adapt to your changing vision.

• Surgery to implant a telescopic lens:

For selected people with advanced dry macular degeneration in both eyes, this option is used to improve their vision by implanting a telescopic lens in one eye. The telescopic lens is equipped with lenses that magnify your field of vision. The telescopic lens implant may improve both distance and close-up vision, however with a very narrow field of view. It was helpful in an urban environment to identify street signs.

For wet macular degeneration, treatment focuses on slowing disease progression and preserving existing vision. If started early enough, treatment may recover some lost vision. It includes:

• Medications:

Some medicines like anti-VEGF drugs are used to stop the growth of new blood vessels. These medicines block the effects of growth signals the body sends to generate these new blood vessels. This is the first line of treatment for all stages of wet macular degeneration. The most common medications for wet macular degeneration are:

• Bevacizumab
• Ranibizumab
• Aflibercept
• Brolucizumab
• Faricimab-svoa

Some medications may be injected into the affected eye. You may need shots every 4 to 6 weeks (about 1 and a half months) to maintain its effects. In some instances, you may even recover some of your vision as the blood vessels shrink, and your body absorbs the fluid under the retina. However, eye shots increase the risks of conjunctival hemorrhage, increased eye pressure, infection, retinal detachment, and eye inflammation.

• Photodynamic therapy:

This procedure is used to treat irregular blood vessel growth, however it’s less common than treatment with anti-VEGF shots. In this therapy, the doctor injects a medicine called verteporfin into a vein in your arm. This medicine travels to blood vessels in your eye. Then the doctor shines a focused light from a special laser on the problem blood vessels in your eye. This activates the medicine, causing the problem of blood vessels to close and stop the leakage. While it may improve your vision and lower the rate of vision loss, you need to repeat the treatment over time to prevent blood vessels from reopening. Additionally, you need to avoid direct sunlight and bright lights until the drug gets cleared from your body which takes a few days.

• Photocoagulation:

In this therapy, your eye doctor uses a high-energy laser beam to seal problem blood vessels under the macula. It can stop the vessels from bleeding to lower further damage to the macula. Similar to photodynamic therapy, blood vessels may regrow, and require further treatment. The laser may also cause scarring that creates a blind spot. It is only recommended for a selected few because it is not a good option if you have a problem with blood vessels directly under the center of the macula. Also, the more damaged the macula is, the lower the likelihood of success of this procedure.

Besides medication and therapies, all other treatment options like low vision rehabilitation or home remedies are the same.

So, we can say wet and dry macular degeneration have different causes which require treatment accordingly.

If you are experiencing any symptoms of macular degeneration, visit our ophthalmology clinic in Brooklyn to get a professional diagnosis and treatment. At Doral Health and Wellness Ophthalmology Center, our eye doctors can help you recover from all types of eye conditions and diseases. To schedule an appointment, please call us at 1-347-384-5690 or visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212. You can also visit our website at https://www.ophthalmologybrooklyn.com