Wet Macular Degeneration

1 What is Wet Macular Degeneration?

Wet age-related macular degeneration (AMD) is a progressive degenerative disease characterized by abnormal growth of blood vessels under the retina.

These new blood vessels leak blood and fluid into the region, lifting the macula from its normal position. This affects functioning of retina, resulting in blurring of central vision.

There is rapid and irreversible loss of vision. Many patients may not notice any changes in vision even with growth of blood vessels under the macula.

Wet AMD in one eye increases the risk in the other eye. It causes more vision loss when compared to dry AMD, the more common form of macular degeneration.

Dry AMD may also progress into wet AMD over a period of time. 

2 Symptoms

Vision loss is the most common symptom of wet macular degeneration. Symptoms of wet AMD that develop rapidly are:

  • Reduction in central vision
  • Reduced intensity of colors
  • Diminished brightness
  • Blind-spot in the field of vision
  • Blurred vision
  • Straight lines seen as bent 

The vision loss worsen rapidly, but does not affect peripheral vision.

3 Causes

The definitive cause of wet macular degeneration is not known. Many cases of dry AMD develop into wet AMD.

Loss of vision, the most common symptom of wet AMD, is caused by the abnormal growth of blood vessels under the macula.

The new blood vessels leak blood and fluid which gets collected in the area. This raises the macula from its normal position, affecting the functioning of retina. It is more prevalent among people above 65 years.

Many genes are linked to the development of this disease. Wet AMD runs in families. Smoking and being exposed to smoke also increases the risk of developing this degenerative condition.

Obesity increases the chance of progression of disease to a more advanced level.

Cardiovascular diseases are also important risk factors for the development of wet AMD. 

4 Making a Diagnosis

Complete eye examination is the first step in diagnosis of wet macular degeneration. Review of medical and family history helps in assessing the risk factors.

Presence of fluid or blood spots at the back of eye is indicative of wet AMD. These spots are revealed by examining the eye after dilation of pupil.

Amsler grid test helps to check for issues in the central vision. Patients with AMD see the straight lines of the grid as distorted or bent.

Retinal changes are noted with fluorescein angiography. In this procedure, colored dye is injected to trace the blood vessels of the eye.

Images of the eye reveal the changes in retina and blood vessels. Another dye-based diagnostic technique is indocyanine green angiography.

This procedure is used to confirm the diagnosis or to detect specific types of macular degeneration.

Optical coherence tomography produces cross-sectional images of retina which show the changes in retinal layer.  

5 Treatment

There is no cure for wet macular degeneration, but the progression of the disease can be controlled by early treatment.

Vision rehabilitation specialist helps in adapting to the changes in vision.

Medications

Medications that block the growth of new blood vessels help to alleviate the symptoms of wet AMD. Bevacizumab, Ranibizumab, and Aflibercept are commonly recommended to prevent the progression of the condition.

These medications are given as injections, once every month. These drugs may aid in shrinking the blood vessels. The macula may fit back into its normal space when the fluid in the area is absorbed. This helps retina to function normally resolving the symptoms to a certain extent.

Photodynamic therapy

In this procedure, injected drug verteporfin moves to the eye through blood. The drug is activated by focusing laser on the abnormal blood vessels of the eye. It blocks the blood vessels, stopping the leakage of fluid and blood into the area. This procedure is repeated to prevent the reopening of blood vessels.

Photocoagulation

Blood vessels can be blocked and sealed by using high-energy laser beams. This will prevent further damage and progression of disease.

6 Prevention

There is no sure way to prevent wet macular degeneration. People with a high risk of developing wet AMD should have regular eye checkups.

Disease progression can be slowed down by quitting smoking, eating plenty of green leafy vegetables, taking multivitamin supplements, taking fish oil supplements, maintaining healthy weight, keeping levels of cholesterol and blood pressure under control, and having regular eye checkups.

7 Alternative and Homeopathic Remedies

Diet high in carotenoids, blue berries, cherries, and fiber is an alternative remedy used for wet macular degeneration.

Antioxidants, astaxanthin, and zeaxanthin are also suggested for preventing degenerative damage by AMD. 

8 Lifestyle and Coping

Lifestyle changes help to control the progression of wet macular degeneration.

Healthy diet with plenty of fruits and vegetables, unsaturated fats, whole grains, and omega-3 fatty acids are also helpful.

Try out ways for using the remaining vision. Counselling can also help in living with limited vision due to AMD. 

9 Risks and Complications

There are several complications associated with wet macular degeneration.

Loss of vision due to wet AMD may result in depression and anxiety.

Some people may develop visual hallucinations due to reduced vision. 

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