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Maculopathy: causes, diagnosis and treatment

25 February 20246 January 2024 by Redazione My Special Doctor

Maculopathy is a disease that affects the retina, to be exact its most important part for vision that is the central part, called the macula. This important region of the eye can go through a variety of different processes; but most frequently the macular region is affected by aging processes in the retina and neighboring tissues, which is why it is commonly referred to as Macular Degeneration (DM). DM is bilateral in most cases and generally has a progressive course.

Maculopathy, which usually appears beginning in the sixth decade of life, constitutes one of the most frequent causes of legal blindness in the Western world. In fact, the condition affects 18-20% of the elderly population, with prevalence for the female sex. In industrialized countries it is the leading cause of irreversible loss of central vision after age 55, causing 41 percent of cases of legal blindness according to WHO.

The causes

The causes of maculopathy have not yet been fully proven, but several risk factors have been identified: age over 50, cigarette smoking habit, alcohol abuse, sedentary lifestyle, obesity, high blood pressure, and diet low in antioxidants. A genetic origin is also documented, as familiarity also appears to be a major risk factor, especially if first-degree relatives are affected.

With aging processes, the blood and nutrient supply is reduced, that is, the delicate mechanisms that oversee the nutrition of worn retinal cells are altered. This results in an accumulation of “waste” below the macula of both eyes that alters the function of the cells deputed to vision. The disturbances and decline in visual acuity are a function of the subsequent disappearance (atrophy) of these cells.

Therapy

In the therapy of neovascular-type age-related macular degeneration, i.e., the UMIDA form, the goal is to counteract the formation-or induce the regression-of new vessels and the subsequent reduction of edema and hemorrhage in the macular area. In particular, there are two treatments that have demonstrated real effectiveness:

Intravitreal injections with anti-VEGF drugs: this therapy takes advantage of the action of drugs that, when injected inside the eyeball, and exactly into the vitreous (that gelatinous substance that fills the eye cavities), interact with the neovascularization process. They are named anti-angiogenic drugs, that is, drugs that inhibit the formation of the abnormal neovases responsible for macular degeneration by binding and promoting the elimination of tissue growth factors that are released into the vitreous by damaged or suffering retinal cells.
Laser therapy: laser therapy in neovascular macular degeneration uses laser energy directed toward the retinal lesion (neovessus), which causes regression or destruction of the neovessus itself.

Rapid timing in diagnosis and administration of therapy are critical in this condition. InWHO ‘s recommendations to put in place strategies to stop what some are calling an epidemic, it is stressed that the most industrialized countries, whose life expectancy has now exceeded 80 years, are at greatest risk. Macular degeneration predominantly affects the elderly population. And Italy becomes a high-risk country. “That’s why it is indispensable,” argues Lucio Buratto, scientific director of the Ambrosian Ophthalmic Center, “a widespread information action because, as from the demographic survey I had carried out, it transpires that only 10 percent of respondents know what maculopathy is and what serious consequences it entails.

Sunglasses: an important act of prevention

26 February 20246 January 2024 by MinnieLuongo

It is not only about looks but also about health and prevention for our eyes. In fact, they too need protection in summer. Just like the skin. Yet only 15 percent of Italians always use sunglasses, while 30 percent rarely use them. And the most at-risk groups, represented by the extreme age groups, are the most exposed: 60 percent of children between two and six years old forget to wear them, and among the elderly this percentage is even higher.

Beware of the sun

But why is the sun one of the greatest dangers to our eyesight? Eighty percent of the information that reaches our brains goes right through our eyes, which are therefore always operational, in any situation. In addition to the long duration of exposure to light, however, it should be pointed out that ultraviolet rays, as is true for the skin, can damage the retina, the sensitive tissue of the eye, triggering degenerative processes over time that are responsible for declining visual acuity in old age.

That’s why sunglasses, hat and T-shirt are essential to defend yourself from UV rays, especially where there are reflective surfaces, such as sand and water at the seaside, rocks and glaciers in high mountains. Even children with corrective means, must be provided with graduated sunglasses. And remember that light-eyed individuals are the most vulnerable. Therefore, the use of certified lenses preserves the health of our eyes.

The rules to follow

1) Seeking advice from the optician, choose sunglasses according to the use to be made of them and the places to which you are to go. For example, whether it is to be worn every day, for sports or driving, whether it will be used in the city or on vacation.

2) Minimize exposure to the sun from 10 a.m. to 4 p.m.

3) For nearsighted people, brown sunglass lenses are preferable, while for farsighted people, gray-green is better, with lenses that can be either graded or progressive.

4) Remember to wear glasses even in the shade and even if the sky is cloudy, to protect your eyes from reflected radiation.

Are you protecting your eyes?

21 February 20246 January 2024 by Redazione My Special Doctor

Sight is the most valuable asset. And those who suffer from common vision disorders, such as myopia or presbyopia, or the annoying and increasingly common dry eye syndrome know that this is not just a popular saying. Seeing well is crucial to ensuring a good quality of life, so it is essential to take a few steps every day to protect your eyes and have regular checkups, especially during childhood and after age 40. How do you guys deal with it? Here is a test to find out.

Sight: when it is transiently reduced

15 February 20246 January 2024 by Redazione My Special Doctor

Nowadays, when eyes are used intensively and protractedly, often in inadequate lighting conditions, suffering from some visual defect or transient eye irritation and fatigue is quite common at any age. Getting regular eye examinations is a must, but it is usually nothing serious. When, on the other hand, the decline in visual capacity is sudden and substantial, resulting in temporary partial or total blindness in one or (more rarely) both eyes, immediate referral to a medical professional or emergency room for a thorough evaluation of the situation and the causes that may have led to it. In fact, in these cases, there may be a vascular or neurological pathology at the origin that needs to be treated quickly. Some information on this .

Visual disorders in adulthood: the main causes

15 February 20246 January 2024 by Redazione My Special Doctor

When you start to see poorly up close or from a distance in persistent way or you have a heavy head or eye discomfort after having read or used the computer for a long time, in most cases the basis is a “refractive defect” (such as myopia, presbyopia or astigmatism) or an as-yet undiagnosed dry eye syndrome. If you are over 60 years old, worsening vision may be related to the cataracts or age-related macular degeneration. In all cases, address immediately to the ophthalmologist helps to avoid discomfort and complications, as well as sometimes to Diagnose diseases that affect other organs or the whole body and that have worsening of vision among their characteristic symptoms. Here are the most common ones .

Visual dysfunction, a misrecognized symptom of Parkinson’s disease

12 February 20246 January 2024 by Redazione My Special Doctor

“The idea that visual symptoms may be associated with Parkinson’s disease is not new, but this is the first time it has been reported at the population level,” he told Medscape Medical News Ali Hamedani of the University of Pennsylvania in Philadelphia, lead author of a study published in European Journal of Neurology.

Analyzing data obtained through a large survey, U.S. researchers found that visual dysfunction is significantly more common in individuals with Parkinson’s disease than in the general adult population. However, this is a generally overlooked and untreated factor, even though it worsens the already compromised quality of life of these patients.

The survey was conducted on more than 150,000 individuals and calculated that people diagnosed with Parkinson’s disease were more than twice as likely to suffer from vision impairment in both near and far vision as the general population.

Vision problems had been repeatedly reported by the patients themselves, their caregivers and attending physicians. So, the suspicion was evidently already there, but the new study provides a confirmation supported by a large-scale survey, and the large number of data allows a statistical correlation to be documented that otherwise would not have been so stringent.

With colleague Allison Willis, Hamedani analyzed data of adults aged 50 years and older provided by the Survey of Health, Aging and Retirement in Europe. (SHARE), a multinational population health survey of people living in one of 27 European countries and Israel.

Although the risk of impaired distance vision was 2.55 higher (and near vision 2.07), people with Parkinson’s reported this difficulty to an ophthalmologist less often, so that the condition remained untreated in many cases.

The study authors report that there have been some suggestions of a subtle change in color vision in the years before Parkinson’s diagnosis, but it is unlikely that patients themselves will notice. “It could probably be found out if screening was done, but it is too early for any recommendations on that,” Hamedani said. Instead, the researcher suggested that physicians examine visual function in already diagnosed patients, although the nature and significance of these symptoms still appear unclear: we do not know whether the mechanism is the result of Parkinson’s-associated changes directly in the eyes or at the brain level.

Source:

Hamedani AG, Willis AW. Self-reported visual dysfunction in Parkinson disease: the Survey of Health, Ageing and Retirement in Europe. European Journal of Neurology 2019, 0: 1-6.