Understanding wet and dry macular degeneration

Dr. David Maberley, MD, FRCSC, Ophthalmologist

Duration: 3 minutes

The macula is a highly specialized area of the retina that is most important when it comes to vision and the general health of the retina. The organization of the photoreceptors is designed to give us fine detail and vision, and most of our color vision. Macular degeneration is a condition in which the photoreceptors and the supporting cells in this zone begin to slowly die or degenerate over time. The cause of this involves a combination of factors. The primary one is simply a combination of time, age and genetics. People may become aware of a problem when they experience symptoms such as blurry or fuzzy vision, difficulty recognizing familiar faces, straight lines appear wavy, and some may see a dark, empty area or blind spot in the center of vision.

The photoreceptor cells are a highly metabolically active and generate waste product, that in some patients is not cleared and can promote inflammation and cell dropout. (That's a complicated answer that I think David should say more about) Wet and/or dry macular degeneration is what we refer to when these cells are slowly dying and degenerating. Without any additional complication, it’s basically slow cell death. Wet macular degeneration refers to the situation in which cells dropout or die, creating an opening or an avenue for blood vessels to grow from the space behind the retina into the retinal tissue itself. A simple analogy is that dry macular degeneration is like a pavement or sidewalk where the concrete is getting cracked, whereas wet macular degeneration is when grass or weeds begin to grow through those cracks. If the blood vessels begin to grow through the retina, vision can deteriorate rapidly as they can bleed and create scarring.

The treatment of dry macular degeneration can be challenging as we have no effective way to reverse this process. At the present time, there is evidence that dietary supplements and nutrition can slow the deterioration process. (Again, it's something you should check with David). The medical treatment of wet macular degeneration involves the injection of anti vascular endothelial growth factor, which are also known as anti-VEGF injections, into the vitreous cavity. These medications help to prevent new blood vessel growth and in turn slows down the process of vision loss.

There have been studies that suggest vitamin supplementation and certain dietary changes can affect the rate of deterioration due to macular degeneration. For example, foods that are good for wet macular degeneration include vegetables that are high in lutein, such as spinach, kale and red peppers, and also foods that contain a property called zeaxanthin, which include orange sweet peppers, broccoli, and dark leafy greens. Learning more about how foods can help macular degeneration is a great way to help manage this condition. If you have further questions about wet or dry macular degeneration, please speak to your local optometrist, family physician or ophthalmologist.

Presenter: Dr. David Maberley, Ophthalmologist, Ottawa, ON

Local Practitioners: Ophthalmologist