MACULAR DEGENERATION (YELLOW SPOT)


Yellow spot disease (macular degeneration) is a retinal disease that affects

central vision. It is quite common after the age of 55 and may lead to loss of vision in the event of progression.

Who does yellow spot disease affect?

• People older than 55 years of age

• Those with hereditary risk

• Smokers

Risk Factors

The main risk factors for age-related yellow spot disease include the person's age and hereditary characteristics. Other risk factors are hypertension, smoking, nutrition, elevated lipid-cholesterol levels, long-term exposure to sunlight and being overweight.

Symptoms of the Disease

• Loss of vision

• Wavy or broken view of objects/lines

• Shadows in front of the eye

• Impaired visual quality

• Trouble discerning colors

Age-related and hereditary factors are impossible to eliminate. However, other risk factors can be controlled. If there is hypertension, it can be controlled. If smoking, the patient should quit. Filter sunglasses should be worn for sun protection. A Mediterranean diet is recommended. It is recommended to avoid butter, red meat and cholesterol-containing food.

How many types of yellow spot disease are there and what are their results?

There are two types of yellow spot disease; dry and wet. The dry type accounts for 90% and the wet type accounts for 10% of all cases. However, early diagnosis is more important in the wet type since it leads to loss of vision. Progressing more rapidly than the dry type, this disease leads to sudden loss of vision accompanied by impaired color vision and a loss in contrast sensitivity, and to blindness because of bleeding in the new vessels that are formed in the retina and macula over time.

Treatment of Yellow Spot Disease

Preventive treatment is given in the dry type of yellow spot disease; intraocular injection and photodynamic treatment is administered in the wet type. Antioxidant vitamins A, C and E, lutein and zinc are used in preventive therapy. Intraocular injections are made by numbing the eye with an eye drop. The patient feels no pain during this procedure. In photodynamic therapy, a drug called verteporfin is first administered intravenously in a special combination and a low power laser is then applied.

Drug Injection in the Treatment of Yellow Spot Disease

A kind of protein (anti-VEGF antibody) is used for intraocular injection therapy. FDA-approved anti-VEGF drugs are injected into the eye with a needle for treatment of the wet type of yellow spot disease, which occurs in one in every three people aged 75-85 years. The anti-VEGF drug used during the treatment inhibits the protein which is released by the eye cells behind the eye in the event of disease and forms new vessels, thus preventing loss of vision. Injected into the eye at 4-6 week intervals, the drug stops the development of new vessels in the yellow spot and improves the patient's complaints significantly. The injection is made at least 3 times but some patients require more. Injection intervals vary between 4-6 weeks depending on the patient's response to therapy.

If untreated, yellow spot disease results in 95% loss of vision and ultimately in total loss of vision. Vision is reduced to a level which is legally accepted as blindness and patients become unable to see what they are looking at. For instance, the patient cannot see the face of the person in front of them, but can see their

arm or leg. These patients usually cannot leave their house alone; they can do their house chores by themselves but need the help of others in many tasks. Since they can't see, they can't read, write, watch TV or drive.

Amsler Grid Test in Yellow Spot Disease

This test is not the equivalent of a routine eye exam. However, it is a graph that you can self-administer to identify the early symptoms of yellow spot disease. Experts recommend that everyone older than 40 years of age take this test.

GRAPH

Method of Administering the Amsler Grid Test

• Wear your eyeglasses or contact lenses if you use a pair.

• In a well-lit room, hold the above graph approximately 30-40 cm away from your face in a fixed way.

• Cover one eye with your hand and focus on the dot in the middle. You should be able to see all 4 corners of the large square in the

graph.

• Test your other eye in the same way.

• You could have symptoms of yellow spot disease if the lines appear wavy, broken or blurry or if you can't see the corners.

In that case, you should see an ophthalmologist specialized in retinal diseases as soon as possible.