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Age-related macular degeneration is one of the most common causes of vision loss in those over 60 years of age. This disease is a disease that affects the VISION CENTER of the nerve layer located at the back of the eye. Damage to this region, which includes the visual center, negatively affects life. Retina is the name given to the nerve layer covering the back of the eye.
This nerve layer is very thin and ensures healthy perception of the image. The degree to which vision is affected in retinal diseases varies depending on where the damage, that is, the disease, occurs. For example, extensive damage to the edges of the retina, that is, away from the visual center, may not affect vision at all, while the slightest disease affecting the exact visual center may result in significant vision loss.
Symptoms of the disease
The disease may not cause serious symptoms at first. For this reason, periodic examinations are very important in diagnosing the disease. The symptoms of the disease are as follows.
- Vision loss
- Seeing objects as larger or smaller than they are
- Seeing objects and lines as crooked or broken
- Darkness in sight
- Deterioration in visual quality
- Color vision disorders
Types of Disease
There are two types of the disease: dry and wet type. The dry type is seen at a rate of 90%, while the frequency of the wet type is 10%. However, early diagnosis is more important in the wet type because it causes vision loss. The disease progresses faster than the dry type and causes sudden vision loss, deterioration of color vision and contrast sensitivity, and blindness as a result of bleeding in the new vessels formed in the retina and macula over time.
Dry Type: It occurs due to the accumulation of drusen (oily material) under the retinal layers. It progresses more slowly and causes vision loss in the long term.
Wet Type: It occurs when damaged capillaries in the patient area progress towards the retina. This type can lead to sudden vision loss. It is less common than the dry type, but it constitutes 80% of the patient group who develops severe vision loss. Especially if the patient has membrane (choroidal neovascular membrane-CNVM) formation in one eye, the other eye is also at risk (22% of the patients develop disease in the other eye within a year).
Both types are distinguished from each other by eye angiography (FFA) – eye tomography (OCT) analyzes and examination. In the FFA procedure, after a special dye (fluorescein) administered through the arm veins is introduced into the circulation system, photographs of the eye are taken for 10 minutes to investigate the presence of damaged capillaries. OCT method is taking very thin tomographic images of the eye nerve layer retina.
Required Analyzes
FFA and OCT assays; It is absolutely necessary in confirming the diagnosis, differentiating the types of the disease, determining the treatment and follow-up.
In the FFA procedure, after a special dye (fluorescein) administered through the arm veins is introduced into the circulation system, photographs of the eye are taken for 10 minutes to investigate the presence of damaged capillaries. OCT method is taking very thin tomographic images of the eye nerve layer retina.
Intraocular Injection Treatment
In the treatment of wet age-related macular degeneration (macular degeneration), intraocular injection is currently the most effective method in suitable patients.
Diabetes and age-related macular degeneration are diseases that affect the retina layer. They are the most common cause of vision loss in older ages. The common cause of vision loss in these diseases is the development of new blood vessel formation in the retina layer containing the visual center. Newly formed veins due to these diseases cannot perform their duties ideally because they are not as strong as the existing original vascular structure. As a result, fluid leaks out of the vessels and bleeding occurs. Retinal edema develops as a result of the existing fluid leaking out of the vessel, that is, collecting in the retina, causing loss of vision. Treatment of developing loss of vision may be permanent, but if it is delayed, it becomes difficult to treat.
New blood vessel formation in the retina may cause blindness. There are some treatment methods to prevent this situation. The aim of treatments is to choose the most effective and least risky method first. Recent studies have shown the effectiveness of Injection Treatment in retinal diseases. Injection therapy is a method applied by injecting a drug that prevents new blood vessel formation into the intraocular fluid. Studies have shown that this drug has no toxic effect on the retina. The fact that it is a useful method for those with diabetes and age-related macular degeneration (macular degeneration) has enabled a wide range of patients to benefit from this treatment.
How is intraocular injection administered?
A type of protein (anti-VEGF antibody) is used in intraocular injection treatment. In some cases (diabetes, etc.), it may be necessary to add some Triamcinolone to the anti-VEGF medication.
In the treatment of the wet type of macular degeneration, which is seen in one in every three people between the ages of 75-85, anti-VEGF drugs applied by needle injection into the eye are a successful method approved by the American Food and Drug Administration (FDA) and started to be applied in the wet type of the disease. The anti-VEGF drug used during treatment prevents vision loss by blocking the protein secreted by the eye cells behind the eye in case of disease and forming new blood vessels. The drug, injected into the eye at intervals of 4-6 weeks, stops the vascular development in the macular degeneration and greatly reduces the patient’s complaints.
How Many Times is the Injection Method Applied?
The injection is applied at least 3 times, but there are also patients who are administered more. Injection intervals vary between 4-6 weeks depending on the patient’s response to treatment.
What Happens If the Disease Is Not Treated?
If left untreated, vision decreases by 95% and the result is blindness. Although it does not cause complete blindness, vision decreases to a level that can be considered legally blind and patients become unable to see the point they are looking at. For example, a person cannot see the face of a person standing in front of him, but he can see his arm or leg.
Such patients cannot go out alone, they can do their own business at home, but they need the help of others in most of their work. Because they cannot see, they cannot read, write, watch television or drive.
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