so you've heard about macular degeneration and you probably know that
is often described as age-related macular degeneration in this video I'm
gonna explain exactly what it is and also whether it's just an inevitable
part of getting old that we all just simply have to live with. Hey what is
happening? My name is Martin Oguzie, thank you so
much for joining me. If you're new here please think about subscribing to the
channel. On this channel we're all about giving you eye care tips, how-to videos
and product reviews all designed to help you see better, see more comfortably and,
be less anxious about your eyes. So let's get started with today's video. Now if
you know anybody with age-related macular degeneration you know that it's
quite a devastating condition to the person's vision and also to your
lifestyle. However for my peace of mind point today I just want to remind you of
the fact that macular degeneration is something that affects the part of the
retina that we call the macula which is located centrally in the vision and what
that means is that although you're gonna lose potentially, in your central vision
you'll always have your peripheral vision there as well so you're not going
to be in total darkness. Now while that may not be the most comforting
thing to hear it's still something that is vitally important to keep in mind and
it doe reassure many people of the fact that you will still have a vision
that is still functional and is useful for certain things.
having said that, as an optometrist I come across many people who I see for the
first time who had a diagnosis of macular degeneration but nobody's ever
told them that they should be taking action to try and limit the rate of
progression or to delay the development of the most aggressive and advanced
stages of macular degeneration. So what is macular degeneration now when your
optometrist or your ophthalmologist has a look at the back of your eyes there are
a couple of key landmarks that we look out for one of the most important is the
area called the macula. Now it looks like a red dark spot and the reason that
looks like that is because it has lots of cells packed in there for
high-definition vision. This area is also a concave so it kind of bows in a little
bit and this combination of features gives
it that darker looking color now macular degeneration itself is a
general term that describes anything that causes a degeneration in that
macular area so one of the most common types of degeneration of the macula is
what we call age-related macular degeneration now the term age-related
macular degeneration is a little bit deceptive I think in that it makes it
sound like we're all gonna get macular degeneration as we get older, but in
actual fact most people will not. So the fact that it's got the name
"age-related" macular degeneration helps us to distinguish that it's not due to
other forms of degeneration that can occur due to other disease processes so
to help us understand a little bit about what goes on in the age-related macular
degeneration of process let's have a look at the structure of the retina in
the macular region so the innermost layer that's most relevant to this
discussion is called the photoreceptor layer and that's made out of your rods
and your cones then further routes we have retinal pigment epithelium layer
which is often abbreviated to RPE layer then further out we have a membrane
layer called the Brookes membrane then further out from that is a vascular
layer called the choroid and the choroid is just a bed of the vessels. Now to
explain age-related macular degeneration as a process is worth starting out at
the RPE layer. This layer is a highly important layer because it helps to
nourish the photoreceptors but it also has function in absorbing UV and blue
light so protecting deeper layers further out into the retina structure
now as part of the normal kind of metabolic process and the work that this
RPE layer does it does create debris overtime which normally would be pushed
out to the space between the Brookes membrane and the RPE layer. Now for
whatever reason, perhaps due to age; some of this debris that builds up and
doesn't get moved along but instead builds up in the Brooks membrane and
also in the area between the Brooks membrane and the RPE layer as a result
of the Brooks membrane, starts to alter in thickness and starts to have an
regularity about it and this then starts to affect, along with
the rpe starts to affect the performance and the health of the rpe layer. The
result is that a retinal pigment epithelium cells and will start to die
off and when they die off then you start to overtime get the dying off of the
photoreceptors that lie above the RPE cells. As eye care professionals, when
we start to see the yellow deposits that we call drusen in your examination then
this is an indication of macular degeneration. If it's only drusen that we
see then this is what we call "dry" macular degeneration
now when dry macular degeneration progresses then it may initiate an
inflammatory response in that area of the retina and the inflammatory response
starts to initiate a range of processes, one of the most important of
which is the releasing of growth factors and the growth factor then causes the
choroid to try and develop new blood vessels. This is quite a significant
event because new blood vessels that grow from the choroid area will try and
come and supply additional blood flow into the affected area and, when
this happens it's a problem because these new blood vessels are not well
formed, they're micro blood vessels and they're not really capable of supporting
the blood flow through them as a result these blood vessels will leak and will
start to bleed into the retina and into the macula area that has been affected.
When this happens, this then progresses to a type of macular
degeneration that we call "wet" macular degeneration. Now the distinction between
a dry and wet macular degeneration is the fact that the dry type only has
these yellow deposits which over time themselves can be harmful as well
because the photoreceptors in that area will start to degenerate and die-off.
It's all been affected by this buildup of this deposit that we called drusen
but the wet type is when we start to get these new vessel formations that leak
and the leak then becomes a real problem to to the site because all of the area where
blood is leaking starts to die-off really quickly and leads to a very rapid
loss of vision in that area. So in terms of categorizing the stage of development
of macular degeneration, there are effectively four phases so first of all
there is a phase of 1 where you have no presentation whatsoever of any drusen
and these yellow deposits so to all intents and purposes your retina is normal and
your macula is normal then you have stage 2 which is the early stage and in
this stage you may just have a few scattered small yellow deposits of the
drusen material. Now the next stage 3 is the intermediate stage where you may
have even just one medium-size drusen or you may have a few medium-size drusen in
that area and then the latter stage stage 4 is the advanced stage and at
this stage we may see bleeding and may also see lots of drusen causing what we might
describe as a geographic atrophy in that area so these kind of processes signify
that you've got to this advanced stage and certainly at the most advanced stage
level four we'll be seeing dramatic impact on your
central vision. Now when it comes to treatment of macular degeneration it's
important to note that there's actually no cure for macular degeneration and
that's true whether we're talking about the dry type or the wet type of the
condition but what there is is for people who have the wet type of macular
degeneration. It's critical that the bleeding is stopped because areas that
are affected with this blood you are vulnerable to a rapid dying off of
the cells in the area. So the treatment that's available is
two-fold really so, first of all, there's an option which involves laser and this
laser is designed to just seal off the area that's leaking. The downside of this
treatment is that it is a destructive treatment and that's to say that in the
area where they have blasted with laser effectively everything dies-off in that
area so we don't want to be doing lots of lasering because you're effectively
damaging a sensitive area and small areas in the macula. So the
alternative option is an injection with a type of medication that is designed
to stop these new vessels forming so these new vessels which form and leak
then the injection holds that process and it's proved to be highly effective
in stopping the progression of the bleeds and also new vessel
formation which then means it preserves people's sight for the long-term and
when I say long term that is with the proviso that you continue to have this
procedure done roughly about every 12 weeks. Now when you get the diagnosis of
macular degeneration it's always important for us to consider what stage
you're at in the process because this may have an impact on the treatment
that's going to be most relevant to you but also it's important because in the
early stages then you definitely should be taking proactive measures and steps
to try and delay the progression of the condition or even to stop it
advancing to the level that will impact your sight. Now research has
shown that one of the most effective ways of doing this is through nutrition
so if you're somebody who is certainly an intermediate stage then you need to
be taking the necessary nutritional steps to be able to help your eye and
potential your macula as much as possible and this may mean that
particularly if you are in the intermediate stage
it just may be more straightforward for you to go straight on to taking
supplements that contain all the necessary
vitamins, antioxidants and minerals as well and the
leading research on this is the AREDS study and the latest version of this
study is the AREDS 2 - so on the screen right now is the
recommended composition of the supplements that you should be taking to
have the most effective benefit in protecting your eyes from macular
degeneration and the advancement of vision loss now even if you don't have
any presentation of macular degeneration in fact we all really need to be taking
these ingredients into account in our daily meals just to protect our eyes as
much as possible now while macular degeneration is described as age-related
it's certainly by no means you know guaranteed that we're all gonna get
macular degeneration in later life in actual fact most people won't get
macular degeneration so it seems to be the case that you may be more
vulnerable if you don't have a good intake of certainly lutein and
zeaxanthin because they are found naturally at the retinal pigment
epithelium layer in your eye and as evidence suggests that having a low
dietary intake of lutein and zeaxanthin and meso-zeaxanthin then this can lead
to your pigment density being Lower than it ought to be and low retinal pigment
epithelium density is associated as well with higher damage from UV
light and blue light and this then can lead to some of the factors that lead to
macular degeneration progressing and developing later on in life as well. So
for my tip of the day I would say that if you're somebody at the intermediate
stage of macular degeneration you ought to be taking supplementation as well as
eating well generally anyway. This just helps to make sure that
you're getting the right formulation of these antioxidant vitamins as
the minerals recommended by the AREDS study just to give yourself the best
protection going forward. If you're somebody who doesn't have any
presentation of macular degeneration or perhaps you are in the early stages or
you've got a family history of it and you're concerned then you know looking
at the nutrition in your day to day diet then it's an important
adjustment to make just to make sure you're getting plenty of the
ingredients that contain lutein zeaxanthin, meso-zeaxanthin...
and a lot of the antioxidant vitamins as well so vitamin C vitamin E you know and
including as much of that in your diet as possible so that then just helps to
make sure that you're doing everything you can from a nutrition point of view
to protect your eyes going forward. If you found this video helpful then
please think about subscribing to the channel hit the notification bell and
also like and share this video that really helps out the channel so
lookout for my next video which I'm gonna post up here if you want tips to
help you with nutrition to protect you from macular degeneration so I look
forward to see you in that video. Take care!