Human Pathophysiology

Age-Related Macular Degeneration: Diagnosis and Treatment

The Diagnosis

From Mr. Ally’s complaints, he could be suffering from age-related macular degeneration (AMD). AMD is an eye disease that affects the retina. The disease occurs when the macula (a part of the retina) is damaged. The macula is located close to the retina’s center, and its core function is to process clear, sharp, and straightforward vision. In this regard, the macula is responsible for people’s color and central vision. Each individual might depict varying AMD signs and symptoms. However, the most common clinical manifestations include a dark spot at the eye’s central vision, fuzzy or blurry vision, loss of central vision, strain in recognizing familiar faces, and straight lines appearing wavy.

AMD occurs in “dry” and “wet” forms. The “dry” type is the most prevalent one, accounting for about 90% of all AMD cases (Hernández-Zimbrón et al., 2018). The “dry” form is defined by a progressive and slow dysfunction of the eye’s retinal pigment epithelium, retinal degeneration, and photoreceptor loss. Furthermore, AMD develops in three stages that include early, intermediate, and late stages. During the early stage, vision remains unaffected, while an individual’s vision becomes blurry in the intermediate stage. However, in the late stage, central vision fails completely. In addition, AMD is diagnosed through various tests that include the visual field test, fluorescein angiography, the dilated eye exam, and OCT.

During the visual field test, an ophthalmologist uses an Amsler grid that contains a grid of straight lines and a dot at the center. The eye specialist asks a client to identify dark, blurry, or wavy sections of the grid. Significant distortion might indicate AMD. On the other hand, the dilated eye exam employs eye drops to dilate the eyes, after which the ophthalmologist uses a lens to inspect the eye for any complications. On the other hand, in the fluorescein angiography test, the eye specialist injects fluorescein into a vein in the arm, then tracks it as it travels through the eye's blood vessels, resulting in photos that can indicate leakage in the macula (Johns Hopkins Medicine, n.d.). In addition, OCT takes images of the retina and macula.

The reason behind Floaters and Dark Spots in the Visual Field

The dark spots and eye floaters are caused by an irregularity of the virtuous humor, the gel-like fluid that maintains the eye shape. This change casts a shadow on an individual’s retina, creating a blocked vision that develops into dark spots and floaters that affect an individual's central vision.

How the Doctor would Treat Mr. Ally

Currently, there is no dry AMD cure or treatment. However, ophthalmologists can employ vision rehabilitation programs to develop Mr. Ally’s visual skills and improve his capabilities in undertaking daily activities. However, there are various treatments that might slow down the “wet” AMD progression to avert severe loss of vision. First, the doctor can employ anti-angiogenic drugs. The doctor should inject the drug into Mr. Ally’s eye. Anti-angiogenic drugs prevent new blood vessels from developing and block leakage from dysfunctional vessels associated with wet macular degeneration (Nazario, 2022). Noteworthy, the doctor shall need to repeat this treatment during Mr. Ally’s follow-up visits.

In addition to the anti-angiogenic drugs, the doctor might use photodynamic laser therapy to treat Mr. Ally’s condition. This treatment entails a two-step treatment employing light-sensitive drugs to damage dysfunctional and abnormal blood vessels. In this treatment, the doctor shall inject the medication into Mr. Ally’s eye to get absorbed into his eye’s blood vessels. Next, the doctor shall shine a laser into the eye so as to activate the drug, consequently damaging the abnormal blood vessels. In addition, the doctor can use laser therapy or low vision aids to treat Mr. Ally’s AMD. Laser therapy uses a high-energy laser light that destroys abnormally growing blood vessels. At the same time, low vision aids shall grant Mr. Ally devices with electronics or special lenses that enlarge small images of nearby objects, leading to visual clarity. These aids include large print products such as clocks, phones, electronic glasses, glasses with binoculars or special lenses, and reading magnifiers that can be electronic or handheld.