4
As mentioned earlier, 10-15% of patients with dry ARMD will convert to
the more serious wet form of macular degeneration.
Due to oxidation stress in the macula, the body reacts by forming new
blood vessels
(“neovascularization”)
in an attempt to transfer more
oxygen to the area. Although the body’s intentions are for a good
reason, this action causes further deterioration of vision as they form
membranes that distort and cover the macula. Furthermore, these
vessels are very fragile causing edema and bleeding.
The appearance of
choroidal neovascularization
(i.e. pathological
and highly fragile vessels that invade the retina from the underlying
choroid) marks the transformation to wet ARMD. If the disease
remains without treatment, the fibrosis and scaring of the area will
eventually lead to total central vision loss.
ARMD usually affects both eyes although often in a random manner.
Initially most patients do not realize that their vision is impaired, espe-
cially if the disease is unilateral.
The first symptom is blurriness or distortion of objects at primary
gaze. This is especially profound while reading, when certain letters
or words appear missing. As the degeneration advances, simple daily
routines such as driving, watching television or even recognition of
faces becomes difficult.
ARMD wet type
How does the patient see with
ARMD?
Macular degeneration does not affect peripheral vision.
So, for ex-
ample, a patient with macular degeneration can clearly see the perim-
eter of a clock but not the central dials to read the time.
