Is Macular Degeneration Hereditary?

Just as age adversely affects our outward, youthful appearance so does it affect the functioning of our organs and body parts. A general feeling of lethargy and tiredness takes over us and we notice how certain organs giveaway our age – one of them being our eyes. Come 40 and our vision diminishes, often getting blurry. Reading without a single-vision glass or progressive goggles becomes next to impossible. But apart from this, another disease affecting the vision of certain people is macular degeneration. In this article, we will cover the linkage of macular degeneration to one’s lineage and what care needs to be taken.

What Is Macular Degeneration

The central portion of our retina is responsible for our central, straight-ahead vision. This portion is known as the macula. After the age of 55, many people experience an alteration in their central vision and oftentimes it happens due to the degeneration of the macula, hence the term age-macular degeneration or AMD. This disease however does not cause total blindness as it does not harm the peripheral vision. Since it is a painless illness many people don’t realize it at the onset of the disease. Classified as dry AMD and wet AMD, this disease can affect either one eye or both the eyes. Dry AMD is known to occur in the majority of the cases whereas wet AMD occurs seldom, comparatively. Various factors can lead to this illness – some being environmental in nature and others related to family history. Smoking, excess body weight, diabetes, high blood pressure, cataract surgery, lack of physical activities, gender, race, iris color, diabetes, excessive exposure to sunlight are also contributing factors to this illness. At present, there is no specific cure for dry AMD except slowing down its progression. Wet AMD can be treated to an extent if detection of the disease is done in the early stages.

Symptoms

For dry AMD symptoms are as follows:

• Blurred vision
• Straining to read, write, see clearly in dim light.
• A reduced vision of what is seen straight ahead.
• Need for bright light.
• Straight lines seem distorted.
• Having trouble recognizing faces of people unless very close.
• Symptoms appear gradually.

For wet AMD most symptoms are the same as that of dry AMD except for the below:

• Vision appears hazy or fuzzy.
• The appearance of a blind spot in the eye
• Symptoms appear suddenly and can go from bad to worse rapidly.

Hereditary Link To Macular Degeneration

Various studies conducted over the subject of AMD have provided results substantiating the fact that those with a family history of AMD do stand a greater risk of getting the disease as compared to those without a family history of AMD. Recent studies have also found out sequence changes in some genes thereby increasing the risk, especially in the gene by the name of complement that is a series of proteins that forms a part of our immune system. Other genes conferring the risk of AMD are the gene by the name ARMS2/HTRA, the ones responsible for cholesterol metabolism, cell signaling as well as those that produce collagen. Of the aforementioned, complement is the gene that is most associated with AMD. This is because complement was shown activated in the retinas of those with AMD, particularly inside the drusen. These findings have led researchers to establish a genetic link to AMD. Owing to these findings, doctors often prescribe complement inhibitors to patients of AMD to either treat the condition or to slow down its progression. Intensive researches are still underway to establish the linkage of the other genes with AMD, with special focus being thrown on ARMS2/HTRA.

Researches and advancements in DNA sequencing technology and a surplus of information on the meaning of DNA sequence changes have made genetic testing more practical now as compared to before. Such advancements will therefore better guide doctors in prescribing treatments for all illnesses including AMD. Also, doctors highly recommend that people, especially those above the age of 60, observing gradual or sudden vision changes in their central vision should check for a family history of the disease and book an appointment with their ophthalmologist at the earliest.

Complications Due To AMD

The main concern for those having macular degeneration is the inability to perform certain everyday tasks by themselves. Simple tasks like reading, writing, recognizing faces, driving all become difficult and challenging as the disease progresses and this can lead to stress and depression in some people. Another reason for concern is that a certain percentage of people suffering from AMD experience visual hallucinations. This is because, as vision diminishes the brain takes up wrong signals and creates false images. Not true for all patients with AMD that they would require mental support but if the hallucinations persist it is always advisable to approach a mental health expert, and share your worries and concerns with regards to the disease to be able to better cope with it.

Diagnosis

Macular degeneration is diagnosed by an ophthalmologist or an optometrist. Some of the eye examinations conducted by them to detect the disease are as follows:

1. Dilated eye exam – where the doctor dilates the pupils using eye drops to get a better view of the retina.
2. Autofluorescence – in this method, the retina is studied using autofluorescence photos to understand and analyze the progression of the disease.
3. Fluorescein Angiography – this test is done if the doctor suspects you have wet AMD where fluid leaking is involved. A fluorescent dye is injected into the arm and traced through the blood vessels to the retina. The appearance of fluorescent patches indicates AMD.
4. Amsler grid – mimicking a graph paper, the Amsler grid is used to detect early stages of the illness where vision changes are monitored and AMD is diagnosed as per the doctor’s findings.
5. Tonometry – doctors prescribe a numbing eye-drop before this test is conducted and then measure eye pressure.
6. Optical Coherence Tomography – when doctors suspect a patient of having advanced AMD, they use this imaging technique where they can measure the different layers of the retina and their related thickness. Thinning of the retina indicates geographic atrophy.

Prevention

Following the below-mentioned habits may help slow down the progression of macular degeneration:

• Maintain one’s body weight at an optimal range at all times. Obesity can lead to macular degeneration as well as various other illnesses.
• After the age of 40, get your eyes checked regularly.
• Consume a diet rich in vitamins and minerals. Make sure to intake a surplus of food rich in antioxidants as they help to keep many diseases at bay.
• Smokers should call it a day and get rid of this unhealthy habit altogether.
• Stay fit and healthy by following a routine exercise regime. Regular exercise not only helps to keep our weight under control but it also works as a mood lifter.
• Keep a check on the overall existing health conditions, ensuring not to skip the prescribed medications.
• Make sure that the blood pressure is maintained at a normal.
• Protect the eyes from direct sunlight by wearing glasses and hats, whenever required.

Conclusion

A general rule of thumb is to never take our health for granted. Be it concerning the eye or any other organ, one must not shy away from approaching healthcare professionals when needed, to discuss health concerns, to be able to better manage the disease. It is true that for certain hereditary diseases, there is a greater possibility for someone down the lineage to contract the disease in their lifetime but the more care we shower upon our body and overall health, the better we can manage illnesses and lead peaceful lives in the long run.