Eye diseases
and treatments

What is age-related macular degeneration?

Age-related macular degeneration (AMD) is a disease of the middle part of the retina, the yellow spot (macula). The macula contains cones that perceive contrast and colors. They ensure that you see clearly. In age-related macular degeneration, those cones gradually die which causes you to see less sharp and fewer colors. In addition, loss of central vision is the result of changes that occur in response to the deposition of abnormal material (drusen) in the retina which can also cause you to see images distorted.

The rest of the retina that surrounds the macula, provides the complete picture of the environment. Those are the images you see with the corners of your eyes and are called your peripheral vision. Peripheral vision is usually spared in macular degeneration so that you can more or less independently find your way around the house and beyond.

But without a healthy macula, everyday activities such as reading or recognizing faces can become challenging. AMD is the most common cause of irreversible vision loss in the developed world in individuals over 50 years of age - making it a significant medical concern to be aware of and be prepared against.

CAUSES AND RISK FACTORS OF AGE-RELATED MACULAR DEGENERATION

Macular degeneration is a complex condition of which the exact causes remain largely unknown. It is described as an extreme exaggeration of the ‘normal’ aging progress of the retina. Age itself is the main risk factor. However, research has highlighted also other factors in developing AMD:

• Positive family history of AMD

• Female gender

• Smoking

• Being overweight (obesity)

• High blood pressure (hypertension)

• Hypercholesterolemia

• Cardiovascular disease

STAGES AND TYPES OF AGE-RELATED MACULAR DEGENERATION

AMD presents itself in various stages. The stages of AMD are determined by changes in the retina. As AMD progresses, two types of macular degeneration may be diagnosed:

NON-EXUDATIVE OR DRY MACULAR DEGENERATION

Dry Macular Degeneration is the most common form of AMD, affecting over 90% of those diagnosed. This slow-progressing condition causes an accumulation of small pale yellow deposits in the macula (drusen). These drusen reduce the number of cones in the macula. This will slowly make your vision worse, usually in both eyes. It can take years for your vision to deteriorate.

EXUDATIVE OR WET MACULAR DEGENERATION

Exudative or Wet Macular Degeneration affects the choroid, a critical layer surrounding the retina. This can lead to abnormal growth of blood vessels that cause bleeding and swelling in subretinal space - ultimately leading to retinal damage, detachment, and potentially blindness if left untreated.

AGE-RELATED MACULAR DEGENERATION SYMPTOMS

Age-related macular degeneration symptoms can occur in one or both eyes and affect your central vision. In the early stages, patients rarely experience symptoms. However, as the condition progresses and depending on the type of AMD, they may experience:

• Impaired central vision; difficulty reading, difficulty recognizing faces, distortion of perceived images (metamorphopsia)

• Positive central scotoma (something obstructing central vision)

• Decreased color brightness

• Loss of color vision

• Difficulty adapting to low light

Pay attention to whether you see distortion in the images of your surroundings. For example, a curve in something that should be straight, such as a curve in a window frame or a line in a text. This may indicate the onset of the more severe form of AMD.

TREATMENT

Depending on the stage of the AMD, there are different treatment options. If you are looking for surgical treatment options for AMD, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Diabetic Retinopathy (DR)

Diabetes affects the retina, which may lead to diabetic retinopathy (DR) – a significant ocular disease that can diminish vision or even cause blindness. Diabetic retinopathy is a condition that results in damage to the blood vessels of the retina, caused by extended periods of elevated sugar levels.

RISK FACTORS OF DIABETIC RETINOPATHY

• DR is more common in type 1 diabetes than in type 2 diabetes

• Duration of diabetes is the most important risk factor. In patients diagnosed before the age of 30 years, the incidence of DR after 10 years is 50%, and after 30 years 90%

• Poor blood glucose control. Raised HbA1c is associated with an increased risk of proliferative disease.

• Pregnancy is occasionally associated with the rapid progression of DR.

• Hypertension

• Kidney disease, if severe, is associated with worsening of DR.

• Asian or Afro-Caribbean background

• Other risk factors include obesity, hyperlipidaemia, and anemia.

STAGES OF DIABETIC RETINOPATHY

Early-stage diabetic retinopathy is usually mild and may not cause any symptoms. Mild cases involve tiny protrusions in retinal blood vessels, while more advanced stages include bleeding into the retina itself, lack of blood supply to the retina, growth of abnormal new blood vessels, bleeding into the vitreous body, scarring, tractional retinal detachment, etc. Diabetic retinopathy can cause irreversible damage when it advances to its more serious stages.

Screening for diabetic retinopathy has a key role in the early detection of the disease and offers essential preventative measures that stop symptoms from progressing beyond repair. More advanced cases of diabetic retinopathy might need laser or surgical treatment.

Diabetic Retinopathy Symptoms

• DR tends to cause no symptoms at the early stages

• Gradually or suddenly worsening of vision

• Blurry central vision

• Blind spot centrally or peripheral in your vision

• Shapes floating in your field of vision (floaters)

• Eye pain and redness in late stages

Treatment options

If you are looking for surgical treatment options for Diabetic Retinopathy, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Epiretinal membrane

An epiretinal membrane (Macula Pucker) is a thin sheet of proliferated retina glial cells that developes on the surface of the macula and can cause problems with central vision. 20% of patients with a Macula Pucker have it in both their eyes.

Epiretinal membrane symptoms

• Blurring of central vision

• Distortion of central vision (Metamorphopsia)

Causes of Epiretinal membrane

As people age, the vitreous inside of their eyes can pull away from the retina - resulting in epiretinal membranes. This is more common among those over 50. Epiretinal membranes may also form due to inflammation or post-surgical healing processes within the eye.

Treatment options

To treat an epiretinal membrane, a vitrectomy is needed. During the procedure, precise incisions are made in your eye to access and remove the vitreous material from within - allowing surgeons to delicately peel away any membrane present on your retina.

If you are looking for surgical treatment options for Epiretinal membrane, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Macula Hole

A macula hole is a small break in the center of the retina (macula). The macula is the central part of the eye that progresses what you see directly in front of you (your central vision).

Macula hole symptoms

• Blurring

• Distortion (small lines appearing wavy)

• A dark spot in the central vision

Causes of Macula Hole

Age-related degeneration is one of the most common causes of macular holes, as it can result in weaker and more fragile tissue that is more susceptible to tears or holes. They occur primarily in patients aged between 60 and 80 years old, affect women more frequently than men, and appear at a younger age in myopic eyes (nearsightedness). If a macular hole develops in one eye, there is a 5% to 15% risk of one developing in the other eye.

Other factors that may contribute to the development of a macular hole include injury or trauma, vitreous traction, diabetic eye disease, epiretinal membrane, chronic eye inflammation (uveitis), or retinal detachment.

Treatment options

If you are looking for surgical treatment options for Macula Hole, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Retinal detachment (RD)

The retina is a complex structure of nerve cells that lines the interior walls of your eyes. It functions much like the film in a camera, allowing you to see clearly by responding sensitively to light stimuli.

A retinal detachment (RD) is a separation of this light-sensitive membrane (the retina) in the back of the eye from its supporting layers which causes vision to be impaired.

Retinal detachment causes

The most common cause of a retinal detachment is a tear in the retina (a rhegmatogenous RD), which can occur in the event of a posterior vitreous detachment (PVD). A PVD is a natural change in the eye during adulthood when the vitreous gel that fills the eye begins to liquify and pull away from the retinal tissue, causing the vitreous to separate from the retina. During this process the retina can be pulled to such an extent that it will tear, allowing liquid vitreous to enter under the retina and detaching it from the lower layer of the eye. Patients with high levels of myopia (nearsightedness) have an increased risk of experiencing a retinal detachment. Forty percent of all retinal detachments occur in myopic eyes; the higher the refractive error the greater the risk of RD.

The retina can also tear secondary to other preexistent eye diseases.

Symptoms of Retinal Detachment

The classic alarming symptoms reported in about 60% of patients with a spontaneous rhegmatogenous RD are:

• Flashing lights (photopsia)

• Vitreous floaters

• Peripheral visual field defect which may progress to involve central vision

Treatment options

Fortunately, retinal detachment can typically be treated if caught early enough with a procedure such as retinal reattachment surgery.

Therefore, it's important to visit a doctor promptly if you are experiencing any symptoms associated with retinal detachment - such as floaters or flashes of light - to maximize treatment success and decrease the risk of further deterioration.

If you are looking for surgical treatment options for Retinal detachment, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Cataract

Cataract is a common eye condition in which the lens of the eye becomes cloudy or opaque, preventing light from properly passing through to the retina. This can lead to decreased vision and can eventually progress to complete blindness if left untreated.

Causes of Cataract

Age-related cataract is the most common type of cataract, as the normal process of aging causes the lens to harden and become cloudy. Age-related cataract can occur at any time after the age of 40.

While age is the most common cause of cataract, other causes may include congenital conditions at birth, steroid use, certain inflammatory eye diseases, and eye injury from trauma. For those with diabetes or certain other health issues, cataracts are especially prevalent.

Symptoms of cataract

Common cataract symptoms include blurred vision, difficulty seeing at night, faded colors, halos around lights, double vision in a single eye, and increasing nearsightedness. If cataract is not treated, it can cause blindness over time. It is important to be familiar with cataract symptoms and to speak to an eye care professional if you experience any changes in your vision. Annual checkups help to ensure cataracts are caught early on and proper treatment can be administered.

Treatment options

If you are looking for treatment options for cataract, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is Glaucoma

Glaucoma is one of the leading causes of blindness. It is characterized by loss of vision due to damage to the optic nerve.

In most cases, the cause of glaucoma is an increase in pressure within the eye that damages the nerve. Thankfully, there are treatment options available. By managing and monitoring the disease closely and implementing a treatment plan - typically via eye drops and/or surgery - it is possible to prevent further vision loss due to glaucoma.

Glaucoma symptoms

Glaucoma signs and symptoms typically develop over a period of years and are often detected during routine eye checks. The initial signs of glaucoma tend to be diminished peripheral vision, with both eyes usually being affected.

Treatment options

An early diagnosis of glaucoma may help preserve your vision. You will not go blind if your glaucoma is diagnosed early enough and you follow your treatment as instructed. Unfortunately, any loss of vision due to glaucoma cannot be reversed.

If you are looking for treatment options for Glaucoma, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.

What is a vitrectomy

A vitrectomy is a minimally invasive surgical procedure that can address vitreous and retinal issues. During a vitrectomy, your surgeon will extract the vitreous humor, the gel-like material that fills the middle of your eye, to be able to reach the backside of your eye. There is a wide variety of eye diseases that call for a vitrectomy and depending on the underlying pathology your surgeon will treat you accordingly. At the end of the surgery, the eye will be filled with a solution, gas, or oil.

Treatment options

If you are looking for surgical treatment options, plan a consultation with Prof. Marco Mura at the Department of Ophthalmology Arcispedale Sant’Anna in Ferrara or at Casa di Cura Toniolo in Bologna, Italy.