In eye hospitals, there are occasional conversations like this:
"Doctor, I have a yellow-brown spot on the white of my eye, can you help me see if I have macular disease?"
"You're not macular, it's a common conjunctival pigmentation."
"Huh? So what is macular disease? ”
"The macula is actually an important tissue part of our eyes, and the lesion in this part is macular disease." Macular degeneration is a fundus disease that is invisible to the naked eye. ”
Regarding the macula, the place where vision is sharpest, we need to re-recognize it. First of all, it is necessary to be familiar with the structure of the eye.
Human eye structure diagram ▼▼▼
The eye is like a camera: the lens in front of the eyeball focuses light on the retina, which is like the film of the camera, the optic nerve layer behind the eyeball, which can sense light and transmit images to the brain, and once the retina is damaged, it may not be able to recover. The macula is located in the central part of the retina, which is the densest place of the photoreceptor nerve, and there are healthy maculas to see the colorful world clearly.
Under normal circumstances, the visual examination of the human eye is to check the visual ability of the macular area. Retinal vision outside the macular area is low.
<h1 class= "pgc-h-arrow-right" > distorted "horizon" in the eyes of macular patients</h1>
There are many diseases that cause macular degeneration (AMD), high myopia, diabetes, etc. Once lesions occur in the macula area, the central vision is immediately affected, and its symptoms include: distorted vision, blurred vision, central visual field defect, decreased contrast sensitivity, decreased vision, decreased stereoscopic vision, and even blindness in severe cases.
In addition, the study found that the prevalence of macular degeneration increases with age, with 1 to 2 macular degeneration patients per 100 people over the age of 50 years, and with age, the prevalence increases more than 3 times in people aged 75 years or older.
<h1 class= "pgc-h-arrow-right" > macular degeneration can be divided into medical and surgical</h1>
Medical-related macular lesions are divided into: senile macular degeneration (degeneration), macular edema, macular hemorrhage, polyposis choroidal vascular lesions (PCV) and so on. Surgically related macular lesions include: macular cleavage, premacular membrane, macular cleavage and other lesions.
★ Treatment of medically related macular degeneration
Internal medicine treatment methods mainly include photodynamic therapy, laser photocoagulation, steroid injection, anti-VEGF drug intravitreal injection therapy, timely injection can prevent neovascularization, reduce edema or scarring, especially suitable for macular hemorrhage/edema patients.
1. Laser photocoagulation: it is a treatment method that uses laser cauterization to fix new blood vessels. It is only suitable for lesions where the neovascular blood vessels are some distance from the central fovea, otherwise the laser may cause damage to the surrounding normal tissue.
2. Photodynamic therapy (PDT): the photosensitizer is injected into the patient's blood, and selectively accumulates on the abnormal blood vessels under the retina, after a non-thermal laser activation, the photosensitizer can block these abnormally proliferative blood vessels, and does not affect other normal tissues on the retina, thereby controlling the deterioration of the disease, improving the patient's visual acuity, reducing the black shadow and correcting the distortion of the object seen, but can not restore the lost vision. Photodynamic therapy has a good effect on the treatment of PCV.
3. Steroid drug injection: Triamcinolone acetonide is a salt corticosteroid that can reduce the destruction of the blood-retinal barrier in the eye. Steroid vitreous injections must be sterilized under surface anesthesia, which can generally be performed in the clinic or operating room, and doctors must take all precautions to reduce the chance of infection.
4. Intravitreal injection of anti-VEGF drugs: the most mainstream method for the treatment of wet macular degeneration at home and abroad. Administered by intravitreal injection, the drug acts directly on the vascular endothelial growth factor (VEGF), a key factor affecting neovascularization, thereby inhibiting neovascularization, preventing further loss of vision or even improving vision.
★ Treatment of surgically associated macular degeneration
For patients with macular cleavage, premacular membrane and macular cleavage, there is currently no effective treatment drug, and surgery is the only way out, and the same is currently true internationally.
The earlier the operation, the more favorable it is for the patient's vision to recover. However, many patients in China are worried about whether the postoperative vision will be worse, so they dare not operate, and delay it again and again, which eventually leads to aggravation of the disease.
In fact, the latest macular surgery is a minimally invasive, seamless microsurgery, the postoperative effect is not bad, more than 80% of the condition has been improved, about 10% and preoperative, 10% worse than preoperative.
Overall, most patients end up with significant improvement in vision after surgery. Therefore, we advocate that patients "go to shallow Chinese medicine", receive surgery at the right time, and see the light again as soon as possible.
#Macula ##Breeze Plan# @Toutiao Health @Toutiao Qingyun Plan