Ophthalmologists Advise Annual Eye Exam to Prevent Blinding Macular Degeneration as 15 Y.o. Becomes the Youngest Patient
Macular degeneration is one of the three major eye diseases that cause blindness worldwide and can result in blurred vision.
Although most of the patients are elderly, the youngest macular degeneration patient in Hong Kong is only 15 years old. Patients with high levels of cholesterol, blood pressure, blood sugar, and stress, as well as severe myopia, are considered the high-risk group.
In Hong Kong, the latest number of macular degeneration cases has increased by more than 1.5 times in 10 years.
The Hong Kong Ophthalmological Society and the Hong Kong Eye Hospital warn the public of any age to address the risk of macular degeneration, especially the people in the high-risk group, to visit an ophthalmologist for eye examination regularly.
Ophthalmologist Dr. Lawrence Iu Pui-leung advises citizens to pay special attention to the subset Polypoidal Choroid Vasculopathy (PCV), a more common eye disease variant in Asia.
PCV patients experience defects and distortion in the central field of vision and comparatively severe bleeding of the fundus at the back of the eye.
PCV causes 22 to 50 percent of wet macular degeneration.
On the other hand, the public should also stay diligent about the subset of Choroid Neovascularization (CNV). Adverse choroid hyperplasia, leakage, or bleeding may be observed in the macular area.
Delays in treatment increase the risk of blindness.
The causes of CNV include age-related macular degeneration, choroid injury, severe myopia, and endophthalmitis (inflammation of the inner coating of the eye). They can also be primary, meaning there is no specific cause of the disease, and people of any age can experience CNV.
Dr. Iu stated age-related macular degeneration (AMD) primarily affects older people.
Age-related macular degeneration is divided into dry and wet macular degeneration, while the former is more common.
Dry macular degeneration is usually due to the deterioration of photoreceptor cells and the accumulation of metabolites in the macular area.
Wet macular degeneration is caused by choroid vascular hyperplasia (the development of abnormal blood vessels in the layer below the retina), leading to a drastic decline in vision in a short period.
Another common type of age-related degeneration is an epiretinal membrane. A layer of fiber membrane grows on the surface of the macular. As the fiber membrane thickens and tightens, the retina becomes wrinkled and distorts images.
Older people with high cholesterol, blood pressure, and blood sugar are also prone to diabetic macular edema and retinal vein occlusion (RVO)—blood clots block the retinal veins causing a build-up of pressure.
In December 2018, Mr. Ng, an 80-year-old man’s right eye vision suddenly went blurry, and the center of his fovea became pitch-black.
Upon seeking treatment at an emergency room, he was diagnosed with retina macular hemorrhage in his right eye caused by PCV. It resulted in vision loss down to 10 percent in his right eye.
The doctor immediately arranged emergency treatment, including vascular endothelial growth factor (VEGF).
Initially, Mr.Ng needed frequent injections to treat and control his eye condition.
The number of injections decreased once the conditions stabilized and with regular follow-up and review.
Mr. Ng’s condition and eyesight improved after receiving regular vascular endothelial growth factor (VEGF).
Mr. Ng’s left eye has also developed PCV and macular edema in recent years. His ophthalmologist immediately arranged vascular endothelial growth factors for his left eye.
His left eye vision has been restored successfully after treatment.
High-risk patients, including people with severe myopia, diabetes, eye trauma, and retinal detachment, tend to experience epiretinal membrane (ERM). In more severe cases, it can result in macular holes and tissue defects in the center of the macular.
People with high-stress levels and anxiety are susceptible to central serous choroid retinopathy (CSC), a condition of fluid leakage and edema in the macular area.
Generally, CSC patients are between 25 and 55 years old.
Bad habits, such as frequent long-term close reading, will worsen myopia; people with severe myopia are more likely to suffer from eye diseases such as myopic macular degeneration, macular hole, macular hemorrhage, and choroid geographic atrophy.
Dr. Lai Hiu-ping, an ophthalmologist, refers to data from Kowloon district cases from 2011 to 2020, pointing out that the total number of PCV and CNV cases shot up by 60 percent every two years on average.
For every 100 patients with CNV or PCV, about six CNV and one PCV patient are people under 50, while the youngest case of CNV is 15 years old.
The record also shows a steady trend in patients of 20 to 30 years old every year.
Ophthalmology specialist Dr. Raymond Wong Lai-man says that many bad living habits are the culprit of macular degeneration.
Dr. Wong warns that the public can prevent macular degeneration by balancing diets, the three highs (blood pressure, blood sugar, and cholesterol), and controlling myopia conditions.
Wearing sunglasses outdoors and quitting smoking are also recommended.
“It is best for high-risk patients and those over 50 years old to have a yearly comprehensive eye exam by an ophthalmologist.” Dr. Wong added.