The importance of the macula

What is the macula?

The retina is the layer of tissue that lines the inside of our eye. On it are reflected the images of what we see. It is a highly vascularized layer, with many blood vessels that nourish it. On it we find two structures that are of the utmost importance. The first one is the optic nerve. Technically, the optic nerve could already be considered as a separate structure, but since its beginning is located right in the center of the retina, it is usually named as one more part of it. The other structure, which we are going to talk about today, is the macula. It is a small point located just next to the optic nerve. It has a different color from the rest of the retina because one of its parts, the fovea, has fewer blood vessels, which gives it a darker hue.

Why is the macula so important?

The macula barely represents 5% of all the space occupied by the retina. However, its importance is enormous since it is the structure that allows us to focus and fix our gaze, distinguish colors and perceive movement.

To understand the importance of the macula, it is enough to say that when we read a book, it is in this structure on which the words we are reading are projected; when we look at a person, it is on the stain where his face is reflected and when we are driving, it is on the stain where we fix the movements of the car in front so as not to crash.

Macular pathologies

As we have just said, the macula is of the utmost importance, since it is in charge of fine vision, that we can focus the images and see them clearly. Therefore, any damage that may be caused will imply a marked drop in vision. These are the most common diseases and their treatments.

Age-Related Macular Degeneration (AMD):

It is a degenerative disease that causes damage to the macula. It usually appears from the age of 50-60, which is why we say that it is associated with age. And there are two types:

It is a degenerative disease that causes damage to the macula. It usually appears from the age of 50-60, which is why we say that it is associated with age. And there are two types:

•       Dry AMD: It is the most common, 4 out of 5 cases of DMAE correspond to this type. It has a slow development so it is easier to detect it and treat it effectively in time. In this type of degeneration, the macula is affected by the appearance of what we call drusen. Drusen are small deposits of waste material that the body is unable to eliminate and accumulate in this area, causing blurred and distorted vision.

Currently there is no specific and effective treatment to treat it. It has simply been shown that the intake of certain supplements, some vitamins or antioxidants can slow down the progression of the disease.•

•       Wet AMD: It is the least common but the most dangerous. They have a sudden appearance and a very rapid development that causes a very accelerated loss of vision, which often means that we do not arrive in time to be able to treat it. It consists of the abnormal growth of blood vessels around the macula, which can bleed and greatly distort vision permanently.

Treatment consists of administering a medication through intraocular injections. The drug is deposited on the macula and prevents, or at least slows, the growth of blood vessels.

Prevention: The best way to prevent the appearance of AMD is to maintain healthy lifestyle habits: not smoking, not drinking alcohol, maintaining a healthy and balanced diet with a high presence of antioxidants and low in fat and, of course, doing sports.

Macular edema:  

This is the name given to the accumulation of fluid around the macula. The causes can be diverse, although poorly controlled diseases such as diabetes may be behind its appearance. In non-diabetic patients it can be the result of another disease such as uveitis (inflammation of the uvea), AMD or retinitis pigmentosa.

Treatment can vary from the application of certain eye drops, in the mildest cases, to the infiltration of injections with a more powerful medication inside the eye that reduces inflammation and allows the reabsorption of the liquid.

Macular hole:

As its own name indicates, a macular hole is a break in the tissue of the macula. The layer of the retina, where the macula itself is located, is a very thin layer and any traction can end up breaking it. Our eye is filled with a gel, the vitreous humor, which is in direct contact with the retina. Sometimes this gel thickens, generating traction that can break the tissue. Depending on the degree of the tear, the loss of vision will be practically imperceptible (grade 1) or much more serious (grade 4) that will cause a very pronounced loss of central vision.

Epiretinal membrane

It consists of the formation of a thin layer just above the macula that causes the affected person to be unable to see correctly. Specifically, it will present blurred vision or even, if the membrane is highly developed, it can be seen as a black spot.

The treatment is surgical. What is called a vitrectomy must be performed by means of which the membrane will be mechanically removed with high precision instruments.

How to detect any macular disease?

In order to detect any of these pathologies, different diagnostic tests are performed. But the most used, and the one that will provide us with the most information, will be the Optical Coherence Tomography or OCT (Optical Coherence Tomography, in its acronym in English).

Through tomography we can obtain countless images of the retina, the macula and the nerve optical, in multiple cuts, planes and depths, which will provide us with all the necessary information to make an accurate diagnosis of the state of health of our retina in general and of our macula in particular.

The test simply consists of looking at a light for a few seconds while the person in charge of carrying out the test takes images of the parts that interest us the most.

At Clínica Oftalmológica Castanera we believe that in order to offer quality medicine to our patients we must be able to have of the latest diagnostic technology, that is why all our exploration and diagnosis instruments are of the latest generation. This allows us to continue being one of the reference ophthalmology centers in Barcelona and to be able to cover any area of ​​the visual system: from refractive problems, through cataracts, glaucoma, oculoplasty and, of course, also the retina.

If you have any problem visual, in our center you will find the best specialists who will be able to solve it in the fastest and most effective way.