Wet macular degeneration is an advanced form of macular degeneration in which new, abnormal blood vessels grow beneath or into the retina or the layers directly below the retina. In some instances, these new blood vessels actually originate from within the retina, a process referred to as retinal angiomatous proliferation, or RAP.
The growth of these abnormal blood vessels is the eye’s attempt to repair the effects of aging, sun exposure, inflammation, or other sources of damage to the eye. Unfortunately, these new vessels are anything but helpful.
These abnormal blood vessels are fragile and often leak fluid and blood beneath and into the retina. The fluid and blood lead to an abnormal contour of the retina and cause the distortion that one often notes as the initial symptom of wet macular degeneration. The greater the leakage, the greater the distortion and/or visual loss.
Early in the process, treatment with intraocular injections of anti-VEGF agents (discussed more extensively) may result in stabilization and even significant visual recovery. With time, the effects of the leak-age can lead to scarring and atrophy (loss of normal tissues), with irreversible vision loss. Prior to the discovery and use of anti-VEGF injections, clinicians differentiated the various types of wet macular degeneration based upon fluorescein angiographic characteristics (see Question 52). This differentiation was important, as only certain types of wet macular degeneration responded to the various therapies.
The growths of new blood vessels were characterized as classic, occult, or a combination of the two. The classic type of pat-tern was more likely to respond to therapy and, in fact, was the only one to be approved for certain approaches. Fortunately, the newer treatments are more versatile with respect to treating the different patterns of leakage, and the different patterns are expected to respond to treatment.
Comment:
My experience was definitely observing horizontal lines as wavy. I probably lived with this, knowing what I know now, for too long, thinking that it would probably go away on its own. I also found that during this period, much stronger lighting was very important to me. Little did I know that I should have sought professional advice immediately.