EP #22: Unraveling the Secrets of Wet Macular Degeneration

Discover the hidden intricacies of wet macular degeneration with Dr. Thuy Nguyen and Jeremy Wolfe on the Jazzy Eyes podcast. This episode, featuring the insights of Dr. Falco, peels back the layers of this serious eye condition, moving beyond its dry counterpart and highlighting the alarming transition to its wet form. Brace yourselves for a journey into the retina's complex structure, the accumulation of waste, and the alarming symptoms like the sudden darkness at the center of vision, that can usurp even the simplest joys of life.

Navigating the conversation with Dr. Nguyen, we explore the vital importance of regular eye exams for early detection, the detrimental effects of smoking on ocular health, and the lifesaving lifestyle changes that could help safeguard your sight. Whether it's understanding the critical role of diet and UV protection or knowing the signs to watch out for, this episode is an invaluable resource for anyone committed to preserving their vision. Join us for a power-packed session that arms you with the knowledge to combat the onset of this challenging condition.

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Transcript

Speaker 1: 0:03

Welcome to the Jazzy Eyes podcast. Taking care of your vision with expert precision. Here's your host, dr Tui Nguyen.

Jeremy: 0:14

Hello, hello everyone, and welcome back to the Jazzy Eyes podcast. I'm your co-host, jeremy Wolfe, joined by your host, dr Tui Nguyen. Dr Nguyen, always a pleasure, nice to see you again. Yes, we just wrapped up a couple of segments with Dr Falco and we were talking all about macular degeneration, specifically the dry variety of macular degeneration. We talked about what it is, how it comes about and also some management and treatment type options. Now there is another type of macular degeneration. It is the wet variety. She alluded to what that was in a past episode, but I'm going to let you explain, because this is all new to me. I learned a lot speaking of Dr Falco. I'm interested to get into this. Please share with us a little bit about wet macular degeneration.

Dr. Nguyen: 1:03

Right Wet macular degeneration. It starts off. It could start off as dry. Within the 10 layers of the retina in our eyes there is a specific layer that's responsible for shutting in nutrients and shutting out waste. Unfortunately, with age the cells that do that. They aren't efficient as they used to be anymore. Over time we get some buildup of waste in our retina. This buildup of waste it could be like metabolic byproducts or like fats, lipids. They get deposited in the retina in the form of what we call drusen. Then that's the beginning of the macular degeneration, the buildup of the waste there. It eventually damages the cells in the macula. Then these damaged cells, because they're damaged, they're calling out for help. They're secreting pro-inflammatory markers or a specific chemical called VEGF, which promotes abnormal blood vessel growth. These blood vessels, they become leaky and then they start to leak out blood products or plasma or waste in the retina. That's why we call it wet macular degeneration, because of the leakage.

Jeremy: 2:18

Is it always start with the dry and then turn into wet, or are there cases where it just onset immediately the wet kind?

Dr. Nguyen: 2:27

Most of the time the dry converts to the wet. Some people have a very rapid onset where it's Dry than wet, or they can start with a wet or, like one eye, can have both dry and wet. So it's it's a case-to-case basis, different for everyone. Not all the time it starts as wet, most of the time it is dry, although there is like a 10 15 percent that a dry can convert into the wet. And if you're a smoker that risk doubles. Smoking is very bad for everything.

Jeremy: 2:57

Yeah, it's exactly I said she mentioned smoking and immediately I was thinking how does that affect that? And I asked her specifically what it is and she said the same thing it's just bad for everything every part of your body every process, so yeah, definitely a risk factor.

Dr. Nguyen: 3:12

They're like smaller things she probably talked about, like diet, uv protection and family history, all that stuff, but smoking is a huge no-no and that's why it's so important for you get an eye exam every, you know six to twelve months, depending on you know if there is family history, you want to get your eyes checked a little bit more more frequent, but that's what we look for when you get an eye exam is, if you have dry, we want to make sure that it doesn't turn into wet, because the onset could be like very quick. And then all of a sudden, you know, you know when you get the wet, maculature generation and what you're gonna see is a black or like gray Central spot, like wherever you're looking, right in the middle. It's like you're looking through a gray spot and it's really annoying because you, you can imagine then you can't read or you Can't do certain hobbies that you used to, you can't even sign checks. You lose a lot of your the simple, like activities of daily living.

Jeremy: 4:03

I Want to back up for a second so I have a better understanding right? Dr Falco mentioned the. The main distinction and you alluded to it between the dry and the wet is Basically the blood, the presence of blood. So I want to dive into that a little bit more. What is it specifically that causes the blood to be released? Obviously has to do with the blood vessels. Can you unpack that a little bit more, just so I have a better understanding of how it transitions from the dry to the wet?

Dr. Nguyen: 4:33

right. So the damaged cell in the dry form kind of secretes all of these chemicals that Tell them, that tell the surrounding cells hey, I'm dying, I want you to grow new blood vessels to give me more nutrients and everything because I'm dying. And so these chemicals make Abnormal blood vessels grow into the macula. These are blood vessels that are not supposed to be there originally and so they're not Stable blood vessels. So when those abnormal blood vessels grow into the macula they start to leak. They're not normal, they're not stable, they're leaky vessels, and that's how you get the wet version of the maculady generation.

Jeremy: 5:17

Absolutely fascinating right.

Dr. Nguyen: 5:20

Like the, the, the eye is trying to repair itself, but in doing so it causes more harm than good. I Mean.

Jeremy: 5:27

The human body never ceases to amaze me, and I have a keen fascination with the human eye. It's just, it's mesmerizing. How we've evolved to this Really is Crazy stuff. So anything else that you want to share about Kind of the what it is and how it comes to be, before we get into kind of management and treatment options.

Dr. Nguyen: 5:51

That covers just the basic surface level of it. So then we'll get into the managed part and I'll let you know how, once there is conversion from dry to wet, what we can do.

Jeremy: 6:00

Perfect, sounds good. Thanks everyone for tuning in and we will see you on the next episode. Everyone take care.

Speaker 1: 6:09

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