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Maculopathy is any illness of the macula, an area at the center of the retina responsible for accurate vision. The retina is a light-sensitive tissue lining the inner surface of the eye, and the macula is a yellow, oval-shaped, area about five millimeters in diameter. While damage to other areas of the retina can result in the loss of peripheral vision, which may go unnoticed for a while, maculopathy causes central vision impairment that the patient usually notices immediately.
One of the most common diseases of the macula is macular degeneration, in which vision loss worsens over time. Macular degeneration is usually age-related, abbreviated AMD or ARMD. Macular degeneration begins when small yellow or white deposits called drusen form on the macula. Most people over 40 have some small drusen with no effect on their vision, a situation called age-related maculopathy. Age-related maculopathy is more likely to develop into advanced macular degeneration if the drusen are large and soft rather than small and hard.
Macular degeneration causes macular holes to form, leading to blind spots in the central vision. Macular holes can also be caused through trauma, though the incidence is low. If a severe blow causes the blood vessels leading to the macula to be damaged, vision loss can also occur. Malattia Leventinese, also called Doyne’s honeycomb retinal dystrophy, is a type of hereditary macular degeneration in which drusen begin to form in early adulthood. The drusen eventually form a honeycomb pattern on the macula, and like AMD, Malattia Leventinese leads to irreversible vision loss.
Macular pucker is another relatively common form of maculopathy, particularly in the older population. Macular pucker occurs either due to a change in the vitreous humor, the clear jelly inside the eyeball, or as a symptom of diabetes. Unlike macular degeneration, macular pucker is usually completely curable, unless it is very advanced.
Macular pucker is characterized by a convergence of cells at the macula, which then pull away, causing many macular symptoms. The cell layer may tighten and cause the macula to wrinkle or pucker, or it may cause macular edema or swelling. Macular edema is the buildup of fluid and protein on or under the macula, which can lead to obscured central vision. Another possible symptom is cellophane maculopathy, in which a thin, shiny membrane forms over the retina and obscures the patient's vision.