Images of Macular Degeneration Offer Clarity for Residents and Students

Stephan Dixon, MD, admired the two scenes of a forest painted by American artist William Thon at different times of his life.

One showed images with very geometric shapes and impressive shadows of trees and was painted before the onset of vision loss due to macular degeneration, while a second one offer a different style though still quite lovely.

"Before macular degeneration, everything has nice focused sharp lines and it’s almost abstract,” says Dixon, a chief resident in the Department of Ophthalmology at the University of Cincinnati (UC) College of Medicine.

"When you turn to this one, the geometric shapes aren’t as sharp anymore,” says Dixon, who is a graduate of the College of Design, Architecture, Art, and Planning and College of Medicine. "We see things are little more blurred, less defined and murky as far as everything goes. It lends itself to the changes you see in macular degeneration as far as the amount of detail and use of straight lines.”

Dixon was among the group of residents, medical students and faculty in the Department of Ophthalmology, to attend a special July 26 showing of "The Persistence of Vision: Early and Late Works by Artists with Macular Degeneration” at the Philip M. Meyers Jr. Memorial Gallery at UC.Replace with your text

According to the American Macular Degeneration Foundation, the ailment is caused by the "deterioration of the central portion of the retina, the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain. The retina’s central portion, known as the macula, is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail."

Adam Kaufman, MD, Vice Chairman and Residency Program Director of the Department of Ophthalmology, commented that the exhibit evokes empathy for these artists and others like them who are visually-oriented and forced to adapt their lives with the onset of macular degeneration.

"All of the artists in this exhibit have macular degeneration, and it’s fascinating as you go through the gallery, you can see some similar style paintings that the artists painted before and after their macular degeneration,” says Kaufman.

"You can see the sort of lack of clarity and color shifting, and in some instances lack of color,” says Kaufman. "In macular degeneration your central vision deteriorates, and the central vision is where your color and fine detail comes from. In advanced macular degeneration you retain peripheral vision and your central vision is significantly compromised.”

Samantha Marek, a fourth-year medical student at UC, says she wants to match into the field of ophthalmology and came to the exhibit in hopes of gaining a better understanding of what happens with macular degeneration.

"These artists previously created such detailed works of art,” says Marek. "Then as their macular degeneration progressed, they transitioned to paintings with no fine details at all. Had I not known that the paintings in one set belonged to a single artist, I would have thought two different artists produced them because the change was so striking. I was able to sympathize on a deeper level with the frustration patients I have seen experiencing with their visual changes.

"Eyesight is important to our daily lives and our functioning as humans,” says Marek. "I imagine these artists may have had a hard time coping with their vision loss, but it is inspiring to see that it did not stop them for doing what they love, creating art.”

Kaufman says there is a genetic predisposition to macular degeneration along with environmental components that may predispose someone to vision loss. "Nutrition is an important factor, and certain vitamin supplements have been shown to delay the progression of dry macular degeneration,” says Kaufman. "There are thought to be risk factors for macular degeneration such as smoking, being overweight, hypertension, cardiovascular disease and sun exposure, but a broad range of people suffer from macular degeneration.

Kaufman explains there are two basic stages of macular degeneration: "dry” and "wet.”

"The wonderful thing about the current status of macular degeneration is wet macular degeneration does respond to treatment when it is caught early,” says Kaufman. "Dry macular degeneration converts to wet macular degeneration, but as it progresses to wet macular degeneration that is the time period to which it can be treated.”

Individuals with dry macular degeneration can look at a grid known as the Amsler Grid daily, and if they see a change in vision, it may be a flag that they are converting from dry to wet macular degeneration, says Kaufman. The wet macular degeneration can be treated with anti-vascular endothelial growth factor (anti-VEGF) injections.

"It was once thought that wet macular degeneration was a hopeless disease, but now, anti-VEGF injections have become a common procedure, since the results have been so successful. With early intervention, progression of wet macular degeneration can be slowed, and in some instances halted,” says Kaufman.