Macular degeneration in younger people is rare, but it can affect people in their twenties. Juvenile macular degeneration is an inherited condition that affects central vision and can occur in children and young adults.

Macular degeneration involves damage to the macula, which forms part of the retina in the eye. The macula allows central vision and the ability to see fine details clearly.

Juvenile macular degeneration, also known as juvenile macular dystrophy, is a type of macular degeneration that people can inherit. It occurs in children and young adults.

This article looks at how macular degeneration may affect a person in their twenties, including symptoms, diagnosis, treatment, outlook, and when to contact a doctor.

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Age-related macular degeneration (AMD) is most likely to affect people over the age of 50 and occurs due to the aging process. However, macular degeneration can affect a person in their twenties.

Juvenile macular degeneration is a set of conditions that damage the macular and affect central vision. These conditions affect children and young adults.

Juvenile macular degeneration is rare, and people inherit these conditions from their parents.

Stargardt disease is the most common type of juvenile macular degeneration, which usually occurs in children, teenagers, and young adults.

Other forms of juvenile macular degeneration include juvenile retinoschisis and Best’s disease.

All types of juvenile macular degeneration share similar symptoms that affect central vision. These can include blurry or distorted vision and dark areas in the central vision.

Symptoms do not typically affect peripheral vision. However, symptoms may affect each eye differently, and as the condition progresses, it may alter color vision.

The initial symptoms of juvenile macular degeneration usually develop during childhood or adolescence.

Learn the early signs of macular degeneration.

Juvenile macular degeneration is a genetic condition that people inherit from their parents. Each type of juvenile macular degeneration has a different pattern in which it passes between a parent and child:

  • Stargardt disease: To develop Stargardt disease, people must inherit the gene from each parent. Parents may not have the disease, but may be carriers of it.
  • Best’s disease: A person inherits the gene from one parent. If one parent has the gene and the other does not, there is a 50% chance of a child inheriting the condition.
  • Juvenile retinoschisis: Juvenile retinoschisis mostly affects males. A male child can inherit the gene on the X chromosome from a female parent.

Currently, there is no cure for juvenile macular degeneration, but treatments may help to slow disease progression and aid vision. Treatment may depend on the type of macular degeneration people have.

Stargardt disease treatment

Treatment for Stargardt disease aims to slow down the rate of vision loss and may include:

  • protecting the eyes from ultraviolet (UV) light from the sun when outdoors with sunglasses and a hat
  • avoiding supplements with vitamin A levels above the daily recommended amount
  • avoiding smoking and secondhand smoke

Low-vision aids, such as magnifying lenses, may help people living with macular degeneration.

People can speak with a doctor about vision rehabilitation, which teaches strategies for living with vision loss. This may include setting up the home to make it easier to move around or training for using devices that can help a person see fine details.

Best’s disease treatment

People may require treatment for Best’s disease if there are complications. Choroidal neovascular membrane (CNVM) can occur as a complication of Best’s disease, in which new blood vessels grow under the retina and affect vision.

If people have CNVM, they may have treatment with antivascular endothelial growth factor (anti-VEGF) drugs, such as:

Other treatments can include laser therapy and photodynamic therapy, which uses a combination of light and medication to destroy the abnormal blood vessels.

People with cataracts may require cataract surgery to help improve vision. Doctors may also offer vision aids to help people with low vision.

Juvenile retinoschisis treatment

Treatment for juvenile retinoschisis includes low-vision aids, such as large-print books.

People may require surgical treatment for complications, such as bleeding in the eye or retinal detachment. However, these complications are uncommon.

People with juvenile retinoschisis may need to avoid contact sports or similar activities to reduce the risk of retinal detachment.

Juvenile macular degeneration can progress at different rates. Vision loss may happen rapidly, or vision may remain into adulthood. Progression can depend on the type of juvenile macular degeneration a person has:

  • Stargardt disease: People may develop 20/200 vision, which meets the definition of legal blindness.
  • Best’s disease: A person may have nearly typical vision for decades without being aware they have the disease.
  • Juvenile retinoschisis: This may cause vision loss to between 20/60 and 20/120. In around half of cases, people may lose their side vision. As a person ages, vision loss may increase and reach 20/200 by the age of 60 or above.

Although there is no cure for juvenile macular degeneration, researchers are investigating new treatment options.

Clinical trials are looking at gene therapy, which targets the abnormal gene causing the macular degeneration. Gene therapy may help to slow down the progression of macular degeneration and prevent vision loss.

A person should see a doctor if they have any symptoms of macular degeneration. This may include the following symptoms:

  • blurred central vision
  • dark or hazy areas in the central vision
  • sensitivity to light
  • a longer time for the eyes to adjust between dark and light spaces
  • color blindness
  • changes to peripheral vision

An eye doctor will carry out an eye examination by dilating the eye. They will look for signs of juvenile macular degeneration and find out which type a person has. Tests for juvenile macular degeneration include:

  • Fluorescein angiography: This is an imaging test with a specialized dye to view blood vessels in the retina.
  • Electroretinography: This allows doctors to measure electrical activity in the retina.
  • Genetic testing: Genetic testing helps doctors identify the gene causing macular degeneration.

People should also see a doctor for any worsening symptoms of juvenile macular degeneration.

If people have any complications or severe symptoms, such as retinal detachment, they will require immediate medical attention.

Macular degeneration in young people is rare, but it can affect a person in their twenties. For example, juvenile macular degeneration is an inherited form of macular degeneration that may affect children and young adults.

Juvenile macular degeneration can cause vision loss, but treatments may slow progression of the disease and reduce the risk of complications.

People should speak with a doctor if they experience signs of juvenile macular degeneration, including blurriness or dark spots that affect their central vision.