Treatment of age-related macular degeneration
What is age-related macular degeneration (AMD)?
Age-related macular degeneration (AMD) is a multifactorial degenerative macular disease that is the leading cause of irreversible vision loss in developed countries. The macula is the central part of the retina whose degeneration impairs precise vision, which is important for activities such as reading, recognizing other people's faces, details, colors, etc. The most important risk factors for the development of the disease are age (over 50 years old), genetic factors, systemic hypertension, obesity, a diet rich in saturated fatty acids and smoking.
Clinical forms of age-related macular degeneration
There are two clinical forms of age-related macular degeneration: dry and wet form.
The dry form of AMD is very common, in almost 80% of cases and is characterized by the accumulation of waste material. Sight is preserved for a long time and gradually decreases over time. The image becomes distorted or incomplete over time. Finally, there is severe damage to the central part of the visual field and the peripheral visual field is almost always preserved.
The disease is diagnosed by an ophthalmological examination of the fundus and with the recommendation of an ophthalmologist, it is sometimes necessary to perform some diagnostic tests: optical coherence tomography (OCT), fundus autofluorescence (FAF), fundus photography, OCT angiography (OCTA), fundus fluorescein angiography ( FFA). There is no medicine to cure the disease. In order to slow down the development of the dry form of AMD, regular use of vitamins and antioxidants for the eyes, smoking cessation, wearing protective glasses and self-monitoring with the Amsler test are recommended.
The wet form of AMD is present in 10% to 15% of cases in which there is a pathological growth of new blood vessels in the macula, which are brittle, break easily and bleed, which causes a sudden deterioration of vision. In such cases, it is necessary to start treatment as soon as possible with biological drugs that block vascular endothelial growth factor (VEGF), which is essential for the growth of new blood vessels.
These drugs are given directly into the eye (into the vitreous area) initially once a month, then less often, depending on the results of the treatment. The late, terminal phase of the disease can take the form of a scar form or geographic atrophy, which is clinically recognized as a sharply limited thinning (atrophy) of parts of the center of the retina and has a chronic, progressive course with a poor long-term prognosis. At the moment, there is no effective treatment that can prevent or affect the development of this form of AMD. Visual rehabilitation is often required at this stage. Therefore, be sure to consult an ophthalmologist in time so that adequate help, advice and treatment can be provided.
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