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Sometimes it develops imperceptibly over the years, sometimes it happens suddenly, leaving little time for treatment. AMD (Age-related Macular Degeneration) is a dangerous and common disease, and the only form of therapy is… preventing its occurrence.
Fight for sight
Not everyone is equally at risk of developing macular degeneration. It is estimated that the most important factors of its development are – age over 50 years of age. (in the group over 65 years of age this disease occurs in every fourth person) and the presence of AMD in one eye. Other factors that influence the development of the disease are: the presence of macular degeneration in relatives, smoking, gender (the disease affects more women than men), deficiency of vitamins from the antioxidant group, cardiovascular diseases, obesity, diabetes, white race, exposure to high UV radiation dose.
Diagnostics
The basic method is an eye fundus examination by an ophthalmologist. The second way is called Amsler test.
There are also more advanced diagnostic techniques. The most important of these is fluorescein angiography (AF) – AMD’s gold diagnostic standard. The method allows you to assess what the blood vessels in the retina look like. In many cases, this examination is sufficient to make a correct diagnosis, but if the doctor also wants to examine the substrate of the retina, i.e. the vascular membrane, then the patient is referred for indocyanine angiography. If this method is not enough to make a correct diagnosis, then a tomographic examination (the so-called optical coherence tomography, OCT for short) is performed. The tomograph shows the eye in cross section, in layers. This method, however, is new, and therefore less available and more expensive than others, but at the same time non-invasive (for angiography, the patient is injected with the so-called contrast, which can cause nausea as a side effect).
AMD dry and wet form
1. Age-related macular degeneration occurs in two forms. The first, concerning 90 percent. cases of the disease, it is the dry form (otherwise non-exudative or atrophic). Poor vision in the patient is caused by the death of the photosensitive cells of the retina. This form rarely causes the loss of central vision, more often the blurring of the image. The dry form of AMD has been developing for many years. The dangerous thing is that it can become wet.
Treatment of the dry form
It consists in preventing the deterioration of the changes or the transition of the disease into an exudative form. For this purpose, dietary supplementation with preparations with lutein, zeaxanthin, zinc and antioxidants is used.
Treatment of the exudative form
1. Photodynamic therapy (PDT). It involves injecting a substance into the patient’s body called verteporfin, which stains new blood vessels in the retina. This allows the ophthalmologist to see which vessels are abnormal. Under the influence of a non-thermal laser beam, verteporfin is activated and damages the endothelium of pathological vessels, which results in their closure and then death.
2. Angiogenesis inhibitors (pegaptanib sodium, ranibizumab). These drugs are considered to be the best available treatment for the wet form of AMD. They are administered directly into the vitreous. These substances act on the VEGF protein, which is responsible for the formation of pathological vessels in the retina of the eye, and thus for the progression of degeneration. Treatments must be repeated every 4-6 weeks.
Prevention
In order to reduce the risk of developing AMD, you should regularly visit ophthalmologic examinations (after the age of 40 every year, if a family member suffers from the disease, after the age of 50 every year, even if there are no AMD cases among relatives). You have to quit smoking and lead a healthy lifestyle (control your body weight and exercise). It is also worth asking the ophthalmologist if he would recommend supplementing the diet with vitamins and preparations with lutein and zeaxanthin. It is also recommended to wear sunglasses with a UV filter.
Text: Maja Denisiuk
Consultation: Małgorzata Figurska, MD, PhD, prof. dr hab. n. med. Andrzej Stankiewicz (Military Institute of Medicine), prof. dr hab. n. med. Wiktor B. Szostak (Food and Nutrition Institute).
Source: Let’s live longer
More about AMD on the website Zdrowie.TvoiLokony