WHAT IS AGE-RELATED MACULAR DEGENERATION?
Age-Related Macular Degeneration Definition: Age-related macular degeneration (AMD) is a disease in the eye which can lead to severe visual impairment. The sense cells of the macula in the center of the eye which is specialized in color vision lose their function. This spot in the eye is responsible for the sharp vision. This area is severely impaired by macular degeneration. The affected person usually retains the outer edge of the facial field.
WHAT CAUSES AGE-RELATED MACULAR DEGENERATION?
Age-Related Macular Degeneration Causes: Causes of age-related macular degeneration in the eye are deposits below the retina . Whitish or yellowish collections are called drusen. Drusen are regarded as an early manifestation of age-related macular degeneration. In the course of the disease, the layer under the retina, the so-called pigment layer, is thinned out. The next layer, the so-called vascular layer, is also affected. Later, the visual cells die, the vision is severely impaired.
WHAT ARE THE SYMPTOMS OF AGE-RELATED MACULAR DEGENERATION?
Age-Related Macular Degeneration Symptoms: The central symptoms are impairments of vision from the blurred vision center to a distorted or dark spot. Affected individuals perceive the first signs of macular degeneration often during reading. The disease occurs in dry and moist form, which are explained below.
WHAT IS DRY AGE-RELATED MACULAR DEGENERATION?
The dry age-related macular degeneration: Dry age-related macular degeneration is the most common variant of the disease: about eight out of ten cases are affected by this form. Over a long period of time the visual disturbance does not develop very strongly. Affected persons, however, perceive that vision is limited.
The dry macular degeneration can come to a standstill temporarily or for a longer period of time. However, if affected persons perceive a dark spot, the central visual field has failed due to the macular degeneration.
The dry age-related macular degeneration can be divided into three phases:
- Early: In the age-related macular degeneration the physician determines numerous small or few druids of medium size. Sometimes the affected persons notice blurred vision .
- Middle stage: In this phase the ophthalmologist observes numerous eyebrows, which have increased in size. The pigment layer becomes thinner due to macular degeneration. The vision is restricted .
- Advanced stage: In the advanced stage numerous and larger drusen predominated. The pigment layer and the retina have thinning, and scar tissue increases. The visual acuity of those affected is severely restricted
WHAT IS WET AGE-RELATED MACULAR DEGENERATION?
The Wet age-related macular degeneration: The moist variant is the rarer form of age-related macular degeneration. It results from the dry age-related macular degeneration. The visual impairment occurs in ten to fifteen per cent of all cases of age-related macular degeneration.
It has a rapid course and the loss of central vision occurs earlier than in the dry variant. As a special symptom, it has an impaired vision in straight lines: these appear to be bent. In the advanced stage of the disease, the central visual field is a dark spot.
The disease produces edema under the retina. Since the membrane shows fractures, blood vessels from the choroid (choroid) grow into the retina. These blood vessels are called choroidal neovascularisations. The messenger VEGF (Vascular Endothelial Growth Factor) is responsible, among other things, for new vessels to grow into the retina. These, however, do not prove to be stable and, due to their tearing, cause hemorrhages that damage the macula . During the examination, the ophthalmologist recognizes newly formed vessels and bleeding in the macula as symptoms for this form of macular degeneration.
WHAT TREATMENT OPTIONS ARE AVALIBLE FOR AGE-RELATED MACULAR DEGENERATION?
Age-related macular degeneration Treatment: In the case of dry macular degeneration, therapy primarily consists in the adaptation of the lifestyle, since there are no concrete treatment methods. Among the important measures are a healthy diet with high vitamin intake and regular exercise . Possibly. food supplements can contribute significantly to the support of vitamin supplements.
For the treatment of the moist form of age-related macular degeneration, there are means available which can slow down or stop this disease. A complete cure is not yet possible.
- Anti-VEGF therapy: An effective method for inhibiting the formation of new vessels in moist macular degeneration is the so-called anti-VEGF therapy. These substances, so-called VEGF inhibitors, reduce the growth of the unstable vessels on the retina and dense diseased blood vessels. Since no new hemorrhages and fluid attachments are used, the edema can “dry out”. With this therapy the progress of the age-dependent macular degeneration can be slowed down and under certain circumstances the treatment can also improve the eyesight. The eye doctor sprays the drug directly into the vitreous body – so the preparation can work exactly where it is needed. Before doing so, the doctor stuns the eye locally so that the patient can not feel pain. First, three doses are administered monthly, after which the doctor decides how to continue the treatment.
- Photodynamic therapy: In the case of photodynamic therapy (PDT), the patient receives a syringe with the active ingredient verteporfin at intervals of three to four months. This medicine is then distributed throughout the blood circulation. The ophthalmologist irradiates the newly formed blood vessels on the retina with a fine laser beam, which meets the blood vessels filled with verteporfin. This contact produces a toxin which leads to the destruction of the diseased blood vessels newly formed by the macular degeneration. During treatment, the active substance must be dosed so that it does not lead to damage to the retina. Whether the photodynamic therapy is suitable for a patient depends on the type of new vessel formation.
- Operational removal of neovascularisation: This surgical intervention in the moist age-related macular degeneration in the eye is suitable for patients with larger hemorrhages under the retina . The surgeon removes the glass body of the eye to suck the blood to the retina after an incision. In the next step, the previously removed glass body is replaced by an artificial silicone oil. There is a risk of additional bleeding during and after the operation. The use of the method should be carefully weighed.