MACULAR DEGENERATION ASSOCIATED WITH AGE

What is macular degeneration?

Age-related macular degeneration (AMD) is a disease of the retina in which various degenerative changes occur in the central part of the retina, called the macula. The cells in this area are responsible for fine vision, for details; Thanks to it we can read and distinguish faces. These changes can therefore lead to poor central vision, preventing activities such as reading or driving.  It is called associated with age because it appears in people over 50 but it is not the same as normal aging of the retina by age.

A person with AMD may therefore notice alterations in the central vision, difficulty in reading and recognition of faces and / or distortion of images (metamorphopsia). However, in the early stages the vision can be completely normal.

How many types of AMD exist?

In patients with AMD, the deterioration of the macula occurs progressively and can be differentiated at the time of diagnosis according to the severity between early or early AMD, intermediate AMD or late AMD.

There is another classification, very useful in view of the need or not for rapid treatment, which is the differentiation between the dry form and the wet form:

• The dry form is the most common and accounts for about 85 percent of people with the disease. Early, intermediate and most late forms of AMD belong to this form. Visual loss is slow and some patients can maintain good visions for a long time. It is called dry because “there is no liquid.” At some point it can become wet.
• The wet form affects the remaining 10-15 percent and constitutes a part of the late AMD. The evolution is rapid and can cause serious vision problems. It is caused by the formation of new blood vessels under the macula (neo-vessels). These blood vessels are abnormal, bleed easily and can leak fluid under or inside the retina. If this persists for a while, irreversible scars form, which leads to visual impairment due to loss of central vision, preventing us from activities such as reading or driving.

How many types of AMD exist?

First there’s preventive treatment. Although we know a non-modifiable genetic base, several studies show evidence that a good diet, a little regular exercise and no smoking reduces the incidence and progression of this disease, although it does not eliminate it.

In cases of intermediate AMD, daily intake of antioxidant drugs is recommended, which has been shown to reduce progress to advanced forms.

For the wet form we have treatments to slow the evolution and avoid visual impairment. Immediate detection and treatment is the key. It is a method that has revolutionized the treatment of wet AMD in recent years such as the injection of drugs that inhibit the growth of new blood vessels: antiangiogenic drugs, such as Lucentis or Eylea. These drugs should be administered by the ophthalmologist according to different guidelines, by intravitreous injections.