Age-related macular degeneration

Age-related macular degeneration (AMD) is a lesion of an important part of the retina, the macula. AMD leads to a loss of central vision, so the patient cannot distinguish details of both distant and close-up objects. At the same time, peripheral (lateral) vision is preserved. For example, the patient will see the numbers on the watch dial well, but the hands will not.

Age-related macular degeneration

Age-related macular degeneration (AMD) is a lesion of an important part of the retina, the macula. AMD leads to a loss of central vision, so the patient cannot distinguish details of both distant and close-up objects. At the same time, peripheral (lateral) vision is preserved. For example, the patient will see the numbers on the watch dial well, but the hands will not.

AMD is very common and is one of the main reasons for blindness in persons over 50.

Terms

Retina is a layer of nerve cells, located on the inner surface of the eye. The retina senses light and sends signals to the brain, with images formed out of these signals in the brain.

Macula is a small but very important area in the centre of the retina. Macula is needed to clearly see the small details of objects.

Druses are small white or yellow lumps which form under the retina. They rarely lead to loss of vision, but if there are many of them (or they are large), this may be indicative of AMD.

Two types of AMD

Dry form of AMD. This form is quite common – in about 80% of AMD cases (8 out of 10 patients). Thinning of the macular area occurs, with druses formed (small lumps of protein). Central vision gradually deteriorates. The treatment of dry AMD has not yet been found.

Wet form of AMD. This form is less common, but more severe. New abnormal blood vessels form under the retina, with blood or other fluids leaking and scarring in the macular area. Wet AMD leads to loss of central vision faster than the dry one.

Often, patients are unaware of AMD until vision becomes blurry. Therefore, you should regularly see an ophthalmologist to identify early symptoms of AMD in time, while vision has not yet deteriorated.

Who is at increased risk for AMD?

Factors which increase the risk of AMD:

  • High saturated fat in the diet (meat, butter, cheese)
  • Overweight
  • Smoking
  • Over 50 years of age
  • Arterial hypertension (high blood pressure)
  • AMD in close relatives
  • Risk factors for AMD are heart diseases and high blood cholesterol levels. White peoples are at increased risk of developing AMD.

 How is AMD diagnosed?

  • During the examination, an ophthalmologist will ask you to look at the Amsler grid, which will help bring out “blind” (dark) and blurred areas in your field of vision. An ophthalmologist will examine the retina with a special lens, after dilating the pupil with eye drops, to detect changes in the retina and macula. Fluorescence angiography is used to detect newly formed pathological vessels in the retina. To do this, a yellow dye (fluorescein) is injected into a vein of the arm.
  • Through the blood vessels, the dye penetrates into the retina, and at this time it is photographed with a special camera.
  • Another method of examining the retina is optical coherence tomography (OCT). A special device scans the retina and forms detailed images of the retina and macula.

 How is AMD treated?

Dry form of AMD. Until now, no effective method of treatment of dry AMD has been found. However, if the patient’s vision has deteriorated significantly, or there are numerous drusen in the retina, some nutrient additives may be effective. A worldwide scientific study has shown that it is possible to slow the development of dry AMD. To do this, you need to consume daily:

  • vitamin C
  • vitamin E
  • lutein;
  • zeaxanthin
  • zinc;
  • copper.

The ophthalmologist will tell you whether you should take vitamins and minerals for the treatment of AMD in your case.

Wet form of AMD.. For treatment of the wet form of AMD, there are medications called vascular endothelial growth factor (VEGF) inhibitors. They reduce the number of abnormal vessels in the retina and slow down the leakage of fluid from these vessels. The medication is injected into the eye cavity with a very thin needle (intravitreal injection).

In some cases, a laser is used to treat wet AMD. The eye surgeon irradiates abnormal blood vessels in the retina with a laser to reduce their number and slow fluid leakage.

Discuss ways to treat AMD with your ophthalmologist.

How to compensate for lost vision

If you are diagnosed with AMD, you should learn to make the most of your vision. For this, there are various magnifying glasses, pocket computers, electronic devices and other special tools which help to perform daily activities, despite the deterioration of vision.

A visual rehabilitation specialist will help you choose these means and teach you how to use your peripheral vision.

Ask your ophthalmologist to send you to a vision impairment rehabilitation specialist. Your goal is to rely on outside help as little as possible.

Check vision with Amsler grid.

AMD leads to a gradual deterioration in central vision, which is not immediately noticeable. However, the sooner these changes are detected, the better. Loss of vision can be slowed down if treatment is started promptly.

Check your eyesight daily with the Amsler grid..

How to use the Amsler grid?

Attach the Amsler grid in a place where it will catch your eyes every day, for example, on the refrigerator or on the bathroom mirror.

The grid should be viewed from a distance of 30-35 cm in a good lighting. If you use reading eyeglasses, put them on.

Cover one eye with a shutter (palm), with the other looking directly at a spot in the centre of the grid. Do you see wavy or crooked lines, or blurry, dull, or distorted parts of the grid?

If you see crooked or blurry lines or sections of the grid, consult your ophthalmologist immediately.

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