Macular degeneration – AMD

What is macular degeneration?

The macula is the part of the eye responsible for providing clear vision. As we grow older, it loses its function, leading to macular degeneration, also known as AMD.

This is a fairly common ailment after the age of 60 and can occur at various levels, in some cases imperceptibly. On the other hand, it can also develop in a much more virulent way, causing total and progressive loss of sight.

  • Wet macular degeneration:
    • New blood vessels grow under the retina causing hemorrhages and fluid leakage.
    • The new vessels form a neovascular membrane.
    • The progression of this AMD is rapid and can significantly impair central vision.
    • Wet macular degeneration can be occult or classic.
  • Dry macular degeneration:
    • This type of AMD evolves slowly over time (years).
    • It occurs when spots called drusen begin to accumulate in and around the macula.
    • It is a much more common type of AMD. More than 85 percent of all people with intermediate or advanced macular degeneration have the dry form.

Prognosis of the disease

Early diagnosis is key in order to start treatment as early as possible. If not treated promptly, the prognosis is poor.

Symptoms of macular degeneration

Macular degeneration does not cause pain, but it can present a number of visual symptoms that the patient should recognize:

  • Straight lines that may appear wavy or choppy.
  • Altered estimation of distances and heights
  • Increased sensitivity to light
  • Need for increased amount of light to read
  • Blurred vision in the central part of vision

When the disease is in a more advanced stage, a black spot may be seen in the central area of vision, which may become darker and larger the longer it has progressed.

Medical tests for macular degeneration

To make a complete diagnosis is usually performed:

  • Visual acuity test
  • Ophthalmological examination, paying special attention to the state of the macula.
  • Fluorescein angiography
  • Optical coherence tomography: This is a scan of the macula, which aims to demonstrate the presence or absence of a neovascular membrane.
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People over 60 years of age are at a higher risk of macular degeneration.

What are the causes of macular degeneration?

Macular degeneration is related to aging, although age-related macular degeneration can occur in middle-aged people, studies indicate that people over the age of 60 are at greater risk.

Other risk factors include:

  • Smoking
  • Obesity
  • Race: White people are much more likely than African-Americans to lose vision due to macular degeneration.
  • Family history: People with closely related family members who have age-related macular degeneration are at greater risk of developing the disease.
  • Gender: Women are more prevalent in AMD than men.

Is it preventable?

It is important to periodically and closely monitor patients who have already suffered exudative AMD in one eye, as they may have a 50% chance of having a neovascular membrane in the other eye, depending on the predisposing lesions that exist in the contralateral eye.

Treatments for macular degeneration

Although there is still no definitive treatment to repair the effects of age-related macular degeneration, early diagnosis is important to slow its progression. It has also been shown that the consumption of antioxidant vitamins and zinc can contribute to the reduction of advanced macular degeneration (dry macular degeneration) and associated vision loss.

Treatments available for wet macular degeneration are:

  • Laser surgery: Laser thermal photocoagulation surgery is the only proven effective surgical treatment option available for people with wet macular degeneration.
  • Ocular photodynamic therapy (PDT).
  • Injections into the eye with new medications, such as vascular endothelial growth factor (VEGF) antagonist therapy.

Which specialist treats it?

The ophthalmologist is in charge of preventing, diagnosing and treating diseases that affect the eyes and the patient’s visual capacity, such as macular degeneration.

The eyes are the essential organ of vision and are susceptible to many abnormalities throughout life. Ophthalmology is in charge of preserving the patient’s visual capacity, through medical treatment techniques, surgery or with the help of external elements such as glasses or contact lenses.