Dr. Ortuño is an ophthalmologist in Alicante, and an expert in presbyopia and accommodation, cataracts, dry eye, myopia, hyperopia and astigmatism. This specialist is Medical Director of the clinic that bears his name: Clínica Oftalmológica Dr. Vicente Ortuño.
Age-related Macular Degeneration (AMD) is considered one of the leading causes of irreversible blindness worldwide. It is characterized by inducing a progressive loss of vision in the central area of the retina known as the macula. Its progression causes the patient to perceive areas of dark vision, as well as the sensation of seeing wavy straight lines or distorted images. These symptoms cause difficulty in performing daily tasks such as reading, driving, or recognizing faces, among others…
What is AMD?
Specifically, AMD is the leading cause of visual loss in patients over 60 years of age in developed countries. Although its prevalence is estimated to be around 10% in the world population, its incidence is expected to increase in the next 10 years.
How is AMD diagnosed?
When a patient comes for consultation suspected of having AMD, the optometrist will check visual acuity at all distances, as well as evaluate whether the central vision is distorted by means of the Amsler Grid. Next, the patient’s pupil will be dilated to visualize the fundus. The ophthalmologist will check the condition of the retina in both the central and peripheral regions. In addition to the above, other tests may be necessary to analyze the condition of the retina or to corroborate the diagnosis, such as Optical Coherence Tomography (OCT) and angiography.
Effects of AMD and how to prevent it
Since the incidence of AMD in the population is estimated, according to scientific studies, to increase in the coming years, it is necessary to know how to prevent its progression or, if necessary, to plan some of the different treatments currently available. Although the main risk factor that influences the progression of AMD is age, there are others such as blood pressure, cholesterol, smoking, obesity or family history that play an important role. In addition, it has been determined that the absence of antioxidants in the diet also plays an important role as a risk factor for the development of AMD. Therefore, foods rich in vitamins (C and E), antioxidants or trace elements (selenium and zinc) are recommended to try to delay the progression of AMD. However, in addition to diet and trying to avoid some of the above mentioned risk factors, it is necessary to perform eye fundus examinations in consultation, especially in patients over 55 years of age. In consultation, the ophthalmologist will evaluate vision at all distances and will pay special attention to central vision, as well as perform a fundus examination with pupillary dilation, and an Optical Coherence Tomography (OCT) and/or angiography if necessary.
What are the main risk factors for the development of AMD?
The main risk factor for the development of AMD is age, although there are other factors that may contribute to its development, such as obesity, lack of antioxidants in the diet, high blood pressure, cholesterol, family history, exposure to radiation or smoking, among others. Scientific studies have determined that vitamins C and E, antioxidants, trace elements such as zinc and selenium are beneficial in reducing the progression of AMD. In order to avoid the visual loss it induces, it is advisable for those patients with a family history of AMD, or who present other risk factors that may lead them to suspect that the pathology will develop over time, to undergo an evaluation of the retinal fundus in consultation.
What treatments improve visual quality in patients with AMD?
Treatments for AMD depend on whether it manifests in the dry form, which is the most frequent, or, on the contrary, in the wet form. Precisely, in the wet form, which manifests itself less frequently, certain characteristic clinical signs develop, such as new blood vessels, as well as hemorrhages, inducing a more rapid visual loss.
When the treatment by intravitreal injections in patients with wet macular degeneration has not achieved good results and in patients with macular degeneration, dry macular or atrophic, to improve visual quality currently has been developed a new treatment by implanting intraocular lenses (IOLs) with a special design to enhance peripheral vision and increase or magnify the central vision, since the central vision will be impaired by the progression of retinal pathology. Likewise, the intraocular lenses implanted in patients with AMD are designed with a flexible material, and are implanted with minimal incision surgery, which does not require sutures, reducing the risk of infection or other postoperative complications. In addition, the design of these intraocular lenses is made with spatial technology, being formed by two optical surfaces, one convex and the other concave like a telescope with the aim of widening vision.