Why AMD occurs and how we can prevent it

Age-related Macular Degeneration (AMD) is a disease that damages the retina, specifically the macular area. Dr. Dolz Marco, specialist in Ophthalmology and retina expert, talks about this age-related pathology.

What is AMD

AMD is a disease that damages the central area of the retina known as the macula, which is responsible for detail vision. AMD is currently the most common cause of vision loss and blindness in developed countries in patients over the age of 50.

AMD can be stratified into:

  • Early AMD: characterized by the development of medium-sized drusen.
  • Intermediate AMD: characterized by larger drusen and pigmentary changes.
  • Advanced AMD: there are 2 main forms of advanced AMD, an atrophic or dry form, and a neovascular or exudative form. Both forms may overlap in the same patient.

Symptoms of macular degeneration

Initially, AMD does not present any symptoms, hence the importance of examination by a retina expert for early diagnosis. As the disease progresses, AMD can cause deformity of images and straight lines, central blurred vision, and patchy loss of central vision that can progressively lead to a total loss of central vision. Among patients with AMD, total vision loss is not common because the peripheral retina is usually unaffected, facilitating activities such as ambulation.

Main causes of macular degeneration

The cause of AMD is not completely known, being a multifactorial disease whose main risk factors are:

  • Age: from the age of 50 onwards, the risk of suffering from AMD multiplies from year to year.
  • Women: AMD is more common in women than in men.
  • Smoking: being a smoker or former smoker is the avoidable cause most related to the development of AMD.
  • Sun exposure: failure to protect the eyes with appropriate sunglasses puts macular health at risk.
  • Family history: genetics plays an important role in the risk of AMD.
  • Macular aging: the specific type of aging signs in the retina can be analyzed on fundus and optical coherence tomography (OCT) by retinal experts to assess the personalized risk in each case.
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Treatment for AMD

Atrophic or dry AMD is characterized by a slow, insidious course with progressive loss of photoreceptor cells and retinal pigment epithelium. Although there are several clinical trials in early stages of evaluation, there is currently no drug approved for its treatment.

On the other hand, neovascular or exudative AMD is characterized by the formation of abnormal blood vessels (neovascularization) that cause hemorrhages and fluid accumulation in the retina, leading to sudden vision loss. Early treatment with intraocular injections of anti-angiogenic drugs is essential to prevent irreversible vision loss which, without this treatment, occurs in all cases.

The prognosis of neovascular or exudative AMD depends mainly on four factors:

  • Time from onset of symptoms to initiation of treatment with intraocular injections of antiangiogenic drugs.
  • Frequency of intraocular antiangiogenic drug injections
  • Frequency of follow-up visits to monitor neovascular AMD activity.
  • Type of neovascular lesion present on optical coherence tomography

How to prevent AMD

Certain habits in our lives can be determinant for the prevention of age-related macular degeneration:

  • Diet: daily consumption of green leafy vegetables, fruits and oils enriched in omega-3 fatty acids can decrease the risk of development and progression of the disease.
  • Quit smoking: quitting smoking benefits both your lungs and those around you, as well as decreases the risk of AMD.
  • Protection from the sun’s rays: wearing approved sunglasses protects the macula from harmful ultraviolet radiation.
  • Taking supplements with antioxidants: there are numerous vitamin supplements enriched in lutein and zeaxanthin that are specially designed to protect the macula and have been shown to decrease the risk of progression from intermediate to advanced forms.
  • Periodic check-ups: regular visits to the ophthalmologist are recommended to evaluate risk factors and other eye diseases such as glaucoma. A detailed study by experts in optical coherence tomography is necessary to accurately assess individual risk and to be able to act early.