Fernández Vega Ophthalmological Institute - Macular degeneration - Instituto Oftalmológico Fernández Vega

AGE-RELATED MACULAR DEGENERATION

Age-related macular degeneration (AMD) is a disease that causes a progressive deterioration of the pigment epithelium of the retina at the level of the macular area (the retina area with a higher concentration of photoreceptors which allows us to have the highest level of visual acuity).

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What it is, causes and types

There are, however, other factors that may increase the risk of a person suffering from this ocular complaint: a family history of macular degeneration, smoking, high cholesterol and clear eyes.  It can affect one or both eyes and causes progressive deterioration of the eyesight.  Peripheral vision is usually maintained, but generates a disabling situation in the central vision.


There are two forms of this disease:

  • Dry or atrophic AMD. This is the most frequent (80% of cases) and also the most benign, since its progression is slower, although it can evolve towards the humid form, which is more aggressive. Its main characteristic is that there is a thinning of the macula tissue that can produce atrophy of some of its parts or form waste deposits that the retina cannot eliminate and accumulate in its posterior (drusen).
  • Wet or exudative AMD. It occurs because of the growth of anomalous blood vessels that exude blood and fluids that deposit and accumulate in the macula. It has a worse prognosis than the dry form and the loss of visual acuity is faster if the appropriate treatment is not received. This treatment can slow or halt the development of the disease.

     

SYMPTOMS

The symptoms of age-related macular degeneration (AMD) affect fundamentally the progressive deterioration of central vision, which becomes blurred and distorted, while not affecting peripheral vision. This deterioration in sight is associated with the following aspects of vision:

  • Blurry vision.
  • Although the ability to distinguish colours is maintained, they are distorted (discromatopsia).
  • Straight lines are also distorted, and things are seen in a different size from their actual one (metamorphopsia).
  • Increased brightness is required for reading.
  • Glare occurs when looking at a light source.

One way to check that you have this eye complaint is by looking at the clock, at a distance, as you can see the sphere perfectly but cannot distinguish the needles or see them undulating. However, it is best to get the so-called Amsler grid and look at it at a distance of 30-40 centimetres. It is a grid with horizontal and vertical lines and a centre point. If you notice areas that are blurred or darker than others and the lines are distorted, it may be a sign of AMD and you should consult an ophthalmologist as soon as possible.
 

Treatment


If it does not occur by chance in an ophthalmologic check-up, it is common for age-related macular degeneration to be detected when appreciable impairment of central vision, has already taken place, usually in one eye, although this may be later.
If it is a dry or atrophic macula, there is no possibility of effective treatment. However, it is usually prescribed a vitamin complex that helps to slow the progression of the disease.

 

In the case of wet or exudative macula it is currently treated with intraocular injections of antiangiogenic drugs, aimed at blocking the formation of new vessels, which is the cause of liquid accumulation in the macula. Treatment is performed in the hospital on an outpatient basis. Three different types of antiangiogenic drugs are currently on the market. Your ophthalmologist will determine which is the most suitable for your complaint.

 

 

ResultsIt is not usual for a person with age-related macular degeneration and who is undergoing treatment to suffer total loss of vision in the affected eye, because even in the most severe cases peripheral vision will be preserved.


Treatment with intra-ocular injection of antiangiogenic drugs allows 70% of patients to have no vision loss after the first year of treatment and at least 40% of them can even drive.


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