Age-Related Macular Degeneration: Causes, Symptoms, and Treatment
Age-related macular degeneration (AMD) is a retinal disease that typically occurs after the age of 50, involving the progressive degeneration and destruction of photoreceptor cells in the macula (yellow spot), the area of sharp vision in the eye. The condition affects the central part of the retina, which can lead to reduced or complete loss of reading ability and central vision. Two forms are known: dry and wet macular degeneration. The types often overlap; the distinction is important primarily for treatment purposes.
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What Is Age-Related Macular Degeneration? What Happens in This Condition?
In dry macular degeneration, the condition is characterized by the accumulation of abnormal metabolic products (drusen, pigmentary changes) beneath the photoreceptor cells of the macula and the atrophy of these cells. In wet macular degeneration, abnormal blood vessel growth develops beneath the retina, causing fluid leakage, macular edema, and hemorrhage in the area of sharp vision.
In both cases, the consequence is the destruction of photoreceptor cells, which in the wet form is also accompanied by significant scar tissue formation. The dry form typically develops more slowly and deteriorates gradually over months or years, while the wet form can cause rapid vision loss within a few weeks. The extent of scarring is generally less when treatment is initiated early.
Screening for macular degeneration is possible during any general ophthalmological examination using slit-lamp examination; if treatment-requiring suspicion arises, the patient is referred to a retina specialist. In addition to fundus examination, detailed instrumental retinal layer examination—that is, macular OCT examination—is also necessary for early and accurate diagnosis. Distinguishing from other similar diseases and establishing a treatment plan is the responsibility of an ophthalmologist specializing in retinal diseases.
What Are the Symptoms of Age-Related Macular Degeneration?
The symptoms of macular degeneration are generally easy to notice, as they always affect central vision.
The symptoms of macular degeneration may include:
- central distortion (lines, letters, objects appear curved)
- central scotoma (blurred vision in one or more spots in the center)
- vision loss (difficulty reading, vision significantly weaker in the central area)
Are the Causes of Macular Degeneration Known?
The exact cause of macular degeneration is rarely determined; the most common factors include genetic background, environmental influences (smoking, UV radiation, unbalanced diet), and age.
How Can Age-Related Macular Degeneration Be Treated?
Treatment of Dry Macular Degeneration
Since the disease is one of the most common causes of vision loss, intensive research is underway worldwide regarding treatment. Despite this, unfortunately there is currently no effective treatment for dry macular degeneration; eye vitamins or a Mediterranean diet (rich in vegetables, fruits, and fish) can only reduce the likelihood of further deterioration in certain phases of the disease.
Treatment of Wet Macular Degeneration
The most effective treatment currently known for wet macular degeneration consists of intravitreal anti-VEGF injections administered into the eye. Several preparations exist, which must be administered into the eye at varying frequencies, but in all cases, three doses given monthly are required at the beginning. Before the procedure, the area around the eye and the eyeball are disinfected, anesthetic drops are instilled, and then the medication is injected, allowing it to exert its effect on the lesion in a sustained and targeted manner. For a few days after treatment, water and contaminants must not enter the eye, thereby avoiding the serious complication of eye infection.
