AMD treatment: age-related macular degeneration

Age-related macular degeneration (AMD) is a common eye condition that affects the macula, the part of the eye that helps you see fine details in the center of your vision. AMD can cause blurred vision, blind spots, and distortion. In some cases, it can lead to legal blindness.

AMD is a progressive disease, which means it gets worse over time. There is no cure for AMD, but there are treatments that can help slow the progression of the disease and prevent further vision loss.

The two main types of AMD are dry AMD and wet AMD.

  • Dry AMD is the most common type of AMD. It affects the macula by causing the death of cells. Dry AMD usually develops slowly and does not cause any symptoms in the early stages. However, as the disease progresses, it can cause blurred vision, blind spots, and distortion.
  • Wet AMD is a less common type of AMD. It affects the macula by causing the growth of abnormal blood vessels. These blood vessels can leak fluid and blood, which damages the macula. Wet AMD can cause sudden vision loss.

Due to the lack of effective treatment options for dry AMD, maintaining a healthy lifestyle is crucial in order to reduce risk factors. On the one hand, regular exercise is part of this. This not only stimulates circulation but also aids in maintaining a healthy weight, blood lipid levels, and blood pressure. Healthy eating is the second. The emphasis should be on vitamin-rich, fresh foods.

Supplements containing vitamin C, vitamin E, zinc oxide, copper oxide, and beta-carotene may help reduce the risk of AMD progression. The “AREDS combination” may be an option for people at particularly high risk. Regular examination of the central vision with the Amsler grid test and controls in the ophthalmologic practice can indicate whether there is danger of progression and a therapy is necessary.

However, people who smoke or have smoked should not take preparations containing beta-carotene, as it can increase their risk of lung cancer. The German Federal Institute for Risk Assessment recommends that non-smokers limit beta-carotene supplementation to 2 milligrams daily. Lutein, for example, can take the place of beta-carotene for smokers. Anyway, smoking is actually taboo in AMD, especially if the risk for age-related macular degeneration is increased in the family.

In a follow-up study (AREDS 2), it was tested whether omega-3 fatty acids (docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA)) and/or lutein plus zeaxanthin in addition to the intake of the above mentioned “AREDS combination” can favorably influence the development of advanced AMD. In the result, no differences could be found; for lutein and zeaxanthin, it was confirmed that they are suitable alternatives to beta-carotene.

Wet macular degeneration: Anti-VEGF therapy can help

Specialized treatment techniques can halt or slow the progression of eye disease if used in good time. There is currently no known cure. Inhibiting the growth of new blood vessels, or so-called anti-VEGF therapy, is currently of the utmost importance.

Inhibition of new blood vessel formation

VEGF is a messenger substance that causes blood vessels to grow in wet AMD, leading to bleeding and damage to the macula. VEGF inhibitors can stop vascular growth and cause scarring. Drugs are injected directly into the vitreous cavity at monthly intervals, with monthly check-ups to assess success.

More options

Surgery: For instance, if there is severe bleeding under the retina, surgery may be an option. The most popular method is to liquefy the coagulated blood with a substance and displace it with a gas bubble to prevent damage to the retinal cells.

From research : Drugs with a longer duration of action that only need to be injected into the eye a few times a year instead of every four weeks are among the new therapeutic approaches. Additionally, there are implant systems that continuously release the vaso-inhibiting substance, eliminating the need for the monthly injection into the eye. Retinal or pigment epithelial cell transplantation is still regarded as an experimental procedure.



4th Professional Medical Student. Karachi Medical and Dental College.

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