Dry eye shape. Age-related macular degeneration

The diagnosis of macular degeneration sounded like a final death sentence just 5 years ago. There was no way to preserve or restore vision.

A lot has changed since then. Thanks to the regenerative therapy technique developed by the laboratory, the UnikaMed clinic has already counted dozens of people who have improved and even returned 100% vision.

And they didn't just improve it. Subject to medical recommendations, our patients keep it for years.

Approved for use and has an official patent.

Medicine offers several methods to combat macular degeneration. This review article will introduce you to the effectiveness of each known method and will provide an objective prognosis for maintaining and improving vision when using it.

Treatment of dry AMD with antioxidants and zinc

These drugs are aimed at stimulating photoreceptors, improving their nutrition and actually temporarily improving vision.

However, macular degeneration is an irreversible, daily process of loss of pigment epithelium. Together with the pigment epithelium, photoreceptors and vision cells also die.

Neither vitamins, nor antioxidants, nor peptides stop the process of destruction of the pigment epithelium, much less restore it. Stimulation only causes the weakened organ to wear out more, and even with temporary improvement, you continue to lose vision. Medical statistics is that Not a single person has been able to preserve their vision using these means..

Here is a typical patient review about using a regimen with Retinalamin:

“Diagnosis - . Every year I take a course in a hospital, constantly drops, pills to improve cerebral circulation. Is there any evidence of the effectiveness of retinalamin treatment? How to determine if it helps? I take retinalamin injections once a year (p\b), there is no improvement, my vision is gradually deteriorating.”

With all its safety, such drug treatment has one very great danger. Unfounded hope for improvement is the main reason for the loss of precious time and late treatment of patients for truly effective treatment.

Treatment of wet AMD

Laser surgery

Laser treatment has been successfully used for retinal detachment, cataracts and glaucoma. However, in the case of a chronic progressive disease, its capabilities are somewhat limited. When treating macular degeneration of the eye with a laser, the doctor’s task is to “block” the blood vessels that grow under the retina and peel it off.

The laser actually makes harmful vessels impassable and temporarily stops further vision loss. Temporarily - because the operation does not in any way reduce the risk of new vessels, so treatment is often repeated.

During the procedure, the laser beam partially destroys healthy areas of the retina and, as a result, impairs vision. Additionally, laser treatment can only be used on vessels outside the macula. Therefore, only a small percentage of patients have indications for laser treatment.

The main disadvantage of using a laser is that the therapy is aimed at eliminating the consequences of AMD, but does not in any way affect the causes of its occurrence. It is impossible to achieve improvement in visual function or at least stabilization of vision only through laser surgery. The laser will only briefly slow down the progression of the disease.

Photodynamic therapy

Photodynamic therapy is a relatively new method of treating macular degeneration of the retina, based on the photochemical effect on newly formed vessels.

The patient is given intravenously special medicine- a photosensitizer, after which the pathological vessels of the fundus are irradiated with weak laser radiation. The so-called “cold laser” does not burn the retina. Only vessels filled with a photosensitizer react to laser exposure.

As a result of photochemical decomposition, the drug releases atomic oxygen and clogs the blood vessels. Unnecessary fluid stops flowing into the macula area and moving it.

Compared to laser surgery, PDT has a more gentle effect on the retina: the method targets exclusively the vessels. The appearance of scars and atrophy of the fundus membranes are excluded.

By gluing blood vessels together, photodynamic therapy slows the rate of vision loss. However, like the previous method, it does not prevent the appearance of new blood vessels and cannot restore vision or stop its loss. The results of treatment are temporary.

Intraocular injections

This is the most common treatment for wet macular degeneration. There are several drugs for intraocular administration, the most common of which is Lucentis. It relieves swelling from the retina and prevents the growth of pathological blood vessels . It really does prevent it.

However, few doctors convey to their patients the information of the International Congress of Ophthalmologists, which, based on the results of clinical observations, adopted the following procedure for working with the drug: if three consecutive injections of Lucentis do not have an effect (and it does not work on all patients), the drug is discontinued.

The fourth and any subsequent injections of Lucentis, even in patients with a positive reaction to the drug, are considered ineffective.

“There is no doubt that Lucentis is a revolutionary drug and it does improve retinal health in many patients. Unfortunately, this medicine is used for unfounded speculation, and some ophthalmologists give several courses of treatment with Lucentis. Unfortunately, after 3 injections, Lucentis is considered ineffective.

Instilling unreasonable hope for improvement, the use of such a mono-regimen for the treatment of macular and posterior pole degeneration deprives the patient of the chance to turn his attention to other effective means for preserving and restoring vision.”

Marina Yurievna, chief physician clinics "UnikaMed"

Regenerative therapy

The greatest effect in the treatment of macular degeneration of the retina is shown by the method of regenerative therapy. Clinics in Israel, Germany and Vietnam are conducting their research in the field of tissue technologies; doctors in Kyiv and Minsk are following a similar path, but have not yet proposed an effective technique. In Russia, the treatment of macular degeneration using the regenerative therapy method was patented by Professor Kovalev’s group and is carried out at the UnikaMed clinic.

"Regenerative therapy - personalized treatment of macular retinal degeneration. This means that the medicine is created individually each time, tailored to your problem.

After the pick up bone marrow stands out from it special group stem cells, concentrated and surgically injected into problem areas of the eye. The entire procedure takes one day, discharge occurs in the evening, on the day of the operation.

Own stem cells trigger the processes of restoration of the pigment epithelium, visual cells and general tissue healing. During the normalization of processes inside the eye, pathological vessels become empty and their growth stops.

So pronounced and system effect no modern method of treating macular degeneration provides. Even in patients at the stage of blindness and patients over 70 years of age, we are able to restore vision from absolute zero to tens of percent.”

Despite the effectiveness of the method, you will not hear stories from our patients “how I cured macular degeneration” or “how I got rid of macular degeneration.” It is necessary to clearly understand that macular degeneration is a serious, steadily progressing disease. No one knows the reasons for its occurrence and cannot influence them. Therefore, no one knows how to cure macular degeneration of the retina forever.

For this reason, in order to maintain the achieved result, the procedure must be repeated regularly - approximately once a year. Violation of the treatment regimen leads to a natural decrease in vision.

The price of the procedure is determined individually based on the characteristics of a particular disease.

It is not necessary to come to the clinic for the first consultation. Send the results of your examinations and analyzes by e-mail [email protected] . The medical council will decide on the prospects for treatment, and if the decision is positive, we will invite you to an appointment.

Age-related macular degeneration (AMD) is an eye disease that has a progressive course. The disease is characterized gradual decline visual acuity due to damage, macular degeneration ( central department retina). Most often, both eyes are affected, but macular degeneration can be asymmetrical, with one eye being more affected than the other.

It must be said that this very common eye disease is diagnosed in people over 40-45 years old. Moreover, it is one of the main causes of vision loss. Patients look at the object, but practically do not see it, cannot examine it. They do not recognize people's faces, cannot watch TV, and cannot distinguish letters when reading, since they become invisible to them. They see straight lines as wavy, significantly worsening color vision. All this greatly reduces a person’s quality of life.

The disease progresses slowly over many years and is usually discovered by chance, already at late stages. What forms does age-related macular degeneration of the retina have, how is it treated, and how is it carried out? Let's talk about this:

Two forms of macular degeneration

In medicine, it is accepted to distinguish between two forms of this disease:

Dry (atrophic). Develops when the pigment density of the macula decreases. The dry form of AMD can smoothly transition into the second form - wet.

Wet (exudative). Although this form develops in only 10-20% of cases of all manifestations of AMD; it is the cause of complete blindness.

Treatment age-related degeneration retina

Unfortunately, this disease cannot be cured. However, it is quite possible to stop the deterioration of vision and stop the development of AMD. Effective treatment methods have been developed for this. Let's talk about them in more detail:

Application vitamin preparations. In the early stages degenerative changes retina, further progression of the disease can be significantly slowed down by taking vitamin complexes. It has been scientifically proven that additional intake of vitamins: C, E, beta-carotene, as well as minerals: zinc and copper reduce the risk of vision impairment. It is recommended for patients with mild and medium degree severity, as well as in advanced dry form of the disease.

Laser treatment. Laser treatment has been successfully used for this disease. During the procedure, pathological blood vessels are destroyed, which actively grow during the development of the disease, reducing vision.

Antiangiogenic medicines. Special medications effectively slow down the development of the disease, namely, they prevent the proliferation of pathological blood vessels. The attending physician will prescribe them to you, based on the diagnosis performed, taking into account your state of health.

Corrective devices. To improve the quality of vision of patients with AMD, glasses with special lenses and special electronic systems. With their help, the image is visually enlarged. This helps patients get the most out of their vision.

There are also some effective experimental treatments for age-related macular degeneration:

Submacular surgery - surgically remove emerging pathological vessels.

Retinal translocation - During the operation, pathological vessels that are located directly under the macula are also destroyed. The operation does not create a scar and prevents further destruction of the retina. The retina is shifted from the place where the pathological vessels are located, after which laser treatment is performed.

Important!

As we have already said, the dry form of age-related macular degeneration tends to develop into the wet form of the disease, which significantly increases the risk of blindness. Therefore, patients diagnosed with the dry form should undergo regular examinations by an ophthalmologist.

In addition, you should monitor your own vision yourself and check it daily. If there is deterioration, you need to rush to see a doctor.

Patients with the wet form who have undergone laser treatment should also undergo preventive examinations. This will help determine whether there is an increase in the size of existing “blind” spots in the field of view, as well as determine whether new ones have appeared. You need to understand that months or even years after laser treatment, new pathological vessels may develop.

If one eye is affected, the other eye should also be examined. It is necessary to exclude the appearance of new symptoms of the disease. Keep this in mind and be healthy!

Our task is to save your vision!

Age-related macular degeneration (AMD) is the leading cause of blindness in people over 50! According to WHO, more than 45 million people in the world currently suffer from this disease.

Preventing blindness and restoring vision is our core philosophy when working with patients suffering from age-related macular degeneration. In our clinic we use modern and effective developments in the diagnosis and treatment of this disease. Timely treatment started together with the use of anti-VEGF therapy gives reliable results!

It's important to remember what's the most reliable way Diagnosis of macular degeneration is a preventive visit to an ophthalmologist and a targeted examination of the fundus with a wide pupil during an ophthalmological examination!

WHAT IS AMD?

Age-related macular degeneration (AMD) is a pathological process in the central (macular) region of the retina, leading to a pronounced decrease in visual functions. The macular area of the retina is responsible for central visual acuity, and when it is damaged, the objects in question first become distorted and straight lines appear curved, then an opaque spot appears in the central area of vision. As a result, patients experience severe problems with facial recognition, reading, driving, it becomes difficult to navigate in space, and the risk of injury (falls, bruises, fractures) increases. Overall quality is deteriorating normal life any person, which leads to social isolation and clinical depression.

Chronic dystrophic process in the central zone of the retina occurs due to age-related changes metabolism and vascular system. As a result, retinal nutrition is disrupted, which leads to damage to the choriocapillaris layer, Bruch's membrane and retinal pigment epithelium. According to statistics, this pathology is the leading cause of loss central vision up to blindness in patients over 50 years of age. The severity of the disease is determined by the central localization of the process and, as a rule, bilateral eye damage.

With macular degeneration, photoreceptors are affected - the cells responsible for object vision, giving us the ability to read, see distant objects and distinguish colors.

FORMS OF MACULAR DYSTROPHY

There are two forms of age-related macular degeneration – dry and wet.

DRY FORM OF AMD (AGE-AGE MACULOUS DYSTROPHY)

Dry AMD is the most common form of the disease and develops in several stages. In the early stages of dry AMD, yellow deposits known as drusen form and begin to accumulate in the layers of the retina. Drusen can vary in both size and number and are considered part of natural process age-related changes in the eyes. Visual loss at this stage is noticeable, especially with unilateral lesions.

Over time, the disease progresses to advanced dry AMD and may eventually transform into the wet form. In the advanced stage of dry AMD, in addition to an increase in the number and size of drusen, patients experience destruction of light-sensitive cells and tissues surrounding the macula. This already causes significant vision problems.

Dry AMD can affect one or both eyes. In cases where only one eye is affected, it is more difficult to detect initial changes in vision in the early stages due to the fact that healthy eye works more intensively to compensate for the lack of vision due to the affected eye. Therefore, it is very important to regularly visit an ophthalmologist to check the visual acuity of both eyes and other preventive tests.

WET FORM OF AMD (AGE-AGE MACULOUS DYSTROPHY)

Wet AMD, also known as neovascular macular degeneration or exudative form AMD is the most serious and aggressive form of age-related macular degeneration. In approximately 15-20% of patients, dry AMD turns into a wet form.

In wet AMD, new abnormal blood vessels begin to form in the choriocapillaris layer under the macula, a process called neoangiogenesis. Fluid and blood leak through these defective pathological vessels, which can cause blister-shaped recesses under the macula. It is these bubble-shaped notches that distort vision in the affected eye, causing straight lines to appear wavy. The patient can see dark spot or various spots in the center of the visual field. This occurs due to the accumulation of blood or fluid under the macula.

Unlike dry AMD, which can develop slowly, wet AMD develops quite quickly and damages the macular area, which soon leads to severe loss of central vision and blindness. Therefore, it is very important for patients at risk of developing wet AMD to have their vision checked periodically by an ophthalmologist. If wet AMD is not treated promptly, bleeding in the eye can cause scar tissue to form, leading to permanent vision loss.

WHAT ARE THE RISK FACTORS AND CAUSES OF AMD?

Age-related macular degeneration is a multifactorial, polymorphic disease of the central zone of the retina and choroid eyes. The influence of the following factors on the body several times increases the risk of developing AMD and the aggressive progression of this disease:

Age over 50 years.
Family predisposition and genetic factors.
Floor. Women are twice as likely to develop AMD as men.
Overweight and obesity.
Smoking.
Prolonged and intense insolation.
The presence of chronic diseases such as:
- hypertension;
- atherosclerosis;
- systemic diseases;
- diabetes mellitus and other diseases.
Professional harmful factors(laser, ionizing radiation).
Bad environment.

Other causes may include injury, infection or inflammatory diseases eye, high myopia.

WHAT ARE THE MAIN SYMPTOMS OF AMD?

In the early stages, AMD may not be accompanied by any noticeable symptoms. Over time, patients notice a loss of brightness and contrast of colors, blurred, unclear images, and it becomes difficult for them to see the details of objects, both near and far. Straight lines are perceived as wavy or partially broken, mainly in central parts fields of view. The perception of familiar objects changes, for example, a doorway seems skewed.

First a blurry, then a dark spot appears in the center of the visual field.
It becomes difficult to distinguish colors.
Blurred vision.
Contrast sensitivity decreases.
Vision decreases when moving from bright to dim lighting.
Spatial vision is impaired.
Increased sensitivity to bright light.
Visual functions improve at night.
Faces become blurry.
It becomes impossible to do work that requires close vision, for example, it becomes almost impossible to thread a needle.

When found similar symptoms You should immediately undergo an examination by an ophthalmologist!

Important to remember! Wet AMD can be cured. The key is to recognize the symptoms as quickly as possible and take immediate steps to receive proper treatment.

CAN VISION LOSS CAUSED BY WET AMD BE REVERSED?

Undoubtedly. Clinically proven that timely diagnosis and specific progressive therapies help restore patients' vision.

HOW IS AMD DIAGNOSED?

Changes in vision can be determined at home independently by simple test, for which the Amsler lattice is used. This test is intended both to identify diseases of the central retina and to monitor the dynamics of treatment for existing pathology of the central retina. The Amsler test should be placed at a distance of 30 cm from the eye, and the other eye should be covered with your hand, then focus on the bold dot in the center of the test. If you find any changes, mark them on the Amsler test or sketch how you see them, and take them with you to an appointment with an ophthalmologist.

WHAT DIAGNOSTIC EXAMINATION FOR AMD IS CARRIED OUT IN THE CLINIC?

In addition to routine methods diagnostic examination for retinal dystrophy, such as determination of visual acuity, biomicroscopy, examination of the fundus (ophthalmoscopy), determination of visual fields (perimetry), we use modern computerized methods diagnostic study retina of the eye. Among them, the most informative for AMD is optical coherence tomography. This study allows us to identify the earliest changes that appear in macular degeneration of the retina. Optical coherence tomography (OCT) can detect changes within tissue structures retina and determine the form of macular degeneration.

Special significance OCT is used in cases where there is a discrepancy between visual acuity and the fundus picture obtained with conventional ophthalmoscopic examination. Besides, this study prescribed to monitor the effectiveness of treatment. In addition to OCT, in some cases we prescribe fluorescein angiography of the retina (FAG) - this allows us to use intravenous dye (fluorescein) to diagnose changes in the structure of retinal vessels, which is necessary to identify the source of edema when prescribing laser coagulation of the retina. All these studies make it possible to clarify the diagnosis, stage of the disease, and choose the right treatment tactics.

MODERN TREATMENT OF WET AMD

Currently, a number of effective methods for treating wet forms of AMD. These treatments aim to stop angiogenesis (the formation of new, defective blood vessels) in the eye and are called "anti-angiogenic", "anti-proliferative" therapies or "anti-VEGF" therapies. The VEGF (vascular endothelial growth factor) family of proteins potentiates the growth of new defective blood vessels. Anti-VEGF therapy aims to slow the progression of wet AMD and, in some cases, improve your vision. This therapy is especially effective if used before the scarring stage, which is when treatment can preserve vision.

WHAT ARE ANTI-VEGF THERAPY DRUGS?

There are several main drugs that are VEGF inhibitors, they are most effective for treating wet form VMD:

Macugen (Pegaptanib) is a VEGF inhibitor and has been recommended for the treatment of wet AMD. Macugen acts directly on VEGF and thereby helps slow down vision loss. This drug is administered directly into the eye as an endovitreal injection. This therapy requires repeated injections every five to six weeks. Macugen stabilizes vision in approximately 65% of patients.

Lucentis (Ranibizumab) is a highly effective treatment for wet AMD. Lucentis is a type of anti-VEGF drug called a monoclonal antibody fragment that was developed to treat retinal diseases. It is injected directly into the eye as an endovitral injection and can stabilize vision and even reverse vision loss.

Our clinical observations show that best results observed if the drug is administered several times monthly. Data received within clinical trials, also showed that after two years of treatment with monthly Lucentis injections, vision stabilizes in approximately 90% of patients, a significant rate of vision recovery.

Eylea (Aflibercept)- this is also highly effective drug for the treatment of wet AMD, prescribed at a lower frequency of administration. Eylea is a type of anti-VEGF drug known as a fusion protein that is injected directly endovitrially into a patient's eye to treat wet AMD. Eylea targets VEGF directly, as well as another protein called placental growth factor (PGF), which has also been found in excess in the retinas of patients with wet macular degeneration. After the first 3 injections at monthly intervals and subsequent injections every two months, Eylea demonstrates the same effectiveness as monthly injections of Lucentis.

A clinical trial in patients with wet age-related macular degeneration compared monthly Lucentis injections with Eylea injections given regularly for three months and then every other month. After the first year of treatment, it was demonstrated that injections of Eylea once every two months improved or maintained vision in patients suffering from AMD at a level comparable to that achieved with Lucentis. The safety of both drugs is also similar. Overall, patients treated with Eylea required fewer injections to achieve the same effectiveness as monthly Lucentis injections.

Avastin (Bevacizumab) - antitumor drug with high anti-VEGF activity, which is prescribed by ophthalmologists as an off-label therapy for the treatment of wet age-related macular degeneration. Avastin is a type of anti-VEGF drug called a monoclonal antibody that was developed to treat cancer (the progression of which also depends on angiogenesis). Avastin is similar in structure to the drug Lucentis. Some ophthalmologists prescribe Avastin to patients suffering from wet AMD, after repackaging the drug so that it can be injected directly into the eye.

Because Avastin injections have been shown to be similar to Lucentis in treating wet macular degeneration, some ophthalmologists use Avastin because it is significantly cheaper than Lucentis. Avastin injections can be given monthly or less frequently on a schedule determined by your doctor.

All anti-VEGF drugs for the wet form of macular degeneration are administered directly endovitrally into the eye only by an ophthalmologist. Vitreoretinologists (retina specialists) are specially trained to perform this endovittrial injection safely and painlessly. The frequency of injections is determined by the ophthalmologist depending on the severity of the patient's condition. In addition to anti-VEGF, dehydration therapy and laser coagulation retina. It is also necessary to know that all drugs used have risks associated with their use, which must be considered in relation to the benefits that such drugs bring. With regard to anti-VEGF therapy itself, such risks may include eye infection, increase intraocular pressure, retinal detachment, local inflammation, temporary blurred vision, hemorrhage under the conjunctiva, eye irritation and eye pain, which go away on their own over time.

Age-related macular degeneration is chronic disease, in which central vision deteriorates. The pathological process is based on damage to the macula, the central part of the retina. The macula contains a huge number of light-sensitive cells that provide sharp and detailed central vision. The macula is located in posterior section The retina is the most sensitive part.

What is it?

Experts distinguish between dry and wet forms of AMD. The first type is quite common and is associated with the appearance of deposits on the retina. The wet form is formed due to the sweating of blood and fluid from the blood vessels.

Age-related macular degeneration significantly impairs quality of life. Patients have deteriorating vision in the central part of the visual field, and this area is responsible for many processes, including reading, recognizing faces, driving a car, and sewing.

Most often, degenerative changes in the macula appear after the age of fifty, although there are cases when the disease occurs in young patients. AMD can develop slowly, with vision remaining unchanged for a long period of time. In other cases, the pathology progresses rapidly and causes significant visual impairment in one or both eyes.

There are wet and dry forms of AMD

Provoking factors

The exact causes of degenerative changes in the macula are still not fully understood, but they occur as the eye ages. This ultimately leads to thinning and destruction of the central part of the retina.

Experts identify the following etiological theories of the occurrence of AMD:

abnormal growth of blood vessels. Fluid flowing from abnormal vessels prevents normal functioning retina and leads to macular opacification. As a result, the objects you look at appear bent and misshapen;
accumulation of fluid in the back of the eye. This causes epithelial detachment, which appears as a blister under the macula.

The dry form of age-related macular degeneration can progress and become the wet type. Experts make no guarantees as to whether such rebirth is possible or when it will happen. For some people, vision loss progresses so much that it leads to blindness.

Smoking is a provoking factor in the occurrence of the pathological process of the macula

Risks of age-related macular degeneration under the influence of the following factors:

smoking. According to research, this bad habit doubles the risk of AMD;
genetic predisposition;
cardiovascular disorders;
overweight;
race. Europeans are more likely to be diagnosed with AMD;
age indicators;
poor nutrition;
inflammatory processes;
elevated cholesterol levels;
surgery for lens opacity;
prolonged exposure to an intense light source.

Experts assure that healthy image life significantly reduces the likelihood of a pathological process occurring. Doctors recommend quitting smoking and engaging in moderate physical exercise, control the level blood pressure and cholesterol. An important role is played by the diet, which should include greens, vegetables, and fish.

Symptoms

Macular degeneration is characterized by the following symptoms:

the need for brighter light for reading and working with small objects;
poor adaptation in low light conditions;
vagueness of the text;
feeling that colors have become faded;
poor face recognition;
the appearance of haze before the eyes;
rapid deterioration of vision;
the appearance of a blind spot in the field of vision;
straight lines appear curved;
visual hallucinations. People or geometric shapes may appear.

Visual hallucinations may occur with macular degeneration

Why is macular degeneration dangerous?

As you know, the eyes are a paired organ, therefore healthy organ vision takes on the function of the affected person. For a long time, manifestations of degeneration may remain undetected. It is also worth noting the fact that with macular degeneration there may not be pain, so the patient may think that everything is fine.

The disease threatens complete blindness and loss of ability to work. Irreversible consequences can develop in just a few weeks. That is why you should contact an ophthalmologist for diagnosis as soon as possible.

The diagnosis is made on the basis of anamnestic data, visual acuity studies, angiogram and CT. Doctor in mandatory examine the fundus.

Macular degeneration occurs when cells in the macula are destroyed.

Living with macular degeneration

If you are diagnosed with age-related macular degeneration, it means you will have to make lifestyle changes. This also applies to nutrition. Consider all these recommendations:

eat fruits and vegetables. The antioxidants it contains are extremely important for eye health. Doctors recommend introducing spinach, beans, broccoli, and kale into your diet. These vegetables contain not only antioxidants, but also lutein and zeaxanthin, which are so necessary in the fight against macular degeneration;
eat fats. It's about about healthy unsaturated fats, which, for example, are in olive oil. At the same time, you should limit your intake of saturated fats. They are contained in butter, fast food;
replace flour with whole grain products;
eat fish. Omega-3 fatty acids, included in the product, reduce the risk of vision loss.

The following tips will help you adapt to changes in vision:

try to select glasses as accurately as possible;
use a magnifying glass to work with small objects;
on electronic devices pick up right size font and image contrast. There are special computer programs designed for the visually impaired. You can install a program with which the text will be produced in mp3 format;
brighten your home;
If you are allowed to drive, do so with great care;
Don’t isolate yourself, seek help from your loved ones. You may need the help of a psychologist or psychotherapist.

Spend more time with your family, loved ones will provide invaluable support

Wet macular degeneration

The pathological process is based on the growth of pathological vessels under the macula on the posterior side of the retina. These abnormal blood vessels are fragile enough to allow blood and fluid to leak through them, elevating the macula from its natural position. The wet form develops quickly and is characterized by rapid deterioration of vision.

Important! In ninety percent of cases it is wet macular degeneration causes blindness.

Treatment for age-related macular degeneration includes conservative therapy. Patients are prescribed dedystrophic drugs, antioxidants and immunomodulators. Also useful for retinal degeneration are lutein and zeaxanthin. Although they cannot restore vision, they are quite capable of stopping the progression of the pathological process.

Currently, methods are used whose effectiveness has been clinically proven:

photodynamic therapy. This is a relatively new treatment method. Abnormal vessels are exposed to photochemical effects. Using a weak laser effect, a special substance is activated, which is first administered intravenously. As a result, abnormal blood vessels are blocked and swelling is relieved;
angiogenesis inhibitors: Avastin, Eilia, Lucentis. These drugs quickly relieve swelling and restore normal indicators vision. The products are injected directly into the eye using a very thin needle. This procedure is absolutely painless.

With wet AMD, fluid and blood leak from pathological vessels

Dry macular degeneration

Characterized by atrophic changes, which results in thinning of the macular tissue. First, the pathological process affects one eye, after which the second organ of vision is also involved.

A characteristic symptom of the dry form is the formation of drusen. They are deposits under the retina. Drusen themselves do not cause vision impairment.

The disease occurs in three main stages:

Early stage. It is characterized by the appearance of several small drusen. As a rule, clinical manifestations are missing.
Intermediate stage. There are a large number of medium-sized drusen and several large ones. There may be no symptoms. In some cases, clouding of the central part of the visual field appears. A person needs more time to enter dark room, and brighter reading lighting.
Late stage. Large drusen appear. Macular cells are destroyed. Significant deterioration of vision.

Treatment for dry macular degeneration includes the following:

timeliness of treatment measures;
impact on the mechanism of development of the pathological process;
comparative analysis of AMD with other pathologies;
lifelong treatment, including lifestyle changes;
the use of medication, laser and surgical treatment.

Resume

Age-related macular degeneration is a serious pathological process that most often occurs in people after fifty years of age. The disease threatens irreversible changes up to loss of vision. Macular degeneration can be dry or wet. Depending on the form of the disease, appropriate treatment is selected. Early diagnosis, timely prescribed treatment and follow-up medical recommendations will help prevent the development of dangerous complications and restore vision.

Age-related macular degeneration (dystrophy) or AMD for short is the most dangerous for older people eye disease, since AMD most often leads to blindness in people over 50 years of age. There are more than 45 million AMD patients worldwide.

“- this phrase very clearly characterizes this disease.

« Age“means that advanced age is a decisive risk factor for AMD, and the older a person is, the more susceptible he is to this disease. For example, for middle-aged people the risk of AMD is 2%, but for those over 75 years old, this figure increases to 30%!

« Macular“means that AMD affects the macula (or macula), the most sensitive area of the retina that provides a person with central vision. It is thanks to central vision that a person is able to distinguish small items and their details. The insidiousness of this disease lies in the fact that it is painless and patients usually turn to doctors in the later stages of AMD, when vision has already noticeably deteriorated.

« Degeneration“implies the gradual destruction of light-receiving cells of the retina (photoreceptors) due to disruption of their nutrition due to atherosclerotic changes in the blood vessels of the eye. As the disease progresses, a person's vision deteriorates in a manner similar to what is shown in this animated graphic:

If you suddenly suspect that the deterioration of your vision is due to AMD, you can do a self-diagnosis on.

AMD is explained in a very accessible and clear way in this 7-minute video:

As you probably understood from the video, there are two forms of AMD - dry and wet. Each of them has its own characteristics of course and treatment. Let's look at them in more detail.

Dry form of AMD

This is the most common form of AMD, occurring in 90% of cases. Due to age-related changes in metabolism, non-degradable polymer structures called drusen are formed in the retina (including the macula). The layers of the retina adjacent to these drusen experience an acute lack of nutrients and oxygen, due to which they degenerate (atrophy) with loss large quantity photoreceptors.

The fewer intact light-sensitive cells left in the macula, the more noticeable the loss of central vision. At first, a person feels the need for stronger lighting for reading and other visual work. Then patients notice the appearance and growth of a cloudy spot in the center of the field of vision. Over time, this spot increases in size and becomes darker. Because of this, difficulties begin when reading or recognizing faces even at a short distance.

Wet form of AMD

This is a more rapidly developing (and therefore more dangerous!) form of age-related macular degeneration, occurring in 10% of patients with AMD. In this case, the lack of retinal nutrition is compensated by the growth of new, but very fragile capillaries that allow blood and fluid to pass through. Macular swelling occurs.

In places of leakage, photoreceptors die and the photosensitive layer swells. The result is a sharp decrease in vision and the appearance of a distortion effect in the visible image:

Prevention and treatment of AMD

As you already understand, the risk of developing age-related macular degeneration is directly related to the condition of the blood vessels of the eyes. Unhealthy image life (physical inactivity, poor nutrition, obesity, hypertension, diabetes), bad habits (), - all these factors contribute to the deposition cholesterol plaques on the walls of blood vessels and deterioration of blood supply to the retina.

It's never too late to give up bad habits, increase physical activity, start eating right and enriching your food. Regular (at least once every six months) visits to the ophthalmologist to examine the fundus will help identify AMD in initial stage when treatment is most effective and the risk of vision loss is minimal.

Otherwise, in the later stages of AMD (when the photoreceptors of the macula have already died), it will be impossible to restore vision, unfortunately.

Ophthalmologists recommend that patients with AMD protect their eyes from direct exposure sun rays, but, in my opinion, this recommendation only aggravates the course of the disease. If you constantly hide your eyes from the sun, increased photosensitivity (photophobia) will be added to the symptoms of AMD, which will further worsen the patient’s condition.

It is well known that on a bright sunny day a person (including those suffering from AMD) sees much better than usual. But if bright light causes your eyes to reflexively close and water, then you simply won't be able to take advantage of the chance to see more clearly.

Still famous Dr. William Horatio Bates proved the benefits for the eyes in practice sunlight. By using special exercise on eye irradiation sunlight– – you can not only get rid of photophobia, but also improve the condition of the retina due to the activation of metabolic processes in it under the influence of light. And this is exactly what AMD patients need.

An indispensable condition effective prevention and treatment early stages AMD is antioxidant protection macula by taking carotenoids (lutein and zeaxanthin) - red, yellow or orange pigments found in plant and animal tissues, as well as the minerals zinc, selenium, vitamins C, E and anthocyanosides. "" is one of the most famous lutein-containing drugs that doctors recommend for AMD.

Lutein and zeaxanthin are the main pigments of the macula and provide natural optical protection visual cells. Natural sources of lutein and zeaxanthin are egg yolks, broccoli, beans, peas, cabbage, spinach, lettuce, kiwi, etc. Lutein and zeaxanthin are also found in nettles, seaweeds and the petals of many yellow flowers.

For dry AMD, treatment is usually limited to taking vitamins and the antioxidants mentioned above. Much less commonly used low-intensity (threshold) laser therapy to destroy drusen (yellowish deposits on the retina) using moderate doses of laser radiation.

Laser therapy is also used to treat wet AMD. One of the types of such therapy is laser photocoagulation– provides for destruction laser beam bleeding defective retinal vessels. However, there is big risk destruction of surrounding healthy tissue. Therefore, such laser surgery is more effective outside the macula, where the death of light-sensitive cells is not so critical for vision.

There is a more “gentle” option laser therapy wet AMD – photodynamic therapy. The patient is given intravenously special drug(“Visudin”), which tends to attach to inner surface blood vessels. After this, the retina of the diseased eye is irradiated with cold laser light, which activates this drug in the pathological capillaries that have grown into the retina. A chemical reaction occurs and the bleeding capillaries are destroyed, which slows down the rate of development of AMD. At the same time, the surrounding healthy tissue is not damaged.

But in first place in the treatment of wet AMD is the so-called anti-VEGF therapy, blocking action specific factor growth (VEGF) of defective capillaries. IN eyeball using a special needle, one of the the following drugs: Bevacizumab (Avastin), Ranibizumab (Lucentis), Pegaptanib (Macugen), Aflibercept (Eylea).

With this method of administration, the drug quickly penetrates all layers of the retina and begins its action aimed at reducing macular edema and preventing new hemorrhages. Some patients experience a positive effect within a week after the injection, but usually 3 injections are needed at an interval of 1 month to achieve maximum results.

Here is a video that explains this method of treating wet AMD in more detail:

Unfortunately, the methods described above AMD treatment are not able to completely cure this disease. Yes, besides, they are not without negative side effects(infection of the eye, increased intraocular pressure, retinal detachment, temporary blurred vision, pain in the eye, etc.).

At best, patients experience some improvement in vision. But usually treatment is considered successful when vision at least stops deteriorating. But this is provided that the patient regularly visits the doctor and undergoes repeated medical procedures if necessary.

“The best treatment is prevention!” This saying is more appropriate than anywhere else in the case of age-related macular degeneration. If you lead a healthy lifestyle and regularly visit the ophthalmologist, then you have a chance to preserve your vision for up to old age increases significantly.

Good vision to you at any age!