Vmd eyes wet form. Macular retinal degeneration - causes and treatment

With the correct functioning of the central part of the retina, a person sees well objects that are located very close to the eyes. He easily reads and writes, distinguishes colors. With its defeat, macular degeneration occurs, in which the patient complains of blurred vision, it is difficult for him to write or read. What is macular degeneration of the retina? What are its symptoms and can this disease be treated?

Macular degeneration of the retina

Macular degeneration is a disease characterized by damage to the retina of the eye, resulting in impaired central vision. The pathology begins with the vessels, passes into ischemia of the central zone of the retina, which is responsible for central vision. AMD (age-related macular degeneration) in people over the age of 55 is the most common cause of blindness. IN last years the disease sharply "rejuvenates".

Women are most prone to this disease, as they live longer than men. It is also passed on through inheritance.

Age-related macular degeneration: causes

Lack of minerals and vitamins in the human body.
A diet that is high in saturated fat.
Age from 55 years and older.
Smoking.
Duration and intensity of direct hits sun rays.
Overweight.
Eye injury.
Diseases arterial hypertension or ischemic disease.

Symptoms of age-related macular degeneration

AMD develops slowly, painlessly, but with obligatory deterioration vision. IN isolated cases blindness in macular degeneration occurs suddenly.

Types of Macular Degeneration

Dry AMD- forms and accumulates a yellowish plaque, which has a bad effect on photoreceptors in the yellow spot of the retina. The disease begins to develop in one eye. About 90% of patients suffer from this type. Dry AMD is divided into three stages of development:

Early stage. Symptoms of visual impairment are not observed, but drusen of small and medium sizes are noticeable in the eye.
intermediate stage. One large drusen or several medium-sized ones appear. The patient has a noticeably distorted spot in the center of the visual field and needs more light to read.
Pronounced stage. In the organ of vision, sensitive cells are destroyed, and the supporting tissue of the retina is damaged. Further, the spot in the center becomes darker and larger. Reading becomes difficult.

Wet (exudative) AMD- new blood vessels grow in the direction of the macula behind the retina. Progresses much faster than dry and appears in people suffering from dry macula, occurs in 10% of cases. Macular degeneration disease develops quickly and a person can lose their sight completely.

Wet AMD is divided into two types:

Hidden. Hemorrhages are not abundant and vascular neoplasms are insignificant. Therefore, violations central vision invisible.
Classical. There is an active growth of new vessels with tissue scarring.

AMD in both eyes

Human life changes significantly. Some patients experience hallucinations, which is associated with impaired central vision. They are called Hallucinations of Charles Bonnet. They appear in the form of figures, animals and human faces. Patients with macular degeneration themselves are afraid that, having told about their visions, they may be mistaken for crazy. The cause of such hallucinations is visual impairment.

In the case of classical macular degeneration, straight lines are distorted, the patient sees them as curved or wavy.

With senile age-related macular degeneration of the retina, vision quickly begins to decline.

Diagnosis of AMD

To determine AMD, a simple Amsler test is performed. The Amsler grid looks like a regular sheet of paper. A square is drawn on a white background and drawn into 400 small squares. Placed in the center of the grid black dot on which the patient should focus his gaze. Testing should be carried out under certain conditions:

The test is carried out in good health, without fatigue. Under stress drunkenness and with the use of certain drugs, the test is not recommended, as this may affect the results of the tests;
Check contact lenses and glasses for transparency and cleanliness;
In the room where the test is carried out, the lighting should be good and natural;
It is impossible to tilt your head, squint your eyes and look away from the central point of the table;
The test is performed on the most healthy eye.

Checking eyesight:

Evaluation of the result. If you saw clarity in the image, all the lines were parallel, the squares were the same, and the corners were right, this means that your vision is in order and there is no AMD.

Treatment

Macular degeneration of the retina, unfortunately, is not amenable to absolute treatment. Here are some ways to help you succeed:

laser therapy. Removes pathological blood vessels and stops their progress;
Photodynamic laser therapy. Vizudin is administered intravenously to the patient, at this time a session of laser exposure is performed under computer control. Pathological vessels are emptied and stick together, in connection with this, hemorrhages stop. The effect of the procedure lasts up to a year and a half.
Anti-angiogenesis factors. The drugs can stop the growth of abnormal vessels.
Low vision devices. Special lenses and electronic devices.

AMD can also be treated with surgery:

submacular surgery. Remove all abnormal vessels.
retinal translocation. Under the retina, only the affected vessels are removed.

When treating dry macula, it is recommended to carry out courses of antioxidant therapy in order to normalize metabolic processes in the retina. Combination Therapy reduces the development of AMD late stage and reduces the risk of losing visual acuity. Prevention and treatment of the dry form of age-related macular degeneration should be carried out regularly, and not in courses.

In the wet form of macular degeneration, treatment inhibits the growth of abnormal vessels. If the treatment of macular degeneration gave positive result, it should be remembered that macular degeneration can return again. Be sure to periodically see an ophthalmologist to avoid complications of AMD.

Folk remedies for the treatment of macular degeneration

Include more in your diet useful products. Eat more berries: blueberries, strawberries, they are able to maintain the health of the retina, which is why there will be no further development of the macula. Vegetables are very useful in this case. Green colour are spinach, dill, celery, parsley and cabbage. They contain antioxidants and vitamins A, C and E, which are so necessary for the eyes.

Make Carrot Salad and Dress vegetable oil, for better absorption of vitamin A. When long-term use grain crops, cholesterol and fat metabolism is normalized, cysts, fibroids, and wen are resolved. The intestinal microflora is restored, the bones are strengthened. A person becomes vigorous, his working capacity increases and he gets rid of obesity.

Use decoctions of cereals and infusions.

Prevention of age-related macular degeneration

In order to age-related macular degeneration did not bring serious consequences, it is necessary to carry out its prevention.

undergo an annual examination by an ophthalmologist;
use sunglasses;
quit smoking;
stick to proper nutrition: refuse fatty foods, add fruits, vegetables and fish to the diet;
take courses of a complex of vitamins for the eyes;
take care of your health and healthy lifestyle life.

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Age-related macular degeneration as a threat of vision loss in pensioners

Time cannot be stopped, just as the aging of the human body cannot be avoided. With age, many problems begin to arise. Including vision problems.

Let's remember a little the structure of our eye. The macula has a second name - the yellow spot. This is the very center of the retina, where the light beam is focused. It provides central vision, as well as color perception of the visual image. Macular lesions occurring in older patients age group, indicates the beginning of such a pathology as age-related macular degeneration (AMD for short).

With macular degeneration, the diameter decreases blood vessels that feed the retina. As a result, its tissues cease to fully receive the necessary substances. Develop dystrophic changes on one or both (left and right) eyes. Often, AMD is the cause of disability and disability.

Of course, when we talk about age-related macular degeneration, we understand that the main cause of this disease is just age-related degenerative changes in the retina. But in some patients the disease develops, while in others it does not, in some it progresses rapidly, while in others it is extremely slow. Until the end, the reasons for this situation have not been studied, but histology helps to understand the mechanism of development of the pathological process and identify a number of risk factors:

Genetic predisposition and heredity (inheritance occurs as an autosomal dominant, autosomal recessive or X-linked).
Smoking. It significantly increases the risk of developing AMD.
arterial hypertension.
Diabetes.
Nearsightedness or farsightedness.
Prolonged exposure to sunlight on unprotected sunglasses eyes.
Overweight. Scientific research indicate a link between obesity and the progression of AMD.
Improper nutrition resulting in the patient's body lacking the nutrients it needs to function properly visual apparatus(particularly carotenoids).
Race. In whites, age-related changes in vision are more common than in African Americans.
Vegetative-vascular dystonia or in short - VVD.
It should also be noted gender- in the representatives of the weaker sex, this disease is diagnosed more often.
Eye pathologies. For example, chronic blepharitis or endocrine ophthalmopathy(pseudotumorous or thyrotoxic form).
Postponed eye injuries.

Age-related macular degeneration is more commonly diagnosed in women and whites.

Classification of macular degeneration

Ophthalmologists classify the pathology according to the forms of the course of AMD:

Dry (other names - non-exudative, atrophic). Develops slowly.
Wet (other names - exudative, neovascular). Develops rapidly.
Cicatricial. Last stage AMD. Develops rapidly.

atrophic form

The dry form of AMD is observed in 85% of cases than other forms of pathology. With age, a person's metabolism changes. As a result, yellowish spots called drusen appear in the macula. These are the foci of atrophy. Druses are divided into hard and soft. Solid - small and clearly defined; soft - large, with blurry edges, can merge with each other. The patient loses visual acuity gradually. This is one of the differences between this form of pathology and others. Cases have been registered when the dry form gradually passed into the last - the cicatricial stage.

Dry AMD is also called non-exudative or atrophic AMD.

Neovascular form

Ophthalmologists diagnose this type of pathology in only 10-15% of cases. The wet form of AMD is the result of the progression of the atrophic form. The disease develops rapidly. In most cases, central vision is almost completely lost. As the drusen increase in size and thicken (due to the dry form), the process of formation of new vessels develops on the retina. It is this process, also called neoangiogenesis, that distinguishes the wet form. As a result, the body tries to mistakenly compensate for the insufficient nutrition of the retina by sending an additional volume of oxygen and substances necessary for the functioning.

With the progression of the pathology, blood cells and fluid accumulate in the area under the retina penetrate the walls of new vessels. Edema develops, hemorrhages appear. As a result, the cells of the retina, especially sensitive to light, are constantly damaged and die. This is how blind spots form in central vision.

Classified into:

Classical, affecting the subretinal neovascular membrane (SNM).
Hidden, also called occult.
Mixed.

The wet form is also called exudative or neovascular.

Scar form

With the germination of vessels under the pigment epithelium, retinal detachment is possible, followed by detachment of the neuroepithelium and the formation of scar tissue (transition to the scar stage).

This is the final stage of age-related macular degeneration. The loss of vision is irreversible.

Symptoms

Symptoms directly indicate the form of the disease. In most cases, the disease is asymptomatic.

Symptoms:

As a result of the gradual appearance and further increase of drusen, visual impairment occurs. With a dry form - slight and gradual, and with a wet and cicatricial - rapid.
Flies begin to flicker before the eyes (especially characteristic of the dry form).
The pigment layer suffers the most, which is why the perception of shades and brightness of the picture, its contrast decreases.
Hemorrhages arising from edema, which are visible to others, indicate a wet form of the disease.
Fields of vision fall out.
The picture that we see is blurred.
Surrounding objects are distorted, straight lines are bent.

The development of the dry form at first is asymptomatic.

Development of the dry form:

On early stages there are no symptoms.
Gradually deteriorating central vision.
Then there is clouding of most of the image.
Over time, the affected area increases and darkens, resulting in the formation of a scotoma.
Peripheral vision remains intact.

The special features of the second and third forms are as follows:

100% loss of vision comes quickly.
It is possible to save peripheral vision in very rare cases.

With the final cicatricial form of AMD, the degree of vision loss reaches 100%.

How is the diagnosis

Despite the possibility of a long asymptomatic course of the disease, age-related macular degeneration can be diagnosed due to modern research eyes. Persons over the age of 50 should have regular eye examinations. This will identify the pathology at an early stage and prevent vision loss.

The dry form can smoothly turn into the most dangerous - the cicatricial form. Therefore, the optometrist should be visited regularly.

With a long process of development of the pathology, patients who come to the ophthalmologist most often complain of the appearance of a “spot” in front of their eyes, resembling fog. Gradually, the defect increases in size.

Diagnostic methods:

collection of anamnesis;
visometry;
ophthalmoscopy (examines the fundus of the eye);
optical coherence retinotomography;
visocontrastometry;
fluorescein angiography;
computer perimetry;
color stereo photography.

These methods allow for timely and high-quality diagnosis of the macular area of the retina.

Based on the results of the diagnosis, a course of treatment is prescribed.

Upon detection of AMD in the eye, the doctor should explain to the patient what it is, prescribe a course of treatment and conduct self-diagnosis training (relevant for the dry form of pathology).

Self-diagnosis

For patients already diagnosed with age-related macular degeneration of the retina, good method Diagnosing the progression of the disease is a test using an Amsler grid (lattice). This method allows you to determine even the initial signs of macular edema due to the formation of new vessels on the retina.

The Amsler grid is a 40 x 40 cm square grid with a dot in the middle. When diagnosing, the test distance to the Amlser grating is about 50 cm. One eye must be closed with the palm of your hand, the other should look at the grid.

In the presence of pathology, the patient can see non-existent "holes" or "dark spots", mesh curvature. With this development of events, it is urgent to undergo an examination by an ophthalmologist.

Self-examination on the Amsler lattice can be carried out even every day.

Self-diagnosis allows you to track the development of AMD.

Treatment of AMD of the eye

Dry Form Treatment

The dry form responds better to treatment than the wet form. It has a more favorable course.

Damage in this form of the disease is irreversible. Reducing the risk of transition to the wet form is achieved by drug therapy, which includes the reception:

Antioxidants.
Vitamin and mineral complexes.
Taurine.
Lutein / beto-carotene / vitamin A / zeaxanthin (one of the drugs or their complex is prescribed depending on the clinical picture of the course of the disease) in the amount of 10 mg / 15 mg / 28000 IU / 2 mg.
Anthocyanosides.
Vitamins C and E in the amount of 500 mg and 400 IU, respectively, daily.
Copper and zinc in the amount of 2mg and 80mg, respectively.
Selenium and other trace elements.
Gingko biloba.

You should regularly visit a doctor to monitor the course of the disease.

In the dry form of AMD, treatment is based on taking vitamin complexes.

To improve blood circulation in the retina, patients are recommended to take antiplatelet agents, vasodilators.

It is worth noting that conservative medicine, which consists in the appointment of dedystrophic agents, immunomodulators and antioxidants (tablets, injections or drops), is ineffective. Taking these drugs, patients, most often, ignore the need to visit an ophthalmologist for control. In this regard, the risk of the transition of the disease to a more severe stage increases.

Wet Form Treatment

Not so long ago, the only effective treatment for the wet form of AMD was laser coagulation - the destruction (destruction) of newly formed vessels using a laser. However this method did not eliminate the cause of the formation of new vessels. In addition, healthy tissue can also be damaged by this procedure.

Less aggressive option laser therapy wet form is photodynamic therapy using the drug "Visudin". It is administered intravenously and the retina is irradiated with a laser. The drug has a tropism only for pathological retinal vessels, is able to accumulate in them and be activated when exposed to a laser beam. In bleeding pathological vessels, blood clots are formed, the vessels are “soldered”. With this procedure, the risk of damage to healthy tissues is practically absent.

Vizudin is used to treat wet AMD with photodynamic therapy.

But, VEGF therapy, developed in the early 2000s, is considered to be a more progressive method today. The second name is “Aimed Therapy”. Treatment of AMD of the eye in this case allows not only to stop the progression of the process, but also partially restore the patient's vision. However, this statement is true only in the case when irreversible cicatricial changes have not yet begun.

In VEGF therapy, injections are made special preparations that stop the formation of blood vessels, vitreous body eyes. The drugs used for these injections are Lucentis, Macugen, Avastin and Eylea.

With this type of therapy, the following risks are possible: intraocular pressure, retinal disinsertion, eye infection, temporary visual disturbance, hemorrhage.

From surgical methods For the treatment of AMD, the following types of operations should be noted:

pigment epithelium transplantation;
removal of subretinal neovascular membranes with the formation of folds of the sclera;
removal of subretinal hemorrhages.

Lucentis is used to treat wet AMD with VEGF therapy.

Additional measures

For patients who have lost visual acuity, glasses are prescribed. Plus lenses set for the nearsighted, and for the farsighted - minus. Recommended Availability anti-reflective coating to protect the eyes from such negative impact, like glare from a monitor or TV, increased eye strain when reading or doing other work.

Treatment with folk remedies

It is permissible to use this or that folk method of treatment only after consulting with your doctor. Unfortunately, ethnoscience unable to cure AMD, but can improve well-being, prevent the development of the disease and relieve symptoms.

In a half-liter jar, soak the washed oat grain for 4 hours. Drain the water, and pour the oats into a saucepan. Pour 3 liters of water and cook over medium heat after boiling for 30 minutes. The resulting broth is filtered and stored in the refrigerator. Take warmed up to 5 times a day in a glass. It is recommended to add grated currant berries, blueberries, chokeberries and honey to the decoction.
1 tablespoon pharmacy calendula pour a glass of boiling water and infuse for 15 minutes. Let stand. Then strain and take 3 times a day for ¼ cup. You can still bury your eyes with this infusion, 2 drops in 1 eye. Take up to 6 months. Then take a break.
Everyone knows about the benefits of aloe and mummy. They can also help with AMD. It is necessary to dissolve 50 g of mummy in 100 ml of aloe juice. Insist. There are two options for using this infusion. The first is to drink 10 ml 2 times a day. The second is to use as eye drops: 1k each. in each eye. After 10 days of admission, take a break.
onion peel(2 parts), rose hips (2 parts) and needles (5 parts) need to be crushed. Pour 1 tablespoon of the mixture with 1 liter of water and boil for 2-3 minutes. Take 1.5 liters daily.
A tablespoon of cumin is poured into 250 ml of water. Boil over low heat for 2-3 minutes. Pour 1 tsp. cornflower flowers, mix and set aside for 5 minutes. Use 1-2 drops in each eye 2 times a day.
Grind celandine. 1 tsp pour 100 ml of water. Heat on fire for 10 sec. Let it brew. The infusion is filtered and stored in the refrigerator. Apply 3 drops in each eye 3 times. in a day. Course - 1 month.
Take 1 part goat milk and 1 part boiled water. Use the resulting mixture as drops - 1 to each eye. After instillation, you need to tie a dark bandage or special glasses on your eyes and lie down for 30 minutes. Course - 1 week.
Add 1 tsp to 1/3 cup of chopped nettle. crushed lilies of the valley and pour ½ tsp. soda. Mix. Put in a dark and dry place for 9 hours. Make compresses from the resulting mass.
Treatment with leeches is a separate, but very useful area of traditional medicine.

Traditional medicine can be used as an addition to the main treatment.

Must be consumed enough foods rich in carotenoids fresh vegetables, fruits, greens.

You should also limit the intake of animal fats with food, which provoke atherosclerotic changes in the retina.

Foods rich in carotenoids:

carrot;
pumpkin;
potato;
melon;
spinach;
cabbage;
zucchini;
citrus;
tomatoes;
Bell pepper;
corn;
apricots;
peaches;
persimmon.

Foods with antioxidants:

Red Ribes;
blueberry;
cranberry.

Prevention of AMD

Measures to prevent senile disease - AMD include:

diet (restriction of animal fats; a sufficient amount of fresh vegetables and fruits);
weight loss;
level control blood pressure;
wearing sunglasses(especially for patients with bright eyes);
giving up bad habits (smoking);
taking vitamin complexes;
playing sports; but from professional sports; for example, triathlon, will have to be abandoned.

And, of course, regular examination by an ophthalmologist is necessary.

Nov 28, 2017 Anastasia Tabalina

18101 02/13/2019 5 min.

If you think that notebook sheet in a cage is crookedly lined, and the seams between the tiles in the bathroom suddenly become uneven and broken, then it's time to worry: something is wrong with your vision. It is possible that you have macular degeneration of the retina. What is this disease, is it curable? The features of this disease will be discussed in this article.

What it is?

Macular degeneration (degeneration) of the retina is a chronic progressive disease in which the central zone of the retina and choroid is affected. In this case, the cells and the intercellular space are damaged, which leads to a violation of the function of central vision.

Macular degeneration is one of the leading causes of irreversible vision loss and blindness among the population of developed countries over the age of 50 years. The problem of macular degeneration is becoming more and more relevant among the age group of the population. However, in recent years there has been a trend towards "rejuvenation" of this disease.

The manifestation of macular degeneration

Causes

Violation of central vision occurs due to degeneration of the macula - the central part of the retina. The macula is a very important element . Thanks to its functioning, a person sees objects located at a very close distance from the eye, and can also read and write, distinguish colors. Macular retinal degeneration involves damage to the cells of the macula.

The exact cause of the development of this disease has not yet been established. Among all the alleged causes, scientists highlight the age of the patient. In addition, several risk factors have been identified, which, according to researchers, are a kind of trigger.

These include:

The central spot is macular degeneration

age (from 55 years and older);
gender (women are affected almost twice as often as men);
heredity (if close relatives suffer from macular degeneration, then the chances of getting sick increase);
overweight body;
smoking;
vitamin deficiency;
prolonged and intense exposure to direct sunlight;
eye injury;
bad ecology.

Types of macular degeneration

As macular degeneration progresses, it may resolve different stages and forms. There are two types of disease:

Dry form of macular degeneration. This is the initial stage of the disease, it is also the most common (about 90% of patients suffer). At this stage, the patient gradually loses central vision, but may not attach any importance to this and may not even notice any special changes. Such changes may lead to the need for special lenses, to choose which will help. During the examination, it will not be difficult for a specialist to identify macular degeneration of the eye and determine its shape.

Manifestation of wet macular degeneration

Wet form of macular degeneration. If dry macular degeneration was not detected on early stage and, accordingly, was not treated, the disease develops into the so-called wet form. The progression of degeneration is aggravated by the formation of new blood vessels, which are very fragile and brittle, leading to hemorrhage and the formation of "drusen" (yellow clusters) in the retina. The wet form of macular degeneration develops rapidly, much faster than the dry form.

The dry form of macular degeneration is much more common than the wet form, and is detected in 85-90% of all cases. in the macular area.

The gradual loss of central vision limits the ability of patients: they cannot distinguish fine details. The dry form is not as severe as the wet form. However, after several years of disease progression and no treatment, the gradual degradation of retinal cells can also lead to vision loss.

The wet form of macular degeneration is present in approximately 10-15% of cases.

The disease in this form develops rapidly and often leads to a significant loss of central vision. With a wet form, the process of neovascularization begins - the growth of new vessels. The walls of such vessels are defective and allow blood and fluid to pass through, which accumulate in the space under the retina. This leak causes frequent damage photosensitive cells retinas that die and create blind spots in central vision.

Distorted vision as a result of a lesion

Symptoms

Macular degeneration usually causes slow, painless, and permanent vision loss. In rare cases, blindness can come on suddenly and abruptly.

Early symptoms of macular degeneration are:

Dark spots before the eyes - one of the symptoms

the appearance of dark spots in the central vision;
fuzziness of the image;
distortion of objects and images;
deterioration in color perception;
sharp at a distance or in the dark.

by the most simple test The Amsler test is used to determine the manifestations of macular degeneration. The Amsler grid consists of intersecting straight lines with a central black dot in the middle. Patients with manifestations of retinal dystrophy may see that some lines look blurry or wavy, broken, and dark spots appear in them.

An ophthalmologist can distinguish the signs of this disease even before the development of changes in the patient's vision and refer him to additional examinations.

Diagnostics

To confirm the diagnosis of macular degeneration of the retina, doctors use different types examinations. The main ones are:

Visometry which helps to determine the acuity of central vision.
Ophthalmoscopy, which allows you to study the state of the retina and blood vessels.
Bioophthalmoscopy(used to study the fundus).
Optical coherence tomography(OCT) is the most effective method diagnosis of macular degeneration, which reveals the disease at the most early stages.
Amsler test(The test can also be done at home.)

Amsler test for home use

Treatment of macular degeneration

Unfortunately, macular degeneration of the retina is not amenable to absolute treatment. However, there are methods to achieve significant success in the fight against this disease.

. Treatment of retinal dystrophy with a laser method allows you to remove pathological blood vessels and stop their progression.
Photodynamic laser therapy. The essence of this method is that the patient is injected into the blood with a special substance that penetrates into the affected vessels of the eye. Then used laser ray, which activates the injected substance and simultaneously affects the newly formed pathological vessels.
Factors of anti-angiogenesis. These are the means latest generation, the reception of which stops the growth of pathological vessels.
Devices for low vision. Since macular degeneration of the retina deprives a person of the ability to see normally, special electronic devices and lenses compensate for the loss of a person by creating enlarged pictures of the environment.

Treatment of macular degeneration can be carried out according to experimental methods, which include:

submacular surgery(pathological vessels are removed);
retinal translocation, during which the affected vessels under the retina are removed.

In the treatment of dry forms of macular degeneration in order to normalize metabolic processes in the retina, courses of antioxidant therapy are recommended.

According to the AREDS study, good effect from taking antioxidants was observed in patients who were at an intermediate or late stage of the development of the disease. Combination therapy with antioxidants, zinc and copper for five years reduced the incidence of advanced macular degeneration by 25%, and the risk of visual acuity loss by three percent or more.

It should be understood that replacement therapy for the prevention and treatment of the dry form of macular degeneration cannot be a course, its use is possible only on an ongoing basis.

Treatment of the wet form of macular degeneration is aimed at suppressing the growth of abnormal vessels. Today, there are already a number of drugs and methods registered in Russia that can stop or reduce the manifestations of abnormal neovascularization. This contributed to the improvement of vision in a significant number of people with the wet form of the disease.

Even if the treatment of macular degeneration has been effective, macular degeneration can recur, so periodic should become mandatory for the patient.

Disease prevention

Macular retinal degeneration entails serious consequences, however, it is possible to “slow down” the development of the disease if you adhere to the following prevention standards:

Get an annual check-up with an ophthalmologist.
Use sunglasses.
Give up smoking.
Limit the consumption of fatty foods, enrich the diet with fruits, vegetables, fish.
Use special complex eye vitamins.
News active image life, control the state of health.
Treat in a timely manner cardiovascular diseases.

which is completely untreatable. can stop, but it is possible with strict implementation ophthalmologist's recommendations.

Retinal dystrophy is a disease in which dystrophic changes occur in the macula. Photoreceptors-cones that perceive light are affected, and the person gradually loses central vision. The name of the disease comes from two words: macula - spot - and degeneration (dystrophy) - malnutrition.

The structure of the eye.

The development of retinal dystrophy is associated with atherosclerotic changes in the vessels of the choriocapillary layer of the eyeball. Circulatory disorders in the choriocapillaries, which, in fact, are the only source of nutrition for the macular area against the background of age-related changes in the retina of the eye, can serve as an impetus for the development dystrophic process. The mechanism of development of atherosclerotic changes in the vessels of the eye is the same as in the vessels of the heart, brain and other organs. It is assumed that this violation is associated with genetically determined sclerosis of vessels related to the macula.
Of great importance in the development of retinal dystrophy is the level of macular pigmentation. Macular pigment is the only retinal antioxidant that neutralizes the action of free radicals and limits blue light, which is phototoxic to the retina.

Fundus of the eye: 1.- macula lutea; 2- disc optic nerve; 3- artery; 4 - vein.

Numerous studies in recent years have revealed the hereditary nature of retinal dystrophy. Children of parents with this disease have high risk the development of the disease. If you have been diagnosed with this, warn your children and grandchildren. They could inherit structural features yellow spot that increase the risk of disease.

With age-related macular degeneration, mainly central and color vision is disturbed, therefore, the first signs of the disease are a decrease in visual acuity, a violation of color perception. As a result, there are difficulties in reading, writing, working at a computer, watching television, driving a car, etc. Peripheral vision in age-related macular degeneration does not change, due to which the patient freely orients himself in space and copes with everyday everyday tasks. The patient needs a brighter light when reading, writing and painstaking work. Very often, people do not notice the deterioration of vision for a long time - after all, with one normal seeing eye, you can read and do small work.

At further development disease, a spot appears in front of the sore eye, the distortion of letters and lines, vision deteriorates sharply.

The older the person, the higher the risk of developing the disease. However, in recent years there has been a significant "rejuvenation" of this disease. According to statistics, at the age of about 50 years, 2% of people can get macular degeneration. This figure reaches 30% as soon as a person crosses the age limit of 75 years. Women are more likely to suffer from age-related macular degeneration.

Risk factors for age-related macular degeneration:

age (50 years and older);

gender (women get sick more often than men, in a ratio of 3:1);

genetic predisposition (the presence of the disease in relatives);

White color skin and blue iris

cardiovascular diseases (arterial hypertension, atherosclerosis of cerebral vessels);

unbalanced diet;

high blood cholesterol;

overweight, obesity;

smoking;

frequent and prolonged stress;

deficiency of vitamins and antioxidants in food;

low maintenance carotenoids in the macula;

exposure of the eye to the ultraviolet part of the spectrum sunlight;

bad ecology.

With age-related macular degeneration, complaints of a noticeable decrease in vision appear, as a rule, only in the later stages of the disease.

There are two forms of age-related macular degeneration: dry and wet. The dry form of the disease occurs in about 90% of patients. Within 5-6 years, it develops first on one eye, and then passes to the other eye. In the macular region of the retina, dystrophic changes appear in the form of small-focal dyspigmentation and light yellow foci of a round or oval shape. A sharp decrease in vision does not occur, but the curvature of objects in front of the eyes is possible.

Retinal dystrophy (central macular degeneration)

Note:

If you have a dry form of age-related macular degeneration, you should be examined by an ophthalmologist at least once a year. An ophthalmologist must conduct an examination of the retina of both eyes in conditions of an enlarged pupil.

Although only 10% of people have wet macular degeneration, 90% of severe vision loss is due to this form of the disease.

Loss of vision occurs due to the fact that new blood vessels begin to grow into the retina towards the macula. These newly formed vessels have inferior, defective walls through which blood begins to seep. Vision is sharply reduced.

One of the symptoms of the wet form of age-related macular degeneration is a feeling of distortion of objects in front of the sore eye. Straight lines to the patient begin to appear wavy. This optical effect arises from the fact that edema occurs in the macular region. At the same time, central vision decreases very quickly and a visual field defect appears in the form of a dark spot in front of the eye.

This is how objects look with retinal dystrophy.

If you have a distortion of objects in front of your eye, a spot and you feel a sharp decrease in vision, you should immediately consult a doctor.

Often patients with age-related macular degeneration with concomitant cardiovascular and neurological diseases consultations of the cardiologist and the neuropathologist are required.

TREATMENT. For the prevention and treatment of the early stages of age-related macular degeneration, it is of paramount importance to maintain a healthy diet, reduce the consumption of foods with high cholesterol levels and mandatory antioxidant protection macula, which includes the intake of carotenoids (lutein and zeaxanthin) - red, yellow or orange pigments found in plant and animal tissues, as well as minerals, zinc, selenium, vitamins C, E and anthocyanosides.

Lutein and zeaxanthin are the main macular pigments and provide natural optical protection visual cells. Of the 600 natural carotenoids, only two - lutein and zeaxanthin - have the ability to penetrate the tissues of the eye. Lutein enters the body with food, and zeaxanthin is formed directly in the retina from lutein.

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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.

Given the "rejuvenation" of this disease, Special attention should be addressed for its prevention, which includes:

a mandatory course of oral intake of lutein, zeaxanthin and anthocyanosides;

quitting smoking and cholesterol-rich foods;

protection from direct exposure to sunlight (sunglasses, headgear, awning, etc.);

usage contact lenses protecting eyes from ultraviolet radiation;

correction arterial hypertension;

regular examinations of the retina to detect signs of disease progression (at least once a year);

self-monitoring of visual disturbances with the help of Amsler grids and if necessary, an appeal to an ophthalmologist.

Amsler test.

For this test, use"Amsler grid"- a sheet of paper in a cage with a black dot in the center. Such a test is an integral part of checking the condition of the eyes, as it helps to identifyvision distortion.This is especially important whenwet AMD,which can be treated in the early stages (although this is almost impossible to do if the macula is damaged).

The test is quite simple: look at the dot in the center of the "Amsler grid". If the lines near the dot look fuzzy, AMD is likely. If your doctor suspects that you have wet AMD, you will most likely have to undergo a fluorescein angiogram. The essence of the survey is as follows. A dye is injected into a vein in your forearm, which eventually travels to your retina. A special device allows you to trace the entire path of the paint through the blood vessels of the retina.

This procedure helps the ophthalmologist determine whether damaged blood vessels can be treated with a laser. If the walls of the vessels are too thin and there is a possibility heavy bleeding, then the doctor may recommend optical devices instead of laser surgery. If your vision deteriorates, optics can help you restore eye function, but cannot fully compensate for the loss of vision.

Amsler grid .

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For complex treatment AMD, glaucoma, cataracts, complicated myopia and in postoperative period for a speedy recovery.

All components included in the preparation provide effective protection and enhance the overall antioxidant effect, which contributes to the improvement and stabilization visual functions.

Peculiarities psychological state patients with age-related macular degeneration.

An unfavorable prognosis for visual impairment is often accompanied by changes in the psychological state of patients.

When a person first learns about the diagnosis after consulting a doctor, as well as in the later stages of the disease with sharp deterioration vision, he begins to worry about the quality of life and experiences fear. Sometimes a feeling of fear leads to a deterioration in general well-being and a loss of interest in life.

To avoid adverse psychological changes in the state of the patient, he needs to receive as many positive emotions as possible.

This is facilitated by the normalization psychological climate in family; breathing exercises and walks on fresh air; work on a personal plot or cottage (caring for plants, animals, birds); eating fresh vegetables and berries containing vitamins, minerals, antioxidants (spinach, carrots, celery, zucchini, Jerusalem artichoke, blueberries, lingonberries, black currants, rose hips, mountain ash, etc.).

If a patient is diagnosed with macular degeneration, treatment should begin immediately, as the disease affects the main part of it. A full-fledged vision depends on it, and if you do not help a person, then he can quickly go blind. Consider what is macular degeneration of the retina, the causes of the onset of the disease, its manifestations, methods of diagnosis, treatment and prevention.

The essence of the disease

Macular degeneration occurs in older people. Especially vulnerable are people who have already crossed the 50-year mark. The problem of vision loss from age-related macular degeneration is on the rise. This proportion of the population is gradually increasing. With the increase in the incidence of atherosclerosis and other comorbidities, the problem of vision loss in macular degeneration is becoming increasingly relevant. The disease does not choose a victim, depending on age, country of residence or social status.

Pathology is a type of chronic degenerative process in the central macula of the eye.

Normally, this area is concentrated great amount cells responsible for photosensitivity. Due to the fact that they exist, a person can see normally. With the development of age-related macular degeneration, pathological changes occur in the eye:

the number of cells capable of sensing light decreases, as a result, the quality of vision gradually decreases;
in the future, the death of the photosensitive elements of the retina occurs;
an increase in the number of fat cells;
pathologically altered blood vessels grow (vascularization);
fat cells accumulate in tissues.

The danger of the disease is also in the fact that pathologically altered blood vessels are prone to rupture. From this, hemorrhages become more frequent, which further enhances the processes of retinal degeneration.

Why does this disease occur?

Macular degeneration of the eye occurs for the following reasons:

the age of the person (usually over 60 years old; today there is a trend towards rejuvenation of macular degeneration, which is why it also occurs in people younger than 50 years old);
unfavorable hereditary predisposition - when the family already has one of the relatives suffering from a similar problem;
smoking;
alcohol abuse;
racial differences (it is noticed that such a disease occurs in Europeans);
some gene mutations;
consumption of large amounts of fatty, fried foods of animal origin (this causes atherosclerosis);
prolonged exposure to the sun (this includes the inept use of solar procedures and the presence of sunburn);
Availability comorbidities(at risk are patients with arterial hypertension and atherosclerosis).

What you need to know about the symptoms of the dry form of the disease

At the beginning of its development, age-related macular degeneration of the retina may not manifest itself in any way, a person does not feel symptoms and does not go to a doctor. Especially at risk are people over 40 who do not visit an ophthalmologist in the order of scheduled medical examinations.

Over time, macular degeneration of the retina begins to manifest itself as blurring of the field of vision, black spots in the visual field and curvature of objects (all this the patient can take for age-related changes in the eye, and if he is also not indifferent to self-medication, then choose glasses on his own, in which he “better sees everything." Precious time is lost, and vision gradually begins to deteriorate, up to blindness.

There are several forms of AMD. The dry variety is initial stage pathological process in humans. Usually, dry macular degeneration can last for several years, while initially the patient does not notice a decrease in vision. The disease is characterized by the fact that foci of fat cells appear on the retina - first single, and then generalized.

With this type of disease, the decrease in vision occurs slowly.

This macular degeneration has several stages in the development of the pathological process:

At an early stage, the patient usually finds several drusen - deposits yellow color located under the retina. At this stage of the development of the disease, visual impairment usually does not occur.
At an intermediate stage of development on the retina appears a large number of friends There is a loss of the pigment epithelium, which is responsible for normal visual acuity. Individual patients describe a large blurred spot located in the center. They use bright light sources to read.
At a later stage, photosensitive elements and other tissues of the eye are destroyed. A large blurred spot appears, sometimes black (scotoma). A person experiences great difficulties while reading, it is difficult for him to recognize people, even if they are at a close distance.

With a dry variety of the disease, a person, as a rule, sees the smooth contours of surrounding objects. If they are defined as curved, then this may indicate that the patient develops a wet form of pathology.

What you need to know about wet macular degeneration

Wet macular degeneration is less common and more dangerous. It is characterized by a fairly rapid progression, therefore, if the patient does not consult a doctor in a timely manner, then in almost 90% of cases this leads to complete loss of vision. The wet form contributes to the appearance of hemorrhages, edema, and newly formed vessels on the retina, which burst even with a slight load.

There is also the so-called choroidal neovascularization. This is a pathological process, which is based on abnormal growth of blood vessels. So the body mistakenly tries to create a new network of capillaries in the affected macula. This is done in order to ensure nutrients eye tissues. These phenomena lead to the fact that areas of rough scarring appear on the retina, due to which a person develops a loss of central vision or an absolute scotoma.

That's what the big one is called. dark spot located directly in the center of the visual field.

The patient has peripheral vision. Its sharpness gradually decreases due to visual overload, which the affected eye is forced to experience. The patient cannot distinguish small objects, sees poorly in the dark.

Diagnosis of pathology

Before starting treatment, the patient must undergo a comprehensive diagnosis of the body. Only then is it possible to assign traditional drugs. None folk methods treatments, homeopathy and other non-traditional practices cannot stop the pathological process.

Diagnosis of the disease includes the following measures:

Initial ophthalmological examination, during which the doctor can determine the signs of age-related changes in the retina.
Fluorescein angiography makes it possible to determine the location of the blood vessels in the eye. The specialist determines the feasibility of further laser treatment macular disorders.
ICZA is an examination of the eye with the help of special green dyes. After that, certain areas of the tissues of the eye are photographed using infrared rays. This type of diagnosis makes it possible to determine the form of dystrophy.
OCG helps to obtain sections of retinal tissue.
Perimetry or diagnostics of the visual field makes it possible to detect where the pathological areas of the retina are located.
The Amsler test consists in the fact that the patient looks at the ratio of horizontal and vertical lines. When a person has macular degeneration, the ratio of such lines will be distorted, fuzzy and faded. If the patient says what exactly these lines are, then the ophthalmologist will have a clear idea of all the processes that occur in the eyes.

Sometimes it may be necessary to take a general and biochemical blood test, an MRI of the eyes. These types of diagnostics are assigned as needed. Only after a complex of studies has been carried out, it will be possible to begin the treatment of age-related macular degeneration.

Ways to treat the disease

Patients turn to the doctor too late when symptoms of such a pathology appear. In advanced cases, the treatment of macular degeneration of the retina is significantly complicated, and sometimes becomes unpromising and useless. In most cases, we can only talk about maintaining the already existing weak vision.

Those patients who practice treatment with folk remedies are especially at risk.

Drug therapy is possible in the early stages of the disease. At the same time, a person still has high vision. There are a large number of drops that can be administered for this disease. What kind of medicines are needed for each specific patient, the doctor decides.

Reception of vasoconstrictive, vitamin and tissue preparations in combination with laser stimulation of the retina is shown. The doctor individually decides whether Aspirin, which has the property of "thinning" the blood, can be prescribed to the patient. Self-medication is strictly prohibited.

If AMD is combined with edema, then it is necessary to carry out laser coagulation. The goal of this treatment is to plug the vascularized areas. So you can reduce the intensity of swelling of the retina.

Features of the treatment of the wet form of the disease

The wet form of AMD is especially dangerous for the patient - it threatens with a rapid loss of visual functions. It will be impossible to restore them. Such a disease is successfully treated only when the patient consulted a specialist in a timely manner. In advanced cases, even a satisfactory restoration of vision, that is, at the level of residual values, may be doubtful due to the severity of the pathological process and its intensity.

Among curative measures used in the wet form of macular degeneration, intraocular administration of inhibitors of vascular formation is becoming increasingly common. They block the mechanisms of vascularization of the retina. There is a gradual closure of the foci of formation of new vessels.

Today, Lucentis is officially used in our country.

It is an angiogenesis inhibitor that is used for ophthalmic purposes. Leading eye clinics the effect of the drug was successfully studied, which made it possible to test it in ophthalmic practice for the treatment of macular degeneration.

The drug can be injected into the vitreal cavity of the eye. This is done only in an ophthalmic operating room. This medical operation does not require hospitalization and can be performed on an outpatient basis. The patient is subsequently re-examined by a doctor (he monitors the effect of such a drug). A month later, the injection is repeated. The multiplicity of such manipulation depends on the severity of the pathological process.

If the patient has undergone a course of treatment, then he needs to be re-examined by an ophthalmologist. The fact is that the disease is prone to a relapsing course, and the patient must strictly follow all the recommendations of the doctor. The effectiveness of the treatment of AMD is determined by an increase in visual acuity and the disappearance of edematous phenomena in the retina. The growth of pathologically altered vessels should stop.

Today, only Lucentis is officially registered for use in ophthalmic practice. Other drugs either do not have sufficient effectiveness, or are simply useless in the treatment of such a severe pathology. Eye drops in most cases can also be ineffective.

What you need to know about macular degeneration prevention

Treatment of any form of this disease is complex, and high therapeutic effect is possible only on condition that the patient, especially at an older age, consulted a doctor in a timely manner. The following recommendations will help prevent the development of such a disease:

The person is strongly advised to quit smoking. Nicotine leads to vasoconstriction, which affects the development of pathological processes in the retina of the eye.
The same applies to alcoholic beverages. Complete failure from alcohol can not only improve general well-being human, but also to prevent the development of pathological processes in the eyes.
Sunglasses are recommended in summer when the weather is sunny. At the same time, one must beware of fakes and choose only high-quality optics - with a high degree of protection against ultraviolet radiation.
It is necessary to eat right, excluding animal proteins, fatty and fried foods from the diet. Patients are advised to add more vegetables and fruits rich in vitamins and microelements to the daily menu.
At risk of AMD and other pathologies of the eye, severe physical labor, sport associated with weight lifting, jumping. It is not recommended to play football.
You should be extremely careful during the icy period, as a fall can adversely affect the condition of the eyes.
It is necessary to constantly monitor the value of blood pressure, because patients with arterial hypertension are included in the group increased risk occurrence of macular degenerative changes.

Timely detection of eye diseases helps to maintain high vision and good working capacity. AMD is dangerous because it can cause permanent vision loss only if a person seeks help from a specialist too soon. If you check your eyes every year, and if there are risks, even 2 times a year, then the likelihood of irreversible loss of vision will decrease significantly.