AGE-RELATED MACULAR DEGENERATION (AMD)

56

Age-related macular degeneration (AMD) is a visual impairment resulting from the degeneration of the macular region of the retina. This impairment commonly affectslder individuals, typically between the ages of 60 and 65. It stands as the leading cause of blindness among those aged 60 and above.

Initially, patients with macular degeneration may experience blurriness in the center of their vision. Also, the surrounding areas appear relatively clear. As the condition progresses, straight lines may seem distorted, ultimately leading to severe impairment and, in the final stages, blindness.

Categories of AMD

AMD is categorized into two types: dry and wet. The majority of cases involve dry AMD, impacting approximately 8 to 10 million people in the United States. Dry AMD has a gradual impact on vision, with a slow deterioration process lasting over 20 years. However, it may transition to wet AMD, where untreated cases experience rapid vision decline.

As of now, there is no active treatment for dry AMD. Physicians commonly recommend lifestyle adjustments such as smoking cessation, blood pressure control, and the intake of specific vitamins. Vitamins like carotene, C, E, zinc, and copper slow the progression of the disease.

Wet AMD, on the other hand, is characterized by the growth of new blood vessels in the macula. This can lead to bleeding, exudates, and water accumulation, resulting in rapid macular degeneration. Current treatments involve intraocular injections of “new blood vessel inhibitors” directly into the eyeball’s vitreous body. This injected drug, interacting with vascular endothelial growth factor, inhibits blood vessel proliferation in the macula. Research indicates that around 40% of patients can experience vision improvement with injections. Additionally,over 90% can maintain their vision, but the inconvenience lies in the need for monthly administration.

Patients undergoing injection therapy currently require regular injections every one or two months. New drug therapies in the form of oral medication and eye drops are under development. This aims to provide more convenient alternatives for patients, although they are still in the testing phase.

Risk Factor

Risk factors for age-related macular degeneration (AMD) encompass several key groups, including:

1. Age: AMD is more prevalent in older individuals, especially those over the age of fifty.
2. High Myopia: Individuals with high myopia (nearsightedness) face an increased risk of macular degeneration. If left untreated, severe cases may lead to blindness.
3. Arthritis: Elderly individuals with arthritis are considered to have a higher likelihood of developing AMD compared to the general elderly population.
4. Hypertension: Patients with hypertension (high blood pressure) are at an elevated risk for AMD. Arteriosclerosis, a result of hypertension, narrows the blood vessels supplying the macula, contributing to AMD.
5. Sun Exposure: Long-term exposure to sunlight, especially ultraviolet rays, is a risk factor for AMD. Directly looking at the sun, experiencing snow blindness, exposure to laser light, and even camera flashes can damage the macula.
6. Smoking: Smoking and exposure to second-hand smoke are strongly linked to macular degeneration. Smoking can lead to blood vessel obstruction and reduced cardiopulmonary function, making it a crucial risk factor for AMD.

The prevalence of AMD has surpassed that of cataracts, making it the most common eye disease among the elderly. Vision deterioration typically becomes noticeable after the age of fifty and is attributed to aging-related changes where retinal cells struggle to absorb necessary nutrients, leading to macular degeneration.

Considering the potential damage caused by UV rays, smoking, and other risk factors, taking preventive measures such as quitting smoking and protecting the eyes from prolonged sun exposure becomes crucial in mitigating the risk of age-related macular degeneration.

While there is currently no cure for age-related macular degeneration (AMD), various treatment options are available to slow its progression, prevent further vision loss, and, in some cases, even improve vision. These treatment modalities include:

Treatments of Age-related macular degeneration

1. Anti-VEGF Injection:
   • Injecting a light-sensitive drug into the bloodstream and activating it by shining a laser light into the eye allows the drug to work actively to destroy abnormal blood vessels.
2. Photodynamic Therapy:
   • Injecting a light-sensitive drug into the bloodstream and activating it by shining a laser light into the eye is part of the procedure. The activated drug works to destroy abnormal blood vessels.
3. Laser Therapy:
   • Using a high-energy laser actively destroys abnormal blood vessels or seals leaking ones, effectively addressing the underlying causes of AMD.
4. Vitamin Supplements:
   • Taking specific vitamins and minerals in appropriate doses is beneficial. This approach can help slow the progression of AMD and reduce the risk of severe vision loss.

It’s important to note that the effectiveness of these treatments can vary from person to person, and the choice of treatment is often based on the specific characteristics and stage of AMD in each individual. Regular monitoring and consultation with an eye care professional are essential to determining the most suitable treatment plan for each patient.

prevention and management of Age-related macular degeneration

1. To shield your eyes from the sun’s harmful rays and potentially lower your risk of age-related macular degeneration (AMD), opt for sunglasses with built-in UV filters.
2. Antioxidant supplements, including vitamins C and E and beta-carotene, can counteract reactive oxygen species and help prevent vision loss in individuals with moderately advanced AMD.
3. Because zinc plays a vital role in macular health, taking supplements can be a powerful tool in slowing down macular degeneration.
4. The Age-Related Eye Disease Study (AREDS) suggests that antioxidants and zinc can reduce the risk of AMD progression by 25–30% in high-risk individuals.
5. Vitamin supplements do not cure AMD but can play a key role in helping those at high risk maintain their vision.

While ongoing research explores promising avenues for AMD treatment, individuals can use high-intensity reading lamps, magnifiers, and other low-vision aids to maximize their remaining vision.