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Age macular degeneration

Age-related macular degeneration (AMD) is a central retinal disease. As we grow older, there is a cumulative decrease in the retina due to oxidative stress and vascular sclerosis. The normal physiological function of the retinal pigment epithelial cells is spoiled because the degradation of lipid-rich photoreceptor disks leads to the formation of toxic deposits of intracellular (lipofuscin) and extracellular remains (drusen).

Most cases occur in people older than 80 years, the incidence being higher as they become older. The main risk factors are: tobacco, high hypertension, cholesterol and a diet rich in saturated fats and low  in fish and vegetables.

There is a classification in two main groups of the AMD: the dry and the wet one. The first corresponds to 90% of the cases and is of slow progression and the second is 10% but it is fast and 90% of cases of blindness.
 

Fons d´ull d´una persona amb una DMAE seca

Dry AMD

Imatge del gruix de la retina d´una persona amb DMAE seca
Fons d´ull d´una persona amb una DMAE exsudativa

Wet AMD

Imatge del gruix de la retina d´una persona amb DMAE exsudativa

At the beginning, there are not many symptoms in dry AMD, but as the disease progress, the person notice an increasing effort in adaptation to darkness, more need of light when reading or sewing. Later on, there is difficulty recognizing faces, driving or reading. The perception of the color is affected and contrast sensitivity diminishes and in the end, distorted images are seen. There is no pharmacological treatment at this time. Yes, there are some antioxidant capsules, zeaxanthin, lutein and omega 3 in order to maintain and delay progression. In advanced cases, the use of special filters works well to improve contrast and vision quality.

Visió simulada d´una persona amb DMAE seca avançada

Simulated image of a person with an advanced dry AMD

In in wet AMD, bleeding occurs that abruptly decreases visual acuity. Currently, the treatment is done with injections of monoclonal antibiotics.