Age-related macular degeneration (AMD) is one of the most common eye diseases. It is one of the most important causes of blindness in the western world. If left untreated, it can have serious effects on vision. According to the current state of knowledge, a cure is not possible. Therefore, therapy aims at slowing down the course of the disease or bringing it to a complete halt. But improvements in visual acuity are also possible.
In our eye clinic, we treat macular degeneration primarily with IVOM therapy. In this form of therapy, drugs are injected directly into the vitreous body of the eye, where they can have an immediate effect on the affected area. The drugs inhibit the abnormal growth of the blood vessels that are responsible for the deterioration of vision in many patients. Thanks to this therapy, we can maintain visual acuity in many cases, and in some cases even improve it.
The term macular degeneration refers to a group of diseases of the retina. These affect the so-called macula, the point of sharpest vision in the back of the eye. The macula is largely responsible for our ability to perceive sharp images and colours. It is the most sensitive area of the retina and the one where the visual cells are most densely arranged.
In degenerative diseases of the macula, the complex processes are disturbed. Particularly due to age, deposits can form on the macula, resulting in a gradual loss of function. This is why we also speak of so-called age-related macular degeneration.
There are different forms of macular degeneration, which differ in their course and severity. Younger patients can also be affected. In particular, a distinction is made between dry macular degeneration, which tends to progress gradually and slowly, and wet macular degeneration. In this form, vascular membranes form under the retina, which can result in blurred and distorted vision. Vision deteriorates relatively quickly. The wet form is much less common than the dry form, with a prevalence of 10%. However, wet macular degeneration is responsible for 90% of vision loss.
Macular degeneration is usually a symptom of old age. In old age, the body's metabolic processes no longer function so well. Metabolic waste products may no longer be completely removed, which can lead to deposits. This damages the light-sensitive photoreceptors.
Over time, this dry form of macular degeneration sometimes develops into wet macular degeneration. Then new vascular membranes form in the area of the retina, which can cause swelling or bleeding. We can measure these swellings of the retina with modern imaging (optical coherence tomography / OCT). There is an increase in certain vascular growth factors.
In addition to advanced age, genetic factors can favour the development of macular degeneration. An unbalanced diet, UV radiation and especially smoking are also possible risk factors.
Typical signs of macular degeneration are grey or dark spots and distorted perception in the central visual field. Straight lines suddenly appear wavy, or when reading, individual parts of text can no longer be recognised.
Based on the symptoms, the ophthalmologist can usually quickly conclude that the macula is diseased. Before a therapy is planned, however, further functional tests are carried out. Among other things, the thickness of the retina is measured and the blood flow is assessed by means of an angiography. With the help of these examinations, the ophthalmologist can rule out other diseases and precisely assess the damage that has already occurred.
So far, there is no known causal treatment for dry macular degeneration. Therefore, the therapy aims at slowing down the course of the disease by preventive measures. In particular, harmful substances such as nicotine and alcohol, but also UV radiation should be avoided. In the near future, drugs will be available that can slow down the process.
We often treat wet macular degeneration very successfully with IVOM therapy (intravitreal injection). In this therapy, drugs are injected directly into the vitreous body of the eye. The active substances inhibit the growth of new vessels in the area of the macula and reduce the swelling of the retina.
This therapy is carried out over a longer period of time. The injections take place under local anaesthetic and are therefore painless for the patient. The individual sessions only take a few minutes. After the macular degeneration therapy you are allowed to go home accompanied.
At the present time, macular degeneration cannot be cured, but it can be well controlled by early therapy. By intravitreal injection, we can maintain visual acuity in the vast majority of cases and even improve it in some cases.
To date, there is no causal macular degeneration therapy for the treatment of the dry form. However, dry macular degeneration usually progresses very slowly and can also be positively influenced to a certain extent by avoiding the risk factors.
As a rule, patients do not have to fear blindness. The visual impairments are usually concentrated in the central visual field, so that orientation vision is still possible. Early diagnosis and therapy are crucial in order to maintain a high quality of life in the long term.