Macular Degeneration – Prevention, Diagnosis, Treatment

What can we do to prevent macular degeneration?

• Wear sunglasses with UV filters to protect the eyes
• You can take dietary supplements, multivitamins and zinc products. Even though it is difficult to prove those products' preventive action, several studies have shown that they can help delay the disease. Dosage should be indicated by the ophthalmologist in cooperation with the pathologist, in case of contraindications
• You should regularly check your eyes after 40 years of age and visit your ophthalmologist as soon as you observe changes in your eyesight, especially scotomas related to your central vision.
• You should reduce or, better yet, quit smoking. Besides, we know how bad it is for our eyes and the rest of our organs.
• Regulate your blood pressure, your cholesterol and consult with a cardiologist, in case it is needed.

Special diagnostic tests for macular degeneration

You should know that we need to do regular tests and, if necessary and after consulting a specialist ophthalmologist, do a special test to photograph the fundus, after we administer first a dye, fluorescein. The test is called fluoroangiography. This test allows us to see if there is any damage in the retina and the macula and if pathological vessels are formed under them. This diagnostic method is performed with inserting the dye (fluorescein) in the blood, which allows to photograph the pathological vessels and their exact expanse.

In addition, there is the option of an optical coherence tomography (OCT) of the macula, during which the retina is examined layer after layer, so that lesions can appear in the area of the macula, or neovascular membranes that emanate from the choroid, in the presence or not of fluid; all that without the use of pigment or other substance, without mydriasis and in a very short time. OCT is used to check how is the response to the treatment , as well as the progress of the degeneration with time.

Treatment

A) Multivitamin supplements

In case of dry macular degeneration, there is no cure. The disease progresses slowly, but we cannot provide medication or propose a surgical solution that will solve the problem. In this case, multivitamin supplements can be administered that would contain lutein and zeaxanthin, since some studies have shown they delay the progress.

B) Antineovascularization agents (only for wet type macular degeneration)

In case of wet type macular degeneration and in the presence of a neovascular membrane, the choice therapy since 2005 until today is to administer antineovascularzation medication in the form of intravitreous injections. These drugs (AVASTIN, LUCENTIS) act in such a way that they inhibit the progress of the neovascular membrane and decrease (or even remove) the edema (fluid) in the macular area, which results not only in the stabilization and halting the progress of the degeneration, but also in improving the visual acuity of the patient. These injectable drugs are administered every 4-8 weeks until inhibition of the disorder.

C) Thermal laser treatment (only for wet type macular degeneration)

It is applied only for problems adjacent to the macula, practically in a very small number of patients

D) Photodynamic therapy (PTD) (non thermal laser only for wet type macular degeneration))

Photodynamic therapy with Visudyne is done with intravenous injection of Visudyne, a light-sensitive substance that is activated when exposed to light. Visudyne concentrates selectively in the pathological vessels of the retina and is activated with the light of a specially designed laser (that does not produce heat and does not burn the retina). The activated substance causes thrombosis and obstruction of the new vessels, without affecting adjacent tissue, thus inhibiting the progress of the disease..

E) Surgery

In special cases, macular degeneration can be surgically treated. Macular translocation is a procedure performed on patients that experience total loss of vision in both eyes after macular degeneration. With macular translocation we manage to place the macula in a new healthy spot in order for vision to be restored in one eye.

 F) Low vision aids

In case of advanced degeneration, the patient can also use low vision aids. These are special glasses or special magnifying lenses or closed circuit televisions and computers that help low vision by enlarging objects or increasing the visual field. They are aids prescribed only by the ophthalmologist and only if there is an indication for them; they can be used after training the patient in their function. However, we should mention that they are a serious solution in a difficult problem, especially when all other treatment options have been ruled out.

Macula

Macular Degeneration

Tags: