How is age-related macular degeneration treated?

Age-related macular degeneration, also known as age-related macular degeneration (AMD), is a senile change in the structure of the macula. The main manifestation is that the retinal pigment epithelial cells have decreased phagocytosis and digestion of the disc membrane of the outer segment of the optic cells, as a result, the residual vesicles of the disc membrane that have not been completely digested are retained in the cellular plasma of the base and are discharged to the outside of the cell, deposited in the Bruch’s membrane, and form vitreous warts. Such changes are more pronounced due to the structural and functional peculiarities of the macula. Vitreous membrane warts are also seen in elderly people with normal vision, but the resulting pathologic changes can lead to macular degeneration. Alternatively, the Bruch’s membrane may break, and choroidal capillaries pass through the broken Bruch’s membrane into the sub-RPE and retinal neuroepithelium, forming choroidal neovascularization. Due to the structural abnormality of the neovascularization wall, it leads to leakage and hemorrhage of blood vessels, which in turn triggers a series of secondary pathological changes. Age-related macular degeneration occurs mostly above the age of 45, and its prevalence increases with age, which is currently an important disease of blindness in the elderly. 1, antioxidants Oral vitamin C, vitamin E, Zn, lutein, zeaxanthin can prevent free radicals from damaging the cells, protect the optic cells, and play the role of retinal tissue trophic agent; 2, anti-VEGF therapy Based on the understanding of the pathogenesis of CNV, vascular endothelial cell factor (VEGF) plays an axial role in the development of choroidal neovascularization (CNV). Ranibizumab (Lucentis) is a humanized recombinant anti-VEGF monoclonal antibody fragment Fab fraction that binds to all detected VEGF isoforms, reduces vascular permeability and inhibits CNV formation. The method of use is intravitreal injection; 3. Laser treatment The heat energy generated by the laser is used to destroy abnormal neovascularization in the macula. Laser photocoagulation is a symptomatic treatment only to close the existing neovascularization, and cannot prevent the formation of new neovascularization. At the same time, a little too much laser, itself can make the choroidal neovascularization, and the nearby normal tissue is also damaged, the visual function will be greatly affected, must be vigilant; 4, through the pupil of the temperature and heat therapy This method is the use of 810nm wavelength of the near-infrared laser, in the retina of the radiation rate of 7.5W/cm2, strong penetration and refractive interstitial absorption of the less, so that the target tissues slowly warmed up to 10 ℃; 5, photodynamic therapy is the use of a specially formulated laser, which is used to treat the macular area, and to destroy the abnormal neovascularization of the macula. Photodynamic therapy is a specific photosensitizer injected into the patient’s blood, when the drug circulates to the retina, 689nm laser irradiation to stimulate the photosensitizer, thus destroying the abnormal neovascularization, and no damage to the normal retinal tissues; 6. Surgical treatments, such as removal of subretinal neovascularization of the membrane, macular transposition, retinal transplantation and so on. As there is no special treatment for this disease, in the early stage, some people think that internal zinc can prevent the progression of macular degeneration, and antioxidants such as vitamin C, E can prevent free radicals from damaging cells, protect the optic cells, and play the role of retinal tissue trophic agent. Most scholars advocate that for the exudative type of the person, laser photocoagulation of the neovascularization should be carried out as early as possible in order to avoid the deterioration of the disease.