How to diagnose and treat age-related macular degeneration

Age-related macular degeneration, also known as age-related macular degeneration, is the most common cause of blindness in the elderly in developed countries, as it affects the quality of life of the elderly. Due to the increasing aging of the population, the number of patients with age-related macular degeneration is also increasing in China. The exact etiology of this disease is still unclear and may be related to genetics, environmental influences, chronic photodamage to the retina, nutritional disorders and metabolic disorders. According to the different clinical manifestations and pathological changes, the disease is divided into two types: atrophic type and exudative type. Atrophic macular degeneration generally starts slowly, and the patient’s visual acuity decreases unconsciously, which can be accompanied by visual distortion and similar degree in both eyes, and is easily mistaken for “aging”. Early in the course of the disease, yellowish-white, rounded vitreous warts of varying sizes can be seen in the posterior pole of the fundus, which can fuse; pigment epithelial hyperplasia or atrophy, pigment disorder; furthermore, a well-defined map-like atrophy appears. In late stage, the choroidal capillaries in this area are atrophied, and the exposed choroidal vessels can be seen. Exudative age-related macular degeneration manifests as sudden vision loss, visual distortion or dark spots in the center of the visual field in one eye, and the other eye may show symptoms only after a longer period of time. Examination reveals subretinal hemorrhage, exudation, and bulging in the posterior pole of the eye. The hemorrhage is located under the neuroepithelium or pigment epithelium, the latter being darker in color dark red or purplish black with a slightly red margin, while there may be superficial bright red hemorrhage. The early stage of fluorescence angiography can be seen as the spread of highly fluorescent leakage within the lesion area. For atrophic macular degeneration, there is no clear and effective treatment method, but oral lutein-like preparations can be taken to slow down the course of the disease. For exudative macular degeneration, it can be treated by intravitreal injection of anti-VEGF drugs such as Lucentis and Compazepine, which can achieve better results, but the shortcoming is that long-term follow-up and multiple treatments are needed. Direct laser closure of non-central recess neovascularization is also possible.