Many middle-aged and elderly patients suffer from a sudden loss of vision, and after a hospital examination, they are diagnosed with “age-related macular degeneration” or “age-related macular degeneration”. What is macular degeneration? As the name suggests, macular degeneration is a degenerative disease of the macular area of the human eye. In young people, macular degeneration is mostly related to heredity, in middle-aged and old people, with the increase of age, macular degeneration, vitreous warts, macular pigmentation disorders in the fundus of the eye, serious macular hemorrhage, edema and oozing and scar formation, and this disease occurs in the population of people over the age of 50 years old, and with the increase of age, the prevalence of increase, so in 1967, according to the macular degeneration of old people, the Gass Therefore, in 1967, Gass proposed the name of senile maculardegeneration (SMD) based on the degenerative changes of vitreous warts, retinal pigment epithelium and choroidal capillaries in the macular region of the elderly, which was later renamed as age-related macular degeneration (AMD). In the human eye, the retina is located in the back of the eye, like the film of a fundus camera, and the macula is located in the center of the retina, which is responsible for light, shape, and color senses, and is the most sensitive place for human eyes to visualize, so if the macula is affected by the disease, the visual function will definitely be seriously damaged. AMD is one of the main causes of blindness in western developed countries. A survey done in Shanghai shows that the prevalence of AMD in people over 50 years old is 15.5%. In China, with the trend of population aging, the prevalence of AMD and the number of patients will increase year by year, and it will become a serious social and public health problem, such as AMD leads to the limitation of self-care ability, inability to read, the number of elderly people fall and fracture because of visual impairment, and the resulting psychosocial problems greatly increased, and the patient’s quality of life is very greatly affected. In the early stage of AMD, some yellowish-white dots called vitreous warts are seen under the retina, which do not affect vision. However, in many patients, AMD develops into severe lesions that have a serious impact on vision. Since it usually starts in one eye, it is often overlooked at first. Types of AMD AMD is categorized as “dry”, and “”wet””, or atrophic and exudative. Dry AMD, in which vitreous warts are visible at the bottom of the eye, can also progressively cause thinning of the macula, which can affect function to some degree. The macular area and the vicinity can be seen a lot of yellow deposits of varying sizes, i.e., vitreous membrane warts (Drusen) “Wet”, mostly caused by severe visual impairment, accounting for 90% of AMD caused by severe visual impairment. The cause of visual impairment is mainly the growth of abnormal neovascularization under the retina, causing retinal hemorrhage, edema and destruction of retinal tissue, which ultimately leads to scarring, thus causing loss of vision. Hemorrhages, yellowish-white exudates and a central yellowish-white mechanized proliferative membrane can be seen in the macula. How to detect “wet” AMD early? In the early stages of AMD, your vision may be slightly altered. The easiest way to detect AMD is to check the Amsler chart yourself. To check, follow these steps: Put on your eyeglasses if you have them. Cover one eye and look at the center of the table. Keep looking at this point during the check. In a normal person, all the lines should be straight and the squares should be the same size. Examine each eye separately. If the grid becomes blurred, distorted, or has an abnormal color, you must go to the ophthalmologist for a funduscopic examination, which usually includes fundoscopy, fundus fluorescein angiography, indocyanine green angiography, and coherence photomicrography (OCT). How to treat “wet” AMD? There is no treatment for AMD because the pathogenesis of AMD is unknown. Until 2000, there was little we could do to treat macular degeneration. Over the past 20 years of research, and especially in recent years, there have been significant advances in the treatment of AMD. There are several treatments as follows: 1. Laser treatment: the heat energy produced by laser destroys the abnormal neovascularization in the macular area, the disadvantage is that it also damages the normal tissues nearby, and the visual function will be greatly affected. 2.Transpupillary Thermal Therapy (TTT): Using infrared light to irradiate the macular lesion area with weak energy to make the lesion localized slight warming, so as to achieve the purpose of making the abnormal neovascularization atrophy. The cost of this treatment is low, but there is some damage to the local normal tissues, and the therapeutic effect is not very satisfactory. 3.Surgical treatment: such as subretinal neovascularization membrane excision, macular transposition. Surgery is risky and the therapeutic effect is not exact. Retinal transplantation: it is still in the research stage. 4.Photodynamic therapy (PDT): it is to inject a specific photosensitizer into the patient’s blood, when the drug circulates to the retina, a special non-thermal laser irradiation is used to excite the photosensitizer, thus destroying the abnormal neovascularization, while there is almost no damage to the normal retinal tissues.The value of the PDT treatment of CNV lies in the fact that, at last, there is a method that can break through the macular central concavity’s The value of PDT for CNV is that there is finally a way to break through the “forbidden zone” of the macula centrale and treat “wet” age-related macular degeneration, which is a milestone in the process of treating age-related macular degeneration. At present, this technology has been carried out for nearly 6 years, which is a blessing for patients and ophthalmologists! However, the disadvantage of this technology is expensive, each treatment costs about 17,000 yuan, in addition, from the point of view of therapeutic effect, it is mainly to stabilize the disease, and not necessarily able to significantly improve the visual acuity. 5, anti-neovascular treatment Based on the understanding of the pathogenesis of CNV, it has been recognized that vascular endothelial cell factor (VEGF) plays an axial role in the development of neovascularization (CNV) in the complex membrane. As a result, drugs targeting VEGF have been developed. Ranibizumab (Lucentis), which was approved by the US FDA for the treatment of CNV in June 2006, is now available in many countries around the world for the treatment of “wet” AMD, and is a humanized recombinant anti-VEGF monoclonal antibody fragment with a Fab portion that binds to all detected anti-VEGF components. Ranibizumab is a humanized recombinant anti-VEGF monoclonal antibody fragment that binds to all detected VEGF isoforms, reduces vascular permeability and inhibits CNV formation. The drug is administered as an intravitreal injection, typically every 4-6 weeks. Multi-center clinical studies have shown that patients receiving Ranibizumab resulted in stabilized or improved visual acuity in 95% of “wet” AMD eyes at one year, which is a very exciting result! This is a very exciting result! This result was recognized as one of the top 10 health news stories in the United States in 2006. With the introduction of Lucentis, coupled with photodynamic therapy, we say that spring has arrived in the treatment of “wet” AMD. There are now definitive and effective treatments for what used to be an untreatable disease. Currently, the most popular treatment for “wet” AMD is the so-called “combination therapy”, which is based on the theory that after PDT treatment, there is an increase in tissue edema and an increase in VEGF expression. The theory is based on the fact that after PDT treatment, there is an increase in tissue edema and an increase in VEGF expression, so PDT combined with anti-VEGF antibodies or/and anti-inflammatory drugs can not only close the CNV and improve the efficacy, but also reduce the recurrence of CNV, reduce the number of PDT and intraocular injections, and reduce the risk of treatment, especially the risk of intraocular infection caused by intraocular injections. However, it is difficult to substantially restore lost visual function with any treatment. Wet” AMD is a “wild horse” that affects visual function very drastically and seriously. Therefore, early detection and early, correct and timely treatment with scientific and advanced methods are advocated. How to prevent AMD? Numerous studies have shown that the occurrence of AMD is related to heredity, environmental factors such as long-term exposure to ultraviolet rays, environmental pollution, smoking, and a decrease in blood antioxidant levels. In response to these triggers, scientists have proposed the following preventive measures: 1. Since the occurrence of AMD may have a certain relationship with heredity, if someone in the family suffers from AMD, then family members over the age of 50 should undergo regular funduscopic examinations. 2. 2. As AMD may be associated with long-term exposure to ultraviolet light, it is recommended to wear sunglasses when going out in strong sunlight. 3. Since vegetables and fruits contain a lot of antioxidant substances, such as trace elements, multivitamins, lutein, etc., it is recommended to eat more vegetables and fruits. Fish contains a lot of unsaturated acid, which has strong antioxidant ability, so it is recommended to eat more. 4, it is recommended to supplement a variety of antioxidant capacity, especially rich in lutein, zeaxanthin health care drugs. Multi-center clinical studies have shown that long-term use of eye health medicines containing lutein, trace elements zinc and a variety of vitamins, unsaturated fatty acids in line with the development of AMD can help prevent. A multi-center study with more than 3,000 participants over a period of nearly 10 years has shown that long-term use of the above eye care medicines can stop at least a quarter of early AMD from progressing to advanced stages. 5. In addition, there are also studies showing that the occurrence of AMD is related to high blood pressure and high blood fat, therefore, it is necessary to actively prevent high blood pressure and high blood fat, eat less overly oily food, and strengthen exercise, which can help prevent AMD or slow down its development. Studies have shown that there is a very clear correlation between smoking and the occurrence of AMD, therefore, it is recommended to quit smoking. In conclusion, with the arrival of the aging society in China, AMD has been a disease that seriously affects the quality of life of middle-aged and elderly patients in China, with an increasing number of patients suffering from the disease, which is a serious public health problem. However, the occurrence of severe AMD can be reduced through active and extensive publicity, increasing the awareness of AMD among patients and physicians, and through active preventive measures. In recent years, thanks to breakthroughs in medical technology, the treatment of the disease is no longer so frightening. As long as patients can be detected early and treated appropriately at an early stage, the stabilization and improvement of patients’ visual function is no longer a distant dream, but an optimistic reality!