Understanding Age-Related Macular Degeneration

  The retina of the human eye is like the negative of a camera, while the macula is located right in the center of the retina, mainly related to fine vision and color vision and other visual functions. Age-related macular degeneration (AMD) is one of the most common fundus lesions in the elderly, and its main symptoms are dark spots in the visual field, distortion of visual objects, loss of central vision, and even vision loss.  In developed countries such as Europe and the United States, AMD is the most common blinding eye disease in the elderly population over 60 years old. With the accelerated aging of our society, the increasing awareness of people’s living standard and daily health care, and the progress of ophthalmic diagnosis technology, the incidence of age-related macular degeneration is increasing year by year.  (A) Classification of age-related macular degeneration Clinically, age-related macular degeneration is divided into two types: dry and wet. Dry age-related macular degeneration, also known as atrophic age-related macular degeneration, accounts for about 90% of age-related macular degeneration patients, mainly due to retinal pigment epithelial degeneration, mainly due to choroidal capillary atrophy, vitreous membrane thickening and retinal pigment epithelial atrophy, etc.  Wet age-related macular degeneration, also known as exudative or neovascular age-related macular degeneration, accounts for about 10%, characterized by the occurrence of choroidal neovascularization, leading to plasma or/and hemorrhage in the retina or/and pigment epithelium and scar formation in the macula, which often leads to serious impairment of visual function and affects the survival quality of patients.  (B) Clinical diagnosis and treatment methods of age-related macular degeneration A clear diagnosis of age-related macular degeneration can be obtained through routine fundus examination, combined with fundus retinal and choroidal fluorescence angiography, optical coherence tomography and other ophthalmic instruments.  For dry age-related macular degeneration, up to now, no definite and effective drug therapy has been found in modern medicine to stop the progress of the disease. For dry age-related macular degeneration, some supportive therapies can be given, such as: antioxidant therapy, oral vitamin C and vitamin E, which can prevent cell damage by free radicals, protect the optic cells and play the role of retinal tissue nutrient.  In recent years, along with the progress of basic retinal research and clinical surgery, the success of experimental research on retinal transplantation, and the continuous progress of artificial vision and stem cell research have given hope to patients with advanced and severe vision loss. For wet age-related macular degeneration, the main focus is on the treatment of choroidal neovascularization. Choroidal neovascularization located outside the central macular recess can be closed by laser photocoagulation of the neovascularization.  Choroidal neovascularization located in the central macular sulcus is treated with photodynamic laser (PDT), transpupillary thermotherapy (TTT) or intraocular injection of corticosteroids and anti neovascular drugs, which have achieved better efficacy.  Currently, the clinical application of ranibizumab and the advent of VEGF Trap-eye offer new hope for patients with wet age-related macular degeneration. Vitreoretinal surgery for age-related macular degeneration includes removal of subretinal hemorrhage, vitreous blood accumulation, removal of subretinal CNV and stripping of proliferative membrane, macular transposition, etc.  (C) Prevention of age-related macular degeneration The exact cause of age-related macular degeneration is still undetermined, and may be related to environmental factors, genetic factors, chronic photodamage, nutritional disorders, toxic substances, immune factors, etc. It is generally believed that it is the result of the compound effect of many factors under the premise of aging of the organism.  According to the consultation process of macular degeneration patients, it is found that people with the following conditions are prone to high incidence of age-related macular degeneration: people with long-term bad habits, research shows that smoking is directly related to age-related macular degeneration; people with obesity and high blood lipids and cardiovascular diseases such as heart disease and hypertension, the blood vessels in the macula of the eyes are also more prone to lesions; excessive light exposure can cause cumulative damage to the macula It is also one of the suspected factors of age-related macular degeneration.  Controlling these risk factors has a positive effect on the prevention of age-related macular degeneration. At the same time, self-testing by patients can detect the condition in time and help doctors to buy time, thus maximizing the preservation of vision.