The disease is still considered difficult to treat today! A causal therapy of manifest dry AMD does not exist so far.The treatment of macular degeneration is based on the following pillars:
- Prevention, that is, reduction of individual risk factors (see below under “General measures”, “Nutritional medicine“).
- Therapy: in neovascular (wet) AMD (nAMD):
- Laser photocoagulation
- Photodynamic therapy
- Injection of a growth factor inhibitor (VEGF inhibitor; agents: aflibercept, bevacizumab, brolucizumab, ranibizumab) [gold standard].
- Nutritional medicine including therapy with micronutrients (vital substances).
General measures
- Nicotine restriction (refraining from tobacco use; smoking, also affects the risk of dry to wet form of AMD).
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of environmental stress:
- Radiation exposure – in the case of intense sunlight (UV-A, UV-B) → Limit or avoid sunbathing as well as visits to solariums.
- Sunglasses protect the retina as well as the sensitive macula from UV rays.
- Caution in discotheques: here it can be damaged by laser use.
- Radiation exposure – in the case of intense sunlight (UV-A, UV-B) → Limit or avoid sunbathing as well as visits to solariums.
Conventional non-surgical therapy methods
- In some patients with wet macular degeneration, laser photocoagulation can prevent or slow disease progression. If the vascular neoplasms are sufficiently distant from the macula (yellow spot), they can be obliterated by laser coagulation with the argon-green laser using a heat effect. However, this is only the case in 15% of patients suffering from AMD with new vessel formation. The disadvantage of this is that when the retina is lasered, healthy tissue is also destroyed. The scar in the area, however, leads to a scotoma (visual field loss).
- Photodynamic therapy (PDT) represents a promising therapeutic concept based on a photochemical effect induced by laser irradiation. In a two-step process, a so-called photosensitizer is first injected intravenously, which accumulates in pathologic vascular growths in the macula. Irradiation with a laser matched to the absorption of the photosensitizer activates it.The activation closes the proliferating blood vessels of the macula. The treatment spares surrounding tissue and especially the remaining healthy sensory cells, since no thermal effects occur during irradiation.
- Injection of a growth factor inhibitor (VEGF inhibitor): growth factors are endogenous substances that stimulate, for example, the formation of new vessels. In macular degeneration the growth factor VEGF – “vascular endothelial growth factor” – plays a special role. By injecting a VEGF inhibitor (aflibercept, bevazizumab, pegaptanib and ranibizumab), the process of new vessel formation in wet AMD can be slowed down.
Regular checkups
- Regular ophthalmological check-ups
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Observance of the following special dietary recommendations:
- Reducing the fat content of the diet – a lower intake of saturated fatty acids decreases total cholesterol and LDL cholesterol levels, as well as triglycerides (neutral fats) in the blood. High fat consumption and increased cholesterol concentration in the blood are considered risk factors for age-related macular degeneration.
- Prefer foods with low glycemic index (whole grains, potatoes, legumes).
- Diet rich in:
- Vitamins (vitamin A (retinol), vitamin C (ascorbic acid), vitamin E (tocopherols), cobalamin (vitamin B12)).
- Trace elements (selenium, zinc)
- Omega-3 fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)).
- Secondary plant compounds (beta-carotene (provitamin A), lutein, zeaxanthin).
- Other micronutrients (if necessary, also L-carnitine, coenzyme Q10 (CoQ10), taurine).
- See also under “Therapy with micronutrients (vital substances)”.
- Detailed information on nutritional medicine you will receive from us.
