Age-related macular degeneration (AMD) has become the most common cause of decreased vision beyond the age of 50 in Germany and other industrialized countries. The macula is the site of sharpest vision on the center of the retina. The function of the macula is required for activities such as reading, driving and watching television.In macular degeneration, which is mostly age-related, the highly sensitive photoreceptors (sensory cells) die at this site due to metabolic changes. Every year 300,000 new cases of macular degeneration are diagnosed. Two different courses of age-related macular degeneration (AMD) are distinguished:
- “Dry” form of AMD – in this case, so-called drusen (yellow deposits) form at the back of the eye in the early stages. In the late stage, it comes to areal degeneration, through which the photoreceptors perish
- “Wet” or “exudative” AMD – small new vessels sprout under the retina of the eye in response to the drusen. However, these new vessels leak and can cause edema (water retention) or even hemorrhage. As a result, there is also the demise of the photoreceptors
Unlike the dry form – which accounts for 80% of cases – the wet form can progress very rapidly! Therefore, the wet form is more common in patients with advanced macular degeneration. In case of the following health risks respectively diseases annual examinations of the eyes and the retina are necessary:
Biographic causes
- Genetic factors – if there is a family history of the disease, one’s risk is also increased
- Gender – women, for example, carry a 2.5 times higher risk of AMD than men
- Heavily tanned fair-skinned people with light hair and eye color.
- People who are sensitive to bright light
Behavioral causes
- Nutrition
- High fat consumption
- A high dietary glycemic index is associated with an increased risk of age-related macular degeneration (AMD)
- Micronutrient deficiency (vital substances) – vitamins, trace elements, etc. – see micronutrient therapy.
- Pleasure food consumption
- “Laser disco macula” as a result of damage caused by laser use in discotheques.
Disease-related causes
- Atherosclerosis (arteriosclerosis, hardening of the arteries).
- Diabetes mellitus
- Hypertension (high blood pressure)
- Infection with Chlamydia pneumoniae
- Coronary artery disease (CAD) (disease of the coronary arteries).
Laboratory diagnoses – laboratory parameters that are considered independent risk factors.
- Elevated C-reactive protein (CRP).
- Hypercholesterolemia – high LDL cholesterol
- Hyperhomocysteinemia (>12 mmol/l) – elevated homocysteine levels.
Operations
- Star surgery for light risk
Environmental pollution – intoxications (poisonings).
- Radiation exposure – intense sunlight (UV-A and UV-B).
Diagnostics
“Dry” age-related macular degeneration During ophthalmoscopy – observation of the back of the eye with the ophthalmoscope (ophthalmoscope) – the doctor recognizes the deposits below the pigment epithelium of the retina, which are called drusen. These are recognizable as small, yellow lesions clustered in the macula. Over time, they enlarge, become more numerous, and coalesce. “Wet” age-related macular degeneration The vascular neoplasms in wet AMD are difficult to secure by ophthalmoscopy because they are located below the retina. Fluid accumulation, hemorrhage, and gray discoloration may be seen on ophthalmoscopy. In wet AMD, a so-called fluorescein angiography – vascular imaging with contrast medium – or, rarely, an indocyanine green angiography may be necessary to detect the vascular neoplasms. Early detection By means of a so-called laser scanning ophthalmoscope the ophthalmologist can already detect an early stage of macular degeneration in which there are no restrictions of the visual ability yet. By suitable therapy measures a further progression of the disease can then be slowed down or even prevented.
Benefit
Regular eye exams every 2 years between the ages of 40 and 50, and annually after the age of 50, are necessary to diagnose macular degeneration early. Your eyesight is one of the most precious things you have. Help keep your eyes healthy for as long as possible with regular preventive care.