Age-Related Macular Degeneration (AMD)

Age-Related Macular Degeneration (AMD)

Age-related macular degeneration (AMD) is an ocular degenerative disease that causes significant visual disturbances by affecting the center of the retina, the macula, and therefore, the center of our visual field and the vision of the details, both near and far.

AMD is a chronic disease of multifactorial origin (it can be caused by multiple causes and some of them at the same time) and, as in many chronic diseases that affect adults, in AMD there are a number of genetic factors, which influence the development of this ocular disease. Doctors suspect AMD in those patients who suffer:

• A deformed vision of objects: For example, door and window frames may look curved instead of straight.
• Black spots in the central field of vision (scotomas) that, for example, hinder the recognition of people, since the macula has been affected.
• Any sudden loss of central vision.

Clinical classification of age-related macular degeneration has been proposed in which small “drusen” (yellow deposits under the retina) are considered normal changes in retinal aging. These cases do not have a significant increase in the risk of developing late forms of AMD. In contrast, in the early form of the disease, patients have medium-sized drusens. In the intermediate AMD, they have large-sized drusens. Late forms of AMD include neovascular, wet or exudative and/or geographic atrophy.

Its prevalence is especially high after 65 years of age, but after the ’50s, serious cases of the disease can still be detected. As the age increases the number of retinal lesions as well as their severity and bilaterality, being especially significant after 85 years.

Although the only universally accepted factor is age, other possible risk factors have been implicated in multiple studies. Tobacco has been linked to AMD through the alteration of the choroidal circulation.

Treatment

At present, there is no treatment for the dry form of the disease. According to the results of the studies, patients who can benefit from it receive supplements with antioxidants.

In the wet form, the treatment of choice is the intravitreal injection of antiangiogenic drugs with a variable periodicity and frequency. In general, all of them start with a monthly injection on three consecutive occasions and then a different pattern according to the obtained response and the chosen drug. Intravitreal injection is performed on an outpatient basis, under topical anesthesia and meeting the established criteria has a very low number of complications.

In general terms, antiangiogenic treatment manages to stop the loss of vision in 90% of situations, of which 40% can even obtain improvements in visual acuity, according to the results of studies with these drugs.

In some cases, we can use direct photocoagulation with a laser when there is sufficient distance to the center of the fovea to treat the choroidal membrane and in cases of the peripapillary choroidal membrane, we can choose the surgical treatment to extract this complex.

Frequently Asked Questions

What age does AMD occur?

Age-related macular degeneration (AMD) typically occurs in individuals over the age of 50, becoming more prevalent with advancing age. However, it can also affect younger individuals, particularly those with a family history or specific risk factors.

What are the stages of AMD?

Age-related macular degeneration (AMD) has two main stages: early AMD, characterized by small drusen deposits in the macula, and late AMD, which is further divided into dry AMD (geographic atrophy) and wet AMD (neovascular AMD) where abnormal blood vessels grow beneath the retina.

What age is at risk for AMD?

The risk for age-related macular degeneration (AMD) increases significantly after the age of 50, with prevalence rising with advancing age. However, certain genetic and lifestyle factors can influence the risk of developing AMD at a younger age.