AMD Age-Related Macular Degeneration

Posted by Xanit Internacional Xanit Internacional | Posted in Ophthalmology | Posted on 09-01-2018

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Sight is the sense that most deteriorates with age. Conditions of varying magnitudes and importance start to appear, including those which are quite common among the population such as age-related blurred near vision, presbyopia and cataracts, as well as other more serious ones such as Age-related Macular Degeneration (AMD).

Dr. Cilveti, Head of the Ophthalmology Department talks to us about this disease which affects around 700,000 people in Spain (1.5% of the population). It is expected to be one of the conditions associated with blindness that will increase most over the coming years.

AMD is a degenerative eye condition which affects the central area of the retina (called the macula) in people over the age of 50. The macula is responsible for central vision and fixation and therefore enables common activities such as reading, watching the television or driving. The main risk factor is age, the condition only affects people over the age of 50 with the risk significantly increasing after the age of 65.

It is one of the current challenges in ophthalmology as it can seriously affect central vision, that is to say, it can leave us unable to read or see details, it is becoming more and more common and does not have a definitive cure. However, we shouldn’t give up hope, we should learn to understand it, prevent it as much as possible, and above all, detect it in time to be able to treat it.

 

What symptoms does AMD cause?

The symptoms of macular affectation can include, from greater to lesser frequency:

  • Blurred central vision, preserving peripheral vision.
  • Alteration in the shape of images (metamorphopsia).
  • Alteration in the size of images: bigger (macropsia) or smaller (micropsia).

The causes are not understood in any depth, although we know many factors which encourage it. Firstly there is a genetic factor, we therefore see families where there are multiple cases, it appears more in patients with blue eyes and in those with greater exposure to the sun, it is also more common in those who are long sighted. It can be induced by mechanisms associated with poor nutrition, smoking, hypertension, hypercholesterolaemia and others.

It is clear that not all patients in whom these factors occur develop the disease, but they do have a greater disposition. 

What types of AMD are there?

Dry or atrophic AMD: is the most common form of the disease (90% of cases). Progression of the disease is slow (years) and severe loss of central vision can take decades. Initially it may not cause any symptoms and be diagnosed at ophthalmological check-ups. It causes a progressive loss of nerve cells in the macula.

Wet or exudative AMD: although this form is less frequent (10% of cases), it is more aggressive and leads to loss of central vision in a short time (weeks, months). New tissue appears under the deepest layers of the retina which grows, produces exudate and may bleed.

 

Diagnosis of Age Related Macular Degeneration

Many patients do not notice they have a problem until their vision has become blurred or visual disturbances such as metamorphopsia have appeared. With testing the ophthalmologist can detect the disease at its earliest stages, performing a series of tests, which depending on the degree of affectation, normally include: 

  • Amsler Grid Test: the patient looks at a gridded page to determine the degree of affectation or metamorphopsia. 
  • Fundoscopy: minute examination of the macular zone, to observe the degree of affectation, as well as to determine which one the two types is the problem.
  • Fluorescein Angiography (FA), generally used in wet AMD, it defines the location, extent and degree of activity of the neovascular membrane which fills with contrast.
  • Optical coherence tomography (OCT), displays virtual, microscopic slices of the macula and provides a lot of information to the ophthalmologist, in both the dry and wet forms of AMD. Indispensable for assessing the response to treatment in the wet form.

 

If you are over the age of 55 and you are affected by some or all of the previously described risk factors you should undergo an ophthalmological review at least once a year, even if you don’t notice anything unusual with your sight.

If you are over the age of 55, whether you have any of the other risk factors or not, if you notice a loss of visual acuity, images becoming deformed or difficulty reading, you should request an appointment with your ophthalmologist as soon as possible.

The Ophthalmology Department at Vithas Xanit International Hospital can provide the different treatments and diagnostic procedures recommended for patients over the age of 55.

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