Maculopathy – Age-related macular degeneration

Maculopathy, or macular degeneration, irreversibly impairs visual function, with a loss of central vision. Even the most severe cases do not lead to total blindness, but a spot (scotoma) forms at the point of fixation without affecting peripheral vision.

What is AMD?

Macular degeneration is a retinal disease in which the central part of the retina (called the “macula”) changes and decreases in function due to the progressive death of photoreceptor cells (cones).

The most common symptoms of AMD

The first symptoms accompanying the onset of age-related macular degeneration include image distortion (metamorphopsia) or black spots in the visual field and reduced colour contrast. This may be seen in different daily situations:

  • while reading books, newspapers, or medicine leaflets you may miss letters or even whole words;
  • when driving at dusk, you may experience glare when looking at car headlights, traffic lights, or street lights;
  • when walking down the street at sunset, you may have difficulty perceiving objects and contrasts in shady areas;
  • when you meet familiar people, you may have difficulty recognizing their faces.

What do people with AMD see?

The central blind area, called a scotoma, may be perceived as the absence of vision or a black spot in the visual field.

Central fixation is often compromised, requiring the use of peripheral vision with less detail and difficulty stabilizing the image.

The causes of AMD

Age-related macular degeneration (AMD or ARMD) is currently considered the leading cause of blindness in affluent countries and the third leading cause overall [WHO].

Environmental causes of maculopathy

Unhealthy lifestyles play an important role in the development of age-related macular degeneration. These include, in particular, an incorrect dietalcohol abuse and smokingsedentariness, and excessive exposure to solar radiation.

Genetic causes of maculopathy

Evidence of genetic predisposition to the disease has been found.

Demographic influence on maculopathy

There is a low incidence of AMD before age 55, but it grows significantly after age 75. It is therefore important to undergo periodic eye examinations and possible tests for a precise diagnosis after the age of 50.

Wet and dry AMD

Dry or atrophic maculopathy

Dry or atrophic maculopathy (85–90% of cases) is characterized by a progressive thinning of the central retina, which atrophies when it does not receive sufficient blood from the capillaries.

Wet or exudative maculopathy

 Wet or exudative maculopathy (10–15% of cases) is the most severe and most rapidly evolving form. It is complicated by the formation of new, very fragile capillaries.

The impact of this form of maculopathy can be severely disabling psychologically and may severely restrict a person’s independence.

What treatments are available?

Early diagnosis of age-related macular degeneration is essential, so it is very important to be aware of any of the symptoms mentioned above.

In Europe, the wet form can be treated with intravitreal injections that block or slow the advancement of the disease. Photodynamic therapy using a special type of laser may also be used.

Adopting an active lifestyle, adequate protection from sunlight, and a proper diet rich in antioxidants can help slow and prevent the development of AMD.

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