What is age related Macular Degeneration ( DMAE)?
It is a degenerative condition which generally affects patients over 60 years old and is the main cause of loss of sight in the developed world. The retina is positioned inside the eye, right at the back. The centre of the retina is called the macula and is the part which allows us to see clearly and sharply. It is this central zone which deteriorates in DMAE, a fact which means that the ability to carry out basic, everyday activities like reading, driving, using the phone or computer and recognising faces will be considerably reduced.
What causes it?
There is no known exact cause at present although it is clearly related to age and genetics. Other associated factors are evironmental such as obesity, high blood pressure, dietry deficiency, smoking and ultraviolet light.
How many types of Macular Degeneration are there?
There are two types, dry DMAE and wet DMAE. The former is more frequent ( 85%) with a slow, progressive evolution while the latter usually develops quicker and is more incapacitating for the person.
What are the symptoms of Macular Degeneration?
Symptoms generally appear slowly, vision is usually blurred and you notice a spot in the middle which is preventing you from seeing clearly. It normally starts in one eye then, later on, affects the other one. These are people who come to us in the clinic because they can’t distinguish faces, have difficulty reading (the lines are twisted) and who see only cloudiness on computer screens.
How is this condition diagnosed?
When visiting your ophthalmologist, who will carry out a series of examinations to make a diagnosis, he will see the state of its development and prescribe treatment. He will test your sight using the very simple Amsler grid of small squares which the patient, using his reading glasses, looks at first with one eye then with the other. A patient suffering from this condition will see distorted horizontal and vertical lines or a spot which stops him/her from seeing an area of the grid.
Another more specific examination would be to dilate the pupil to see the back of the eye. Sometimes it is necessary to inject a colourant into a vein in the arm so as to carry out an image test called OCT. This will allow us to examine all the layers of the macular in detail
Is it possible to prevent or cure Macular Degeneration?
No, it is not possible to repair damage already done. A diet rich in vitamins is recommended, antioxydents also lutein to avoid any advancement in dry DMAE, There are various supplements on the market which contain these substances, nevertheless, it must be the ophthalmologist who prescribes it since smokers must not have this treatment. If you have the second type, wet DMAE, several subsidiary treatments can be used: Laser photocoagulation if the anomalous vessels are not in the central area. Photodynamic Therapy where a light activates a medication which is put into a vein to destroy the anomolous vessels. Antiangiogenic Therapy where medicaments such as Lucentis, Avastin or Macugen are injected directly into the eye to destroy the existing pathological vessels and prevent others from forming. This treatment is painless and must be repeated several times. Lastly, in already well advanced cases, patients with very poor sight will be helped (?) with special optic equipment. With respect to the present, clinical trials are underway using cells from human embryos, foetal cells obtained from umbilical chords and stem cells from bone marrow which show promise for the future. For the moment though, they are still under trial and are not yet being applied for lack of convincing results.
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