February, the month of the fight against senile macular degeneration

Retinal disease specialists around the world declare February as the month of attention to vision loss due to senile macular degeneration – yellow spots – ARMD-Age Related Macular Degeneration Awareness month.

Retinologists emphasize the importance of fighting senile degeneration, which is one of the leading causes of vision loss in people over 55.

It points out: the importance of combating risk factors that can be influenced, the recognition of early symptoms of the disease, the importance of the existence of heredity, also points to available diagnostic procedures and options for prevention and treatment.

Most importantly, the importance of regular check-ups with ophthalmologists – retinologists is emphasized.

Risk factors that we cannot influence are: heredity and the aging process.

Risk factors that we can influence are: avoid smoking, protection from UV and blue spectrum of visible light – goggles, control of general diseases, especially arterial hypertension, high cholesterol and blood sugar levels, quality diet rich in lutein, zeaxanthin, amines D , C, E, Zn, omega 3 fatty acids.

In dry macular degeneration (which exists in 90% of cases), the basic symptoms are:

• gradual reduction of visual acuity,
• colors become less “alive”,
• the light dimmed.

When it comes to the wet form of degeneration (10% of all people with macular degeneration) the symptoms are:

• a sharp drop in visual acuity,
• loss in the central part of the visual field, the central scotoma, which patients describe as a more or less pronounced “dark spot”,
• “Distorted image” – metamorphosis, image deformation occurs due to accumulation of fluid and bleeding at the point of clear vision,
• peripheral vision is preserved for a long time, and fortunately these people do not have a problem with movement,
• the main problem is reading and recognizing characters.

When we state the initial form of dry degeneration, the so-called small hard druses, recommended check-ups for patients are once a year, with visual acuity check, fundus / macular examination on a biomicroscope – a 78D or 90D magnifying glass as well as OCT macula. We advise self-monitoring along the Amsler grid, as well as a healthy lifestyle, quality nutrition, moderate physical activity and control of underlying diseases.

With the appearance of soft and soft confluent druses, controls must be more frequent due to the higher chance of transition to a wet form of degeneration, they are advised every 4-6 months. Visual acuity, fundus / macular examination with a 78 or 90D magnifying glass as well as OCT macula are monitored. In addition to a healthy lifestyle, patients are advised to use supplements containing lutein, zeaxanthin, vitamins E, D, C Zn and omega 3 fatty acids to slow down the process – it is considered 25%. Patients are stressed the importance of more frequent self-monitoring along the Amsler grid.

Self-monitoring along the Amsler lattice is important for detecting metamorphosis

Objective monitoring is possible only with the finding of macular OCT

The wet form usually brings the patient to the doctor very quickly due to sudden problems in the form of decreased visual acuity, central scotoma and metamorphosis. This is very important because timely diagnosis and therapy provide an opportunity for a better outcome of treatment, ie to achieve better visual acuity. The therapy of the wet form of macular degeneration consists in giving antibodies to the growth factor of pathological blood vessels – Vascular Endothel Growth Factor – anti VEGF Th. The drug is applied to the eye only in the form of injections into the vitreous, usually in multiple doses. Available drugs in our country are: Avastin, Lucentis and Eylea. The application of the drug is performed in strictly sterile conditions in the operating room, by an ophthalmologist – retinologist. The intervention is completely painless. After the application, the next control and re-application is scheduled for a month. Visual acuity is monitored, the condition of the macula is examined on a biomicroscope with a magnifying glass of 78 or 90D, with OCT of the macula, fluorescein angiography is rarely necessary.

Intravitreal therapy-anti VEGF