Age Related Macular Degeneration
Age Related Macular Degeneration is a degeneration of the retina and specifically so the central area of the retina which is called the macula, that is why it is called Age Related Macular Degeneration. It is seen in patients who are 50 years or more that is why we should screen our patients for age related macular degeneration after 40 years of age. It is more seen in patients who are already having hypertension or have a family history of age related macular degeneration and more commonly seen in smokers. That’s why smoking should be completely avoided in patients who are at risk of age related macular degeneration. There could be some genetic test that could be done to see patients or also to see which kind of patients would respond to which kind of therapy, even before the patients goes into age related macular degeneration.
Age related macular degeneration is basically of two types; one is the wet type & one is the dry type. So in the wet type, new blood vessels formulations below the retina grow blood vessels below the retina and they start leaking or bleeding under the retina. So if that bleeding happens we need to diagnose with an angiography like that is done for diabetic retinopathy to find out where exactly the leakage is happening from and if it is not a bank in the center we could also offer the patient’s laser treatment so that the number of injections can be reduced.
As said the standard protocol for treatment for patients with age related macular degeneration are injections given within the eyes. There are specific injections that can be given for avoiding the progress of age related macular degeneration and to stop the leakage and stop bleeding from these new blood vessels which are formed under the retina. The injections need to be on regular basis and need to be monitored on regular basis and if that is not done then the patients could still lose vision despite treatment. So close monitoring for new leakages or a fresh leakage in a case of wet age related macular degeneration is important. The other forms of treatment that also could be given depending upon the patient-specific conditions like photodynamic therapy or direct photo qua relation to the new membrane or most common treatment given is the type of injections which could either be Avastin or it could be Anti-VEGF in the form of Ranibizumab or it could be Aflibercept or Eylea which could be given as it has a longer effect. Commonly steroids do not work all that well for age related macular degeneration as they worked for diabetic retinopathy.
So once it is diagnosed a regular eye test and a regular screening are always required for patients with age related macular degeneration. So if treated in time and regularly with good follow-ups we could still save vision for patients who could have age related macular degeneration. The symptoms of age related macular degeneration are going to be the distortion of vision, loss of central vision, darkening in the center or central vision and if anybody has these symptoms then should get themselves screened and if they have it and for monitoring a specific amslers grid could be used to monitor the progression of the disease.
The other type of age related macular degeneration is the dry type of macular degeneration in which there are yellow spots developed in the center of the retina and the retinal cells start getting atrophy right in the center and because of the atrophy, there could be loss of vision. Unfortunately, at this moment there is no direct treatment for that, but preventive treatment can be given for the dry type of age related macular degeneration. Also for both wet and dry age-related macular degeneration there could be special vision enhancers or low vision aids that could be used to aid the patient because the patient is not able to see fine things and reading is difficult, so to avoid or to make them read better there could be digital device be used or special magnifiers that could be used for such situations.