Many people in the world suffer from age-related macular degeneration (AMD). Scientists have proven that this disease is directly linked to the geneticdefects.
The symptoms of this disease are different. In particular, the first symptoms can be changes in the Central zone of the retina, which manifest as atrophy of the retina or changes to the layer under the retina.
Macular degeneration seen in persons over 40 years. With age, the percentage of incidence increases. At the age of 60 years the disease is detected in 6.2% of cases. In a later age of AMD is shown with greater frequency. Disability in this disease occurs in 28 percent of cases.
The severity of the disease due to the fact that AMD is a bilateral process. Manifests as one eye and the other. The time period is different from one month to several years. In addition, for a long time, the disease goes unnoticed. As a rule, people turn to doctor when the disease is already in full swing, or when there is the completion of the process, appear atrophic lesions — fibrosis — and then the doctor did little to help the patient.
However, many doctors are struggling withthe disease at earlier stages. It is therefore very important to undergo preventive examinations from ophthalmologists.
Why is developing this disease? Theories are many, in particular, many researchers claim that AMD develops on the background of aging of the retina Central zone, responsible for visual acuity. There was also a theory that the retina is damaged by oxidative processes, in particular, changes of the reaction of lipid peroxidation. Many researchers have proven that the disease are genetic defects. That is why the disease begins to manifest itself in the weakening of the protective properties of the retina with age. This was the theory the pathological changes of blood supply with age. But at the moment, the leading theory is genetic damage to the retina.
AMD what do we know? The first is atrophic form or stage where you are already atrophic processes of change in the retinal tissue.
The second is neekssudativnuyu form when there is a change in the area that separates the retina and choroid. And the third is the exudative stage, the stage height, which is manifested in an immediate change in the structure of the retina. This stage is characterized by the appearance of hemorrhage, fibrosis, retinal edema. As a rule, at this stage, the patients go to the doctor.
Finally, the later stage is a stage of scarring. In this case, the process is completed by the fact that in the region of the retina, in its active part, there is a scar, which does not perceive light, respectively,the patient loses his eyesight.
What causes macular degeneration? Everything is based on oxidative (oxidative) stress. It can lead to infringement of immune responses in the retina. The result is cell death, there are changes, the so-called Druze.
Oxidative stress can be on the background of various factors — sun exposure, genetic defects, etc.
Pathogenetic aspects are most reflective of the essence of the disease, include several factors. First of all, the development factors — hypoxia, thinning of the capillaries. Then, the factors included start to develop the disease. Further background on the connection of the immune system begins to grow new blood vessels, which in norm should not be. Because of these blood vessels and begins to manifest the disease.
How to treat age-related macular degeneration? If we talk about medical treatment, then apply the antioxidants (lutein, zeaxanthin), bilberry drugs, antiplatelet agents, increasing the nutrition of the damaged retina. However, at later stages, this therapy is ineffective and we have to resort to drastic measures of treatment, in particular, to the introduction into the vitreous body of hormonal drugs. This technique has existed for a long time. And she has the right to life. But now these drugs are not practically used. Because I have a lot of side effects, for example, can cause the development of cataracts.
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Now, the most effective is photodynamic therapy. This therapy with the use of drugs and laser. As a result, the doctor seeks to ensure that newly formed vessels in the Central division beginning to zaustaviti and cease to develop. This therapy is quite strong, but she also has many contraindications and negative aspects. Many patients have to resort to surgical methods of treatment. GBU "Ufa research Institute of eye diseases" carried out such operations, we remove new vessels interfering with visual acuity. Also we remove the hemorrhage occurring on the background of this disease. Also, we are using transplantation of pigment epithelium cells and other techniques for improving the properties of retinal cells.
In our Department, in the division of vitreoretinal and laser surgery of the Ufa research Institute of eye diseases is used antimonopolization therapy. At the moment it is the gold standard. It is aimed at the blockade of new blood vessels which are formed in the Central area of the retina and interfere with high visual acuity. In this case, used as intravitreal injection directly into the eye cavity, the blocker of new blood vessels. Causing the vessels zapustevayut, decreases the bleeding, decreases swelling, and we stop the development of disease. However, it happens that the disease is developing so intensively that almost impossible to stop it.
How to protect yourself from this disease? Measuresprevention include the use of preparations containing trace elements, which are responsible for the function of the retina. This vitamins C and E, trace elements selenium and zinc. The important role played by carotenoids and enzymes. They must be contained in the diet. Their deficiency can cause diseases.
Despite the fact that the disease is genetically grounded, it will not occur in the absence of growth factors, start-up and development.