Pathology macular degeneration of the retina - treatment and causes. How to prevent disease from ruining your eyesight? All about the most effective ways to treat macular degeneration of the retina

Date of: 21.10.2019

5199 08/02/2019 6 min.

After the age of fifty, visual acuity in many people begins to decline. Most often this happens due to the development of macular degeneration, in which the central part of the retina is affected due to oxygen starvation.

Macular degeneration can lead to the fact that a person will lose central vision and will no longer be able to read, work with small items and manage vehicle. But this disease cannot lead to complete loss of vision.

Disease Definition

Vision is reduced due to degeneration of the macula, which is one of the main areas of the retina.

Degeneration can be caused by an intensive metabolism in the retina, which provokes the formation of free radicals, but only on condition that the work of the antioxidant system is insufficient. Under the action of oxygen and light, non-cleavable druses (polymers) consisting of lipofuscin are formed. Because of this, the adjacent layers of the retina atrophy, the number of pathological newly formed vessels increases. Then scarring processes begin, as a result of which many retinal photoreceptors are lost.

With macular degeneration, there is a rapid loss of central vision and general performance is lost. The severity of the disease depends on its form.

Dry or non-exudative, atrophic. This is the most common form of the disease. It is diagnosed in eighty-five percent of cases. Vision falls relatively slowly. Sometimes dry macular degeneration can turn into wet. Stages of dry macular degeneration:
- Early. Friends no more than two. There are no symptoms of the disease.
- Intermediate. Druse becomes larger, they increase in size. A dark spot appears in the central zone. Comfortable reading requires additional source lighting.
- Expressed. The retina is destroyed. The dark spot increases and darkens. Almost impossible to read
Wet or exudative, neovascular. It occurs in ten to fifteen percent of cases. Wet macular degeneration progresses rapidly and leads to severe visual impairment. Kinds:
- Hidden. brittle blood vessels little, hemorrhages are almost imperceptible.
- Classic. The blood vessels are enlarged. There is scarring of the tissues of the eye. Decreased visual acuity.

Causes

With age, health problems inevitably begin, and with vision in particular, for example,. The main reason for the development of macular degeneration is age. At the age of seventy-five years and older, every third person has signs of this disease. Among such age-related diseases is also retinal dystrophy (about retinal dystrophy symptoms we will tell in another).

It is worth noting that many have a hereditary predisposition to macular degeneration.

Degenerative changes in the vessels of the retina can also cause macular degeneration, as they lead to oxygen starvation of tissues.

There are a number of risk factors that can weaken natural defense mechanisms and contribute to the development of macular degeneration of the retina. These include:

Race. Most often, macular degeneration occurs in people belonging to the Caucasian race.
Floor. The risk of developing macular degeneration is higher in women than in men.
hereditary predisposition. People whose immediate family members have age-related macular degeneration are more likely to develop this disease.
Gene mutations. A greater likelihood of developing macular degeneration is in the presence of changes in certain genes (the CFH gene, the BF and C2 genes, the LOC gene).
Cardiovascular diseases. It has been proven that in atherosclerosis the risk of developing this disease increases three times, and in the presence of hypertension- seven times.
Smoking. This bad habit increases the risk of developing macular degeneration of the retina.
Direct impact sun rays.
Overweight.
Unbalanced nutrition.
Light rainbow.
Cataract. Surgical removal of a cataract can cause the development of the disease in people who already have changes in the macular zone.

Read about how to treat cataracts.

Symptoms

Macular degeneration slowly but irreversibly leads to loss of vision. It runs painlessly.

On the early stages You can suspect macular degeneration by the following symptoms:

The appearance of dark spots in the central vision.
Loss of image clarity, its distortion.
Impaired color perception.
A sharp deterioration in vision in the dark.

The main symptom of dry macular degeneration is blurred vision. It is caused by the destruction of light-sensitive cells, causing the central vision to become blurry. The fewer cells in the macula normally work, the more problems with vision.

Read about the treatment of macular degeneration of the retina at this.

When there are very few photosensitive cells, a dark spot appears in the middle of the visual field, which increases with time.

The main symptom of wet macular degeneration is the curvature of straight lines. This is due to the fact that the fluid that leaks from the blood vessels collects under the macula and lifts it, distorting the image of objects. In this case, a dark spot may also appear.

The simplest test to determine the presence of macular degeneration is the Amsler test. The Amsler grid consists of intersecting straight lines with a central black dot in the middle. People with this condition may have some blurry or wavy lines and dark spots in their field of vision.

Possible Complications

Macular degeneration does not cause complete loss of vision. Because of it, only central vision can be lost.

This disease adversely affects the quality of life, making it impossible to work, read, watch TV, and so on. Even in domestic plan weakened central vision makes people feel helpless.

Treatment with folk remedies

Folk remedies can be used as an addition to the main treatment of macular degeneration.

Decoctions, teas

Oatmeal decoction. Rinse the whole grain of oats (the volume is a half-liter jar), soak it for four hours. After that, drain the water, pour the grain into a three-liter saucepan, add water and bring to a boil over medium heat. Boil for half an hour. Then strain and put in the refrigerator. Drink the decoction warm (up to five glasses a day). You can add grated blueberries, currants, chokeberries or a little honey.
Infusion of calendula. Pour a glass of boiling water one tablespoon of calendula flowers, leave for fifteen minutes. Cool, strain and drink three times a day for a quarter cup. Simultaneously with the internal reception, you can drip two drops of infusion into the eyes. The course of treatment lasts six months.
Infusion of aloe and mummy. In a hundred milliliters of aloe juice, dissolve fifty grams of mummy. Drink ten milliliters of infusion twice a day and drip one drop into the eyes. The course of treatment lasts ten days.
A decoction of needles, wild rose and onion peel. Grind all ingredients and stir. The proportion of ingredients is 5:2:2. For one unit take a tablespoon. Boil the broth for ten minutes, pour a liter of water. Drink one and a half liters of decoction every day.

Ointments, drops

Cumin drops. One tablespoon of cumin pour a glass of boiling water. Cook over low heat for no more than five minutes. Add a teaspoon of cornflower. Stir and leave for five minutes. Drip twice a day.
Drops from celandine. Pour one teaspoon of finely chopped celandine with one hundred milliliters of water. Hold over the fire for just a few seconds, insist. Strain and put in the refrigerator. Drip three times a day, three drops for one month.
Drops with goat milk. Mix equal amounts of milk and water. Drip one drop into the eyes. Put on a dark blindfold and rest for thirty minutes. Drip during the week.

Compresses

Compresses from lily of the valley and nettle. Pour one third of a glass of nettle and a teaspoon of finely chopped lilies of the valley with a glass of water, add half a teaspoon of soda. Insist nine hours in a dark and dry place. Compress do twice a day.
Leeches. The saliva of leeches contains useful material, which reduce intraocular pressure, reduce pain and improve blood circulation.

Prevention

Since there are no effective ways to treat macular degeneration, close attention should be paid to methods for preventing this disease.

They include:

Rejection bad habits(smoking).
Usage sunglasses and wide-brimmed hats in bright sunlight.
Taking vitamins for the eyes (as recommended by a doctor). For example, a vitamin-mineral complex with lutein and zeaxanthin, vitamins C, E, zinc and selenium. It has been proven that such a composition prevents the development of age-related changes in the retina of the eye, and allows even the elderly to enjoy sharp vision.
Moderate physical activity.
Regular examination by an ophthalmologist.

It has been proven that people who eat a lot of fresh fruits and vegetables every day suffer from macular degeneration much less frequently.

Vegetables and fruits are rich in vitamins, nutrients, trace elements and antioxidants. Many of them contain lutein and zeaxanthin. These substances are very useful for the prevention of macular degeneration. Vitamin C, tocopherol, selenium and zinc are also very useful. They nourish, restore and protect eye tissues.

Video

conclusions

Start taking care of your vision as early as possible. Take preventive action now. And of course, special attention should be paid to the issue of macular degeneration for older people, since they are at risk of developing this disease. Remember that when timely treatment the chance to save vision is much higher.

Read about what is presbyopia and atrophy optic nerve.

retinal dystrophy - This is a disease in which dystrophic changes occur in the macula. Photoreceptors-cones that perceive light are affected, and the person gradually loses central vision. The name of the disease comes from two words: macula - spot - and degeneration (dystrophy)- malnutrition.

The development of retinal dystrophy is associated with atherosclerotic changes in the vessels of the choriocapillary layer. eyeball. Circulatory disorders in the choriocapillaries, which, in fact, are the only source of nutrition for the macular area against the background of age-related changes in the retina, can serve as an impetus for the development of a dystrophic process. The mechanism of development of atherosclerotic changes in the vessels of the eye is the same as in the vessels of the heart, brain and other organs. It is assumed that this violation is associated with genetically determined sclerosis of vessels related to the macula.

Of great importance in the development of retinal dystrophy is the level of macular pigmentation. Macular pigment is the only retinal antioxidant that neutralizes the action of free radicals and limits blue light, which is phototoxic to the retina.

Numerous studies in recent years have revealed the hereditary nature of retinal dystrophy. Children of parents with this disease are at high risk of developing the disease. If you have been diagnosed with this, warn your children and grandchildren. They could inherit the features of the structure of the macula, which increase the risk of the disease.

With age-related macular degeneration, mainly the central and color vision therefore, the first signs of the disease are a decrease in visual acuity, a violation of color perception. As a result, there are difficulties in reading, writing, working at a computer, watching television, driving a car, etc. Peripheral vision in age-related macular degeneration does not change, due to which the patient freely orients himself in space and copes with everyday everyday tasks. The patient needs more bright light in reading, writing and hard work. Very often, people do not notice the deterioration of vision for a long time - after all, with one normal seeing eye, you can read and do small work.

With the further development of the disease, a spot appears in front of the diseased eye, the distortion of letters and lines, vision deteriorates sharply.

The older the person, the higher the risk of developing the disease. However, in last years there is a significant "rejuvenation" of this disease. According to statistics, at the age of about 40 years, 2% of people can get macular degeneration. This figure reaches 30% as soon as a person crosses the age limit of 75 years. Women are more likely to suffer from age-related macular degeneration.

Risk factors for age-related macular degeneration:

age (40 years and older);
gender (women get sick more often than men, in a ratio of 3:1);
genetic predisposition (the presence of the disease in relatives);
white skin color and blue iris;
cardiovascular diseases (arterial hypertension, atherosclerosis of cerebral vessels);
unbalanced diet;
high blood cholesterol;
overweight, obesity;
smoking;
frequent and prolonged stress;
deficiency of vitamins and antioxidants in food;
low content of carotenoids in the macula;
irradiation of the eye with the ultraviolet part of the spectrum of sunlight;
bad ecology.

With age-related macular degeneration, complaints of a noticeable decrease in vision appear, as a rule, only in the later stages of the disease.

There are two forms of age-related macular degeneration: dry and wet.

"Dry" form of AMD with the formation of "hard" and "soft" drusen, it usually proceeds with minor functional and visible impairments. Most patients have a fairly high visual acuity (0.5 and above).

Drusen should be considered as an "ocular" risk factor for the development of neovascularization in AMD.

Formation of the neovascular membrane

"Wet" AMDprogresses much faster than dry AMD, and almost always manifests itself in those people who already suffer from the "dry" form of AMD.

Symptoms wet form AMD:

Decreased visual acuity (decrease in visual acuity may be gradual in patients with a "dry" form and sharp - in the case of "wet").
Difficulty reading, the inability to improve vision with spectacle correction.
Blurred vision, reduced image contrast.
Loss of individual letters or distortion of individual lines when reading.
Distortion of objects (metamorphopsia).
The appearance of a dark spot in front of the eye (scotoma).

More than 90% of cases of blindness from AMD are associated with the development of the so-called "wet" orexudative form diseases. exudative formAMD is characterized by abnormal, pathological growthnewly formed vessels, which, originating from the choriocapillary layer of the choroid, grow through defects in the Bruch's membrane under the retinal pigment epithelium and / or neuroepithelium. Ophthalmologists classify this situation as the formationsubretinal(i.e. located under the retina)neovascular membrane.

Blood plasma begins to seep through the wall of newly formed vessels that are part of the subretinal neovascular membrane, lipid and cholesterol deposits accumulate under the retina. Very often, as a result of rupture of newly formed vessels, hemorrhages occur (usually local, but in rare cases quite significant in volume). These processes lead to malnutrition of the retina, stimulate the development of fibrosis (replacement by connective tissue). The outcome of the exudative form of AMD is the formation of a subretinal scar. Above the area of the scar, the retina undergoes such gross changes that it becomes unable to perform its functions.

Age-related macular degeneration never leads to complete blindness. The patient gradually loses central vision, a dark spot appears in the central part of the visual field (absolute scotoma). The peripheral visual field is preserved because the process affects only the central region of the retina (macula). Visual acuity at the end of the process usually does not exceed 0.1 (one line), the patient sees "sideways", "lateral vision".

How the patient sees terminal stage process at age-related macular degeneration.

If you have a distortion of objects in front of your eye, a spot and you feel a sharp decrease in vision, you should immediately consult a doctor.

TREATMENT

Usual for modern ophthalmology methods of treatment of exudative form of AMD include laser coagulation, photodynamic therapy (PDT), transpupillary thermotherapy (TTT), and removal of the subretinal neovascular membrane through surgery.

Due to the seriousness of the problem of AMD in recent years, the use of drugs that inhibit endothelial vascular factor growth (VEGF), allows you to count on the successful treatment of patients. The names of these drugs are: Avastin, Lucentis, Macugen.

Avastin(Avastin) inhibits the binding of endothelial vascular tissue growth factor to its Flt-1, KDR receptors on the surface of endothelial cells, which leads to a decrease in vascularization and inhibition of membrane growth.

The anatomical effect of Avastin administration includes thinning of the retina in the macula and stabilization of the subretinal neovascular membrane. Fluorescein angiography shows a decrease in fluorescein extravasation.

Injection of the drug into the vitreous cavity almost completely eliminates the risk of systemic side effects due to the microdosage required for point exposure (the dose is 400-500 times less than that used for injection into a vein), and at the same time gives the doctor the opportunity to create the desired concentration of the substance in the desired area. 1.25 mg of Avastin is injected into the vitreous cavity with an interval of three to four weeks. Maximum effect usually observed after the first Avastin injections.

With the start of use this drug there has been a positive shift in the treatment of the exudative form of age-related macular degeneration.

Avastin causes a significant increase in visual acuity in a third or more of patients, and in half of all patients visual acuity stabilizes.

Lucentis® (Lucentis, ranibizumab) is an antigen-binding fragment of a mouse antibody to VEGF obtained by the method genetic engineering (recombinant drug). Being a highly specific part of the antibody to VEGF, the Lucentis drug molecule has a low molecular weight and is able to penetrate through all layers of the retina to the target (blocks the receptors of newly formed vessels that make up the subretinal neovascular membrane).
Based on positive results clinical research In June 2006, Lucentis was approved in the US for the treatment of choroidal neovascularization associated with neovascular (wet) AMD. Then it was approved for use in EU countries. In Russia it is allowed and registered on 06/16/2008. ( registration number LSR-004567/08) for the treatment of neovascular (wet) AMD. Then, by the Decision of the Ministry of Health and Social Development of the Russian Federation of February 28, 2011. No. 31-3-400730 approved the use of the drug for the treatment of diabetic macular edema (DME).
The goal of treatment is to prevent further deterioration of visual acuity. Although many patients experience improved visual acuity, Lucentis cannot repair parts of the retina that have already died as a result of the disease. Also, Lucentis cannot prevent the recurrence of the disease and further deterioration of visual acuity as a result of relapse.

For prevention and treatment early stages age-related macular degeneration, priority is given to compliance healthy eating, reducing the consumption of products with high level cholesterol and mandatory antioxidant protection of the macula, which includes the intake of carotenoids (lutein and zeaxanthin) - red, yellow or orange pigments found in plant and animal tissues, as well as minerals, zinc, selenium, vitamins C, E and anthocyanosides.

Lutein and zeaxanthin are the main pigments in the macula and provide natural optical protection to visual cells. Of the 600 natural carotenoids, only two - lutein and zeaxanthin - have the ability to penetrate into the tissues of the eye. Lutein enters the body with food, and zeaxanthin is formed directly in the retina from lutein.

YOU SHOULD KNOW IT!

Sources of lutein and zeaxanthin are egg yolks, broccoli, beans, peas, cabbage, spinach, lettuce, kiwi, etc. Lutein and zeaxanthin are also found in nettles, seaweeds, and the petals of many yellow flowers.

Given the "rejuvenation" of this disease, special attention should be paid to its prevention, which includes:

a mandatory course of oral intake of lutein, zeaxanthin and anthocyanosides;
quitting smoking and cholesterol-rich foods;
protection from direct exposure to sunlight (sunglasses, headgear, awning, etc.);
use of contact lenses that protect the eyes from ultraviolet radiation;
correction of arterial hypertension;
regular examinations of the retina to detect signs of disease progression (at least once a year);
self-monitoring of visual disturbances using the Amsler grid and, if necessary, contacting an ophthalmologist.

AMSLERA test (test for the definition of macular degeneration)

The easiest and fastest method of checking the central field of vision(the time for its implementation is 10-15 seconds). Do it regularly (even daily) to assess vision and possible appearance early symptoms of age-related macular degeneration.

Put on glasses or contact lenses(if you usually wear them).
Place the net in front of you at a distance of 20-30 cm.
Cover 1 eye.
Focusing on the center point, without taking your eyes off the center point, evaluate the rest of the grid.

Are all grid lines straight and even?
Are all the squares of the grid the same size?
Are there areas where the pattern is distorted, fogged, discolored?

Repeat the test for the other eye.

Evaluation of results:

Normally, when performing the Amsler test, the visible image should be the same in both eyes, the lines should be even, without distortion, spots and curvature, which corresponds to the norm. If changes are found, contact an ophthalmologist, because. this may indicate pathological processes in central departments retina (macular degeneration).

Remember that the Amsler test does not replace the mandatory regular visits to the ophthalmologist for patients over 50 years of age.

Time cannot be stopped, just as the aging of the human body cannot be avoided. With age, many problems begin to arise. Including vision problems.

Let's remember a little the structure of our eye. The macula has a second name - the yellow spot. This is the very center of the retina, where the light beam is focused. It provides central vision, as well as color perception of the visual image. Macular lesions occurring in older patients age group, indicates the beginning of such a pathology as age-related macular degeneration (AMD for short).

With macular degeneration, the diameter of the blood vessels that feed the retina decreases. As a result, its tissues cease to fully receive the necessary substances. Dystrophic changes develop in one or both (left and right) eyes. Often, AMD is the cause of disability and disability.

Of course, when we talk about age-related macular degeneration, we understand that the main cause of this disease is just age-related degenerative changes retina. But in some patients the disease develops, while in others it does not, in some it progresses rapidly, while in others it is extremely slow. Until the end, the reasons for this situation have not been studied, but histology helps to understand the mechanism of development of the pathological process and identify a number of risk factors:

Genetic predisposition and heredity (inheritance occurs as an autosomal dominant, autosomal recessive or X-linked).
Smoking. It significantly increases the risk of developing AMD.
arterial hypertension.
Diabetes.
Nearsightedness or farsightedness.
Long term exposure sunlight on unprotected eyes.
Overweight. Scientific research indicate a link between obesity and the progression of AMD.
Improper nutrition, as a result of which the patient's body receives less nutrients necessary for the proper functioning of the visual apparatus (in particular, carotenoids).
Race. Whites age-related changes vision are more common than African Americans.
Vegetative-vascular dystonia or in short - VVD.
Gender should also be noted - in the fairer sex, this disease is diagnosed more often.
Eye pathologies. For example, chronic blepharitis or endocrine ophthalmopathy (pseudotumor or thyrotoxic form).
Postponed eye injuries.

Age-related macular degeneration is more commonly diagnosed in women and whites.

Classification of macular degeneration

Ophthalmologists classify the pathology according to the forms of the course of AMD:

Dry (other names - non-exudative, atrophic). Develops slowly.
Wet (other names - exudative, neovascular). Develops rapidly.
Cicatricial. Last stage AMD. Develops rapidly.

atrophic form

The dry form of AMD is observed in 85% of cases than other forms of pathology. With age, a person's metabolism changes. As a result, yellowish spots called drusen appear in the macula. These are the foci of atrophy. Druses are divided into hard and soft. Solid - small and clearly defined; soft - large, with blurry edges, can merge with each other. The patient loses visual acuity gradually. This is one of the differences between this form of pathology and others. Cases have been registered when the dry form gradually passed into the last - the cicatricial stage.

Dry AMD is also called non-exudative or atrophic AMD.

Neovascular form

Ophthalmologists diagnose this species pathology in only 10-15% of cases. The wet form of AMD is the result of the progression of the atrophic form. The disease develops rapidly. In most cases, central vision is almost completely lost. As the drusen increase in size and thicken (due to the dry form), the process of formation of new vessels develops on the retina. Exactly this process, also referred to as neoangiogenesis, is a feature of the wet form. As a result, the body tries to mistakenly compensate for the insufficient nutrition of the retina by sending an additional amount of oxygen and substances necessary for the functioning.

With the progression of the pathology, blood cells and fluid accumulate in the area under the retina penetrate the walls of new vessels. Edema develops, hemorrhages appear. As a result, the cells of the retina, especially sensitive to light, are constantly damaged and die. This is how blind spots form in central vision.

Classified into:

Classical, affecting the subretinal neovascular membrane (SNM).
Hidden, also called occult.
Mixed.

The wet form is also called exudative or neovascular.

Scar form

With the germination of vessels under the pigment epithelium, retinal detachment is possible, followed by detachment of the neuroepithelium and the formation of scar tissue (transition to the scar stage).

This is the final stage of age-related macular degeneration. The loss of vision is irreversible.

Symptoms

Symptoms directly indicate the form of the disease. In most cases, the disease is asymptomatic.

Symptoms:

As a result of the gradual appearance and further increase of drusen, visual impairment occurs. With a dry form - slight and gradual, and with a wet and cicatricial - rapid.
Flies begin to flicker before the eyes (especially characteristic of the dry form).
The pigment layer suffers the most, which is why the perception of shades and brightness of the picture, its contrast decreases.
Hemorrhages arising from edema, which are visible to others, indicate a wet form of the disease.
Fields of vision fall out.
The picture that we see is blurred.
Surrounding objects are distorted, straight lines are bent.

The development of the dry form at first is asymptomatic.

Development of the dry form:

There are no symptoms in the initial stages.
Gradually deteriorating central vision.
Then there is clouding of most of the image.
Over time, the affected area increases and darkens, resulting in the formation of a scotoma.
Peripheral vision remains intact.

The special features of the second and third forms are as follows:

100% loss of vision comes quickly.
Save peripheral vision succeeds in very rare cases.

With the final cicatricial form of AMD, the degree of vision loss reaches 100%.

How is the diagnosis

Despite the possibility of a long asymptomatic course of the disease, age-related macular degeneration can be diagnosed due to modern research eyes. Persons over the age of 50 should have regular eye examinations. This will identify the pathology at an early stage and prevent vision loss.

The dry form can smoothly turn into the most dangerous - the cicatricial form. Therefore, the optometrist should be visited regularly.

With a long process of development of the pathology, patients who come to the ophthalmologist most often complain of the appearance of a “spot” in front of their eyes, resembling fog. Gradually, the defect increases in size.

Diagnostic methods:

collection of anamnesis;
visometry;
ophthalmoscopy (examines the fundus of the eye);
optical coherence retinotomography;
visocontrastometry;
fluorescein angiography;
computer perimetry;
color stereo photography.

These methods allow timely and high-quality diagnostics of the macular area of the retina.

Based on the results of the diagnosis, a course of treatment is prescribed.

Upon detection of AMD in the eye, the doctor should explain to the patient what it is, prescribe a course of treatment and conduct self-diagnosis training (relevant for the dry form of pathology).

Self-diagnosis

For patients already diagnosed with age-related macular degeneration of the retina, good method Diagnosing the progression of the disease is a test using an Amsler grid (lattice). This method allows you to determine even the initial signs of macular edema due to the formation of new vessels on the retina.

The Amsler grid is a 40 x 40 cm square grid with a dot in the middle. When diagnosing, the test distance to the Amlser grating is about 50 cm. One eye must be closed with the palm of your hand, the other should look at the grid.

In the presence of pathology, the patient can see non-existent "holes" or "dark spots", mesh curvature. With this development of events, it is urgent to undergo an examination by an ophthalmologist.

Self-examination on the Amsler lattice can be carried out even every day.

Self-diagnosis allows you to track the development of AMD.

Treatment of AMD of the eye

Dry Form Treatment

The dry form responds better to treatment than the wet form. It has a more favorable course.

Damage in this form of the disease is irreversible. Reducing the risk of transition to the wet form is achieved by drug therapy, which includes the reception:

Antioxidants.
Vitamin and mineral complexes.
Taurine.
Lutein / beto-carotene / vitamin A / zeaxanthin (one of the drugs or their complex is prescribed, depending on clinical picture course of the disease) in the amount of 10mg / 15mg / 28000ME / 2mg.
Anthocyanosides.
Vitamins C and E in the amount of 500 mg and 400 IU, respectively, daily.
Copper and zinc in the amount of 2mg and 80mg, respectively.
Selenium and other trace elements.
Gingko biloba.

You should regularly visit a doctor to monitor the course of the disease.

In the dry form of AMD, treatment is based on taking vitamin complexes.

To improve blood circulation in the retina, patients are recommended to take antiplatelet agents, vasodilators.

It should be noted that conservative medicine, which consists in the appointment of dedystrophic agents, immunomodulators and antioxidants (tablets, injections or drops), is ineffective. Taking these drugs, patients, most often, ignore the need to visit an ophthalmologist for control. In this regard, the risk of the transition of the disease to a more severe stage increases.

Wet Form Treatment

Not so long ago, the only effective treatment for wet AMD was laser coagulation- destruction (destruction) of newly formed vessels with a laser. but this method did not eliminate the cause of the formation of new vessels. In addition, healthy tissue can also be damaged by this procedure.

Less aggressive option laser therapy wet form is photodynamic therapy using the drug "Visudin". It is administered intravenously and the retina is irradiated with a laser. The drug has a tropism only for pathological retinal vessels, is able to accumulate in them and be activated when exposed to laser beam. In bleeding pathological vessels, blood clots are formed, the vessels are “soldered”. With this procedure, the risk of damage to healthy tissues is practically absent.

Vizudin is used to treat wet AMD with photodynamic therapy.

But, VEGF therapy, developed in the early 2000s, is considered to be a more progressive method today. The second name is “Aimed Therapy”. Treatment of AMD of the eye in this case allows not only to stop the progression of the process, but also partially restore the patient's vision. However, this statement is true only in the case when irreversible cicatricial changes.

With VEGF therapy, injections of special preparations that stop the formation of blood vessels are made into the vitreous body of the eye. The drugs used for these injections are Lucentis, Macugen, Avastin and Eylea.

With this type of therapy, the following risks are possible: increased intraocular pressure, retinal detachment, eye infection, temporary visual disturbance, hemorrhage.

From surgical methods For the treatment of AMD, the following types of operations should be noted:

transplantation pigment epithelium;
removal of subretinal neovascular membranes with the formation of folds of the sclera;
removal of subretinal hemorrhages.

Lucentis is used to treat wet AMD with VEGF therapy.

Additional measures

For patients who have lost visual acuity, glasses are prescribed. Plus lenses are for nearsighted people and minus lenses for farsighted people. It is recommended to have an anti-reflective coating that allows you to protect your eyes from such negative effects as glare from a monitor or TV, increased eye strain when reading or doing other work.

Treatment with folk remedies

Use one or the other folk method treatment is permissible only after consultation with the attending physician. Unfortunately, ethnoscience unable to cure AMD, but can improve well-being, prevent the development of the disease and relieve symptoms.

In a half-liter jar, soak the washed oat grain for 4 hours. Drain the water, and pour the oats into a saucepan. Pour 3 liters of water and cook over medium heat after boiling for 30 minutes. The resulting broth is filtered and stored in the refrigerator. Take warmed up to 5 times a day in a glass. It is recommended to add grated currants, blueberries, chokeberry and honey.
1 tablespoon of pharmacy calendula is poured with a glass of boiling water and infused for 15 minutes. Let stand. Then strain and take 3 times a day for ¼ cup. You can still bury your eyes with this infusion, 2 drops in 1 eye. Take up to 6 months. Then take a break.
Everyone knows about the benefits of aloe and mummy. They can also help with AMD. It is necessary to dissolve 50 g of mummy in 100 ml of aloe juice. Insist. There are two options for using this infusion. The first is to drink 10 ml 2 times a day. The second is to use as eye drops: 1k each. in each eye. After 10 days of admission, take a break.
onion peel(2 parts), rose hips (2 parts) and needles (5 parts) need to be crushed. Pour 1 tablespoon of the mixture with 1 liter of water and boil for 2-3 minutes. Take 1.5 liters daily.
A tablespoon of cumin is poured into 250 ml of water. Boil over low heat for 2-3 minutes. Pour 1 tsp. cornflower flowers, mix and set aside for 5 minutes. Use 1-2 drops in each eye 2 times a day.
Grind celandine. 1 tsp pour 100 ml of water. Heat on fire for 10 sec. Let it brew. The infusion is filtered and stored in the refrigerator. Apply 3 drops in each eye 3 times. in a day. Course - 1 month.
Take 1 part goat milk and 1 part boiled water. Use the resulting mixture as drops - 1 to each eye. After instillation, you need to tie a dark bandage or special glasses on your eyes and lie down for 30 minutes. Course - 1 week.
Add 1 tsp to 1/3 cup of chopped nettle. crushed lilies of the valley and pour ½ tsp. soda. Mix. Put in a dark and dry place for 9 hours. Make compresses from the resulting mass.
Treatment with leeches is a separate, but very useful area of traditional medicine.

Traditional medicine can be used as an addition to the main treatment.

It is necessary to consume a sufficient amount of foods rich in carotenoids, fresh vegetables, fruits, greens.

You should also limit the intake of animal fats with food, which provoke atherosclerotic changes in the retina.

Foods rich in carotenoids:

carrot;
pumpkin;
potato;
melon;
spinach;
cabbage;
zucchini;
citrus;
tomatoes;
Bell pepper;
corn;
apricots;
peaches;
persimmon.

Foods with antioxidants:

Red currant;
blueberry;
cranberry.

Prevention of AMD

Measures to prevent senile disease - AMD include:

diet (restriction of animal fats; a sufficient amount of fresh vegetables and fruits);
weight loss;
level control blood pressure;
wearing sunglasses (especially for patients with light eyes);
giving up bad habits (smoking);
taking vitamin complexes;
playing sports; but from professional types sports; for example, triathlon, will have to be abandoned.

And, of course, regular examination by an ophthalmologist is necessary.

Nov 28, 2017 Anastasia Tabalina

Macular degeneration is an eye disease associated with malnutrition of the central region of the retina, a type of retinal dystrophy. This disease mainly affects older people over 60 years of age. Retinal dystrophy usually affects both eyes and causes a significant reduction in vision. There are several varieties of the disease, which proceeds in several stages.

Forms of macular degeneration disease

There are "dry" and "wet" forms of the disease.

Dry macular degeneration

"Dry" macular degeneration is characterized by a slow deterioration in visual acuity. It occurs when the metabolism between the retina and intraocular vessels is disturbed, which leads to the accumulation of waste products of cells, which are deposited in the form of tiny tubercles under the retina.

Wet macular degeneration

“Wet” retina occurs when new vessels grow under the retina, and blood or fluid penetrates through their damaged walls and accumulates under the retina. In the early stages of wet macular degeneration, there are the following symptoms: blurred vision, distortion of objects, decrease in the brightness of colors, loss of letters. With the development of the disease, central vision slowly deteriorates, an opaque or translucent spot appears in the central part of the visual field. In this case, the decrease in visual acuity is sharp - significant deterioration can occur within a few days or weeks.

Treatment of macular degeneration of the retina

Treatment of macular degeneration of the retina is currently successfully treated with injections of drugs that inhibit the growth of new "harmful" vessels. Macular degeneration, being a serious ophthalmic disease, threatens with significant troubles, however, complete loss of vision is not observed even in the most severe cases, since paracentral and peripheral vision is preserved.

Diagnosis of macular degeneration

Macular degeneration is diagnosed by examining the eyes through an ophthalmoscope after instillation of drops that dilate the pupils. Other methods - color perception, fluorescein angiography of the fundus vessels, the Amsler grid test, computerized central perimetry, optical coherence tomography - make it possible to clarify the diagnosis, determine the stage of the disease and select the optimal tactics for treating macular degeneration.

Age-related macular degeneration (AMD) is a progressive retinal disease that affects the macula (the central area of the retina that provides the highest visual acuity and color perception). As a result, in patients with age-related macular degeneration, a steady deterioration in vision and color perception is observed, it becomes difficult for them to distinguish small details of the image, the outlines of objects may be distorted; especially in low light conditions.

Causes and forms of the disease

The causes of the disease have not been fully established. It is known that the combined effect of a number of factors (age over 60 years, aggravated heredity, smoking, the presence of vascular atherosclerosis and hypertension) is important for the development of pathology.

Age-related macular degeneration can occur in two forms: dry (approximately 85-90% of cases of AMD incidence) and wet (in 10-15% of patients). The dry form of AMD is characterized by the formation of drusen in the macula zone - non-cleavable polymeric structures with a high content of lipofuscin pigment. As a result, the nutrition of the retina suffers, and atrophic changes progress in the macular zone, causing a gradual deterioration in central vision.

The wet form of AMD is characterized by the appearance of choroid eyes of pathological blood vessels (neovascularization), with the help of which the body tries to compensate for the deterioration of the trophism of the macula. Newly formed vessels are extremely fragile, therefore, patients experience local hemorrhages, followed by the formation of fibrous (scar) altered tissue in their place. Visual impairment in wet AMD is more pronounced and progresses faster than in dry AMD.

Treatment of macular degeneration

The choice of treatment regimen for age-related macular degeneration depends primarily on the form (wet or dry) and the stage of the disease. Treatment should be complex and be selected individually, taking into account changes in eye tissues diagnosed in a particular patient.

All patients with AMD are shown to use preparations containing natural antioxidants - vitamins A, C and E, lutein and zeaxanthin, copper and zinc, omega-3. The same drugs can be taken to prevent age-related macular degeneration and prevent the progression of pathological changes in the retina in patients older than 50 years, especially if they have the previously mentioned risk factors. In patients with the wet form of age-related macular degeneration, special methods treatment, the purpose of which is to suppress the formation of pathological vessels ( drug treatment, photodynamic therapy, laser coagulation, etc.).

The most effective method for the treatment of wet forms of AMD, recognized by the world's leading experts, today is the use of drugs that selectively suppress the growth of pathological choroidal vessels.

Their use allows not only to avoid rapidly progressive loss of vision in patients with wet AMD and to achieve stabilization of its acuity, but also in some cases leads to an improvement in vision.

The drugs are administered in the form of intravitreal injections (directly into the vitreous cavity), under operating conditions, in compliance with all the rules of asepsis and antisepsis.

Due to the point administration, it is possible to achieve a targeted effect on the pathological vessels of the eye and avoid the occurrence of systemic side effects. The frequency of use and duration of treatment are determined by the attending physician individually.

Turning to the "Moscow Eye Clinic" you get the attentive attitude of recognized Russian specialists, examination with the latest equipment and treatment using the most effective methods, which guarantee high results and allow you to save your eyesight.

Video about AMD

Benefits of treatment at MHC

The modern equipment used in our clinic allows our doctors to conduct an examination in the shortest possible time, painlessly and with comfort for the patient, while it is possible to identify any pathologies of the visual apparatus at the initial stage, when there are no symptoms of diseases.

Clinic doctors have a huge practical experience treatment of eye diseases, including atrophy of the optic nerve. The MGC uses the widest range of medical procedures to preserve vision in patients with optic nerve atrophy. Developed comprehensive program treatment with the use of drug therapy, hardware techniques, hirudotherapy, physiotherapy. Our specialists are ready to provide highly professional assistance to patients with the most severe forms of optic nerve atrophy.

The specialists of our clinic have developed programs for the course treatment of patients with macular degeneration, aimed at maintaining and restoring visual functions lasting 10 and 15 days, including the use of medicinal leeches.