Age-related macular degeneration of the retina, treatment. Macular degeneration of the retina treatment Age-related macular degeneration of the retina treatment

Macular degeneration is considered an eye disease that affects the central part of the retina called the macula. In another way, the macula is called the yellow spot. It is located in the part where the light is focused after the refraction of the rays. It is in this place that the cells that transmit nerve impulses to the brain are located. Thanks to such cells, a person can read, write and clearly recognize objects. Most often, age-related macular degeneration occurs, which occurs against the background of malnutrition of cells and, accordingly, wear of the visual organs.

The dry form is most common, as it is a provocateur of the wet form. It occurs initially on one visual organ, but eventually passes to another. The main symptom can be considered difficulty in working with small details and the inability to read without bright lighting. The patient slowly loses central vision, which is inherent in many ophthalmic pathologies. Many people, especially in old age, do not attach any importance to this. Therefore, it is important to periodically visit an ophthalmologist in order to timely identify a particular visual impairment.

The wet form of macular degeneration of the eye develops against the background of the dry form. Patients notice dark spots and a veil before their eyes. Straight lines look wavy, visual acuity is lost quickly. The wet form is characterized by the growth of new blood vessels, which are very fragile and brittle. This leads to hemorrhages because they burst. When examining the affected eye, yellow accumulations can be seen in the retina. Over time, it becomes difficult for the patient to distinguish small elements of images.

Causes of macular degeneration

In fact, the disease is multifactorial, since so far no direct causes have been identified. Factors include the following:

Age-related macular degeneration occurs against the background of age-related changes. The disease develops from the age of 50.
Female. For unknown reasons, it is women who are most susceptible to developing macular degeneration of the retina.
The hereditary factor plays an important role, since the pathology is transmitted at the genetic level.
Abuse of ultraviolet radiation. This is a frequent visit to the solarium and a long stay in the open sun without sunglasses. But everyone knows that ultraviolet radiation has a negative effect on the retina.
Tobacco smoking, alcohol abuse, drug use.
Diseases of the heart and blood vessels. For example, strokes, atherosclerosis, changes in blood pressure, myocardial infarction, and so on.
Obesity and malnutrition, beriberi.
Diseases of the visual apparatus and consequences after surgery on the eyes.

Symptoms of macular degeneration

Dark spots before the eyes and a veil.
Lack of image clarity.
Inability to see small details.
Difficulty reading without bright light.
Image distortion.
Decreased visual acuity.
Deterioration of color perception.

Rules for the diagnosis of macular degeneration

Diagnosis of macular degeneration of the retina is carried out by several methods:

An anamnesis is being collected. That is, the doctor asks the patient about the symptoms that appear, etc.
Diagnostics is carried out according to the Amsler test. It is a rectangle (square) consisting of crossed straight lines. There is a black dot in the center. The examination is performed first on one organ, then on the other, in turn. Usually, a patient with macular degeneration has distortions of straight lines. Dark spots may also be observed.
Fluorescein angiography examines the eyeball. Cameras and contrast agents are used.
Visiometry determines visual acuity.
Ophthalmoscopy examines the condition of the blood vessels and retina.
Bioophthalmoscopy is characterized by examination of the fundus.
Optical coherence tomography allows you to examine the structure of the retina for degeneration.

How to treat dry macular degeneration

Treatment of macular degeneration of the retina of the dry form is carried out only in a complex manner. Methods and preparations are selected on an individual level. The main treatment measures include the following:

The use of antioxidant drugs and medicines based on zinc. These funds will slow down the progression of pathology.
Preparations containing a complex of vitamins C, E, A.
Medications based on lutein, copper, zeaxanthin.

How to treat wet macular degeneration

Since the wet form of macular degeneration progresses rapidly due to the growth of blood vessels, it is necessary to use therapy that suppresses the formation of thin capillaries. Therapeutic measures:

First of all, it is a medical antioxidant therapy, similar to the treatment for dry form. Also used drugs: "Lucentis", "Avastin", "Makugen" and so on.
Photodynamic therapy is based on light exposure. The patient is injected intravenously with the drug "Visudin", which is distributed throughout the body. The substance fills the pathological blood vessels. At this moment, the doctor produces a light irradiation in the area of the retina. This takes a maximum of one and a half minutes. A light beam is needed to activate the injected drug, which destroys thin vessels. This method allows you to stop the decrease in visual acuity and destructive processes. After the procedure, it is strictly forbidden to expose your eyes to direct sunlight. It is necessary to avoid bright light in the apartment. These warnings are designed for a period of 5 days. Then the person can lead a normal life.
Laser therapy is characterized by the removal of diseased blood vessels. The destruction of capillaries is carried out by directing a laser beam at them.

Preventive measures

Every person who has reached the age of 50 is prone to developing macular degeneration of the eye, so it is very important to prevent the possibility of the disease in a timely manner. In addition, there is a risk of relapse in those patients who once got rid of this pathology. Therefore, experts recommend following simple rules:

Reading, writing and watching TV is possible only in normal lighting conditions. Twilight is categorically excluded. Remember, the eyes should be comfortable.
It is undesirable to overstrain your eyesight. Therefore, even if there is a need to sit at the computer all day, be sure to give your eyes a rest once an hour.
It is useful to engage in special eye gymnastics.
Don't go out in the sun without sunglasses. This provokes the development of macular degeneration of the retina.
Stick to the rules of proper nutrition. Avoid excessively fatty foods, stop smoking. Eat more fresh berries, vegetables, fruits.

ethnoscience

IMPORTANT! One woman claimed to have cured macular degeneration of the eye with folk remedies. Therefore, the question arises, is it possible to treat macular degeneration of the retina with folk remedies? Any sane ophthalmologist will answer in the negative. Because traditional medicine cannot fully cure any disease. However, non-traditional methods can be used in combination with drug therapy. Natural products have many useful substances that have a beneficial effect on the visual organs. In addition, they can enhance the effect of drugs. So use recipes as an aid!

Traditional medicine recipes:

Be sure to eat germinated grains. Legumes are also helpful. To cook wheat, you need to take the grains, rinse them, put them in gauze and pour water over them. They will sprout in a few days. Then you need to rinse them again and pass through a fine sieve of a meat grinder. The resulting mixture should be consumed within 3-4 days. In the morning you need to take 12-14 tbsp. tablespoons of the mixture, pour water and let it swell. Consume throughout the day.
A mixture of aloe and mummy will help restore visual acuity. For 20 grams of aloe juice, you need to take 100 grams of mummy. The resulting mixture is recommended to instill in the eyes and take it inside. Be sure to warm it up a bit first! It is permissible to drip eyes twice a day, 1 drop. Inside: 20 grams of the mixture twice a day.

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 that occur in patients of the older age group indicate the onset 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 in the 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.
Prolonged exposure to sunlight on unprotected eyes.
Overweight. Scientific studies point to a link between obesity and the progression of AMD.
Improper nutrition, as a result of which the patient's body does not receive the nutrients necessary for the proper functioning of the visual apparatus (in particular, carotenoids).
Race. In whites, age-related changes in vision are more common than in 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. The last stage of 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 type of 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. It is this process, also called neoangiogenesis, that distinguishes the wet form. As a result, the body tries to mistakenly compensate for the insufficient nutrition of the retina by sending an additional volume 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.
It is possible to save peripheral vision 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 thanks to modern eye examinations. 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 for timely and high-quality diagnosis 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 those patients who have already been diagnosed with age-related macular degeneration of the retina, a good method for diagnosing the progression of the disease is the test using the Amsler grid (grid). 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 a wet form is achieved by drug therapy, which includes taking:

Antioxidants.
Vitamin and mineral complexes.
Taurine.
Lutein / beto-carotene / vitamin A / zeaxanthin (one of the drugs or their complex is prescribed depending on the clinical picture of the course of the disease) in the amount of 10 mg / 15 mg / 28000 IU / 2 mg.
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 the intake of 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 the wet form of AMD was laser coagulation - the destruction (destruction) of newly formed vessels using a laser. However, this method did not eliminate the cause of the formation of new vessels. In addition, healthy tissue can also be damaged by this procedure.

A less aggressive option for wet form laser therapy is photodynamic therapy using Vizudin. 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 a 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 have not yet begun.

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 impairment, hemorrhage.

Of the surgical methods for the treatment of AMD, the following types of operations should be noted:

pigment epithelium transplantation;
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

It is permissible to use this or that folk method of treatment only after consulting with your doctor. Unfortunately, traditional medicine cannot cure AMD, but it 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 currant berries, blueberries, chokeberries and honey to the decoction.
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) must be chopped. 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 currants;
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;
control of blood pressure;
wearing sunglasses (especially for patients with light eyes);
giving up bad habits (smoking);
taking vitamin complexes;
playing sports; but from professional 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 of the retina - a disease more commonly known as AMD(Age-related macular degeneration). It affects the central, one of the most important areas of the retina - the macula, which is essential in visual perception.

The reason for the decline in quality is called macula degeneration - one of the important areas of the retina of the eyeball. The retina is the layer of the eyeball responsible for the quality and "focus" of central vision, which is used when driving or reading. The disease is characterized by a rapid process of loss of central light perception. Today, this issue is most acute, as the percentage of the population at risk is growing every day. The level of complexity of the disorder is primarily due to the form of macular degeneration.

Macular degeneration is the main cause of the irreversible process of vision loss, the category of people who have reached the age of fifty years is considered a risk group.

Macular degeneration of the retina
degeneration or degeneration of the visual spot

The constant exchange of nutrients in the retina contributes to the emergence of free radicals, which subsequently provoke an increase in destructive processes due to a malfunction of the antioxidant system. At the same time, drusen (a polymeric structure that cannot be split) is formed in the retina of the eyeball.

The formation of drusen leads to atrophy of the layers bordering the retina, vessels begin to form in the epithelium of the retina. Following this, the processes of scar formation begin, which are accompanied by the loss of receptors responsible for the transmission of light.

Specialists in this field distinguish two forms of the course of the disease - dry and wet macular degeneration.

Dry form of retinal macular degeneration diagnosed much more frequently. The disease is characterized by the appearance of yellow spots in the pupil. The progress of the disease causes patients to lose the ability to distinguish small details, and a process of loss of focus occurs. The disease progresses slowly, but after a long period of time, geographic atrophy may develop, and in the future complete blindness.

Despite the enormous advances in medicine over the past few decades, there are still no radical measures to influence the disease. Scientists have proven that the use of certain vitamins can slow down the progress of the disease, expressed in the dry form. From these same studies, we can conclude that the use of special food additives can reduce the risk of developing macular degeneration by twenty-five percent. Treatment of dry macular degeneration of the retina is a grueling procedure, the result of which is impossible to predict. Ophthalmologists advise patients diagnosed with the dry form of the disease to wear tinted glasses that protect their eyes from the harmful rays of the sun.

Both forms are characterized by a low-contrast image, a veil before the eyes and a violation of color perception.

Wet form of macular degeneration of the retina- received a much lower prevalence among the population. The disease has a rapid development and entails a significant loss of vision. During the wet form of macular degeneration of the retina, vascular growth originates. Neoplasms are inferior, due to the thinning of their structure. The blood circulating through them is passed into the gap under the retina, which causes a violation of the cells of the retina. As a result, blind spots appear in the area of central vision.

The unhealthy course of vascular neoplasm is explained by an incorrect attempt by the body to create another circulatory network, in order to obtain a full amount of oxygen and nutrients by the retina of the eyeball.

Symptoms

The development of the disease causes a slow and painless, but, unfortunately, irreversible loss of vision. There are cases when the disease has a transient character. In the initial stage, the symptoms of macular degeneration of the retina are as follows:

distortion of perception;
significant deterioration in the quality of vision in the dark;
loss of clarity of the "picture";
the appearance of various spots before the eyes;
loss of color perception.

A special technique is used to establish the diagnosis and identify the disease. The Amsler grid contains intersecting straight lines, in the center of the plexus, of which there is a black dot. People with symptoms of macular degeneration of the retina of the eyeball perceive some of these lines as blurry, and when they try to focus their vision, spots of dark shades appear.

A competent specialist is able to diagnose the disease at the stage of development, before the onset of catastrophic changes, and prescribe the appropriate treatment for macular degeneration of the retina.

Causes and risk factors for the development of macular degeneration of the retina

Scientists have struggled for many years over the causes of macular degeneration of the retina of the eyeball. Despite the fact that many factors contributing to the manifestation of the disease have not yet been identified, the following points can be summarized in ninety percent of cases.

Macular degeneration usually affects both eyes, but it doesn't happen at the same time.

Age. One of the main reasons for the development of the disease. In the middle age group, this disease occurs in only two percent of cases. In the age range from sixty-five to seventy-five, twenty percent of those who applied for the help of an ophthalmologist. At a later age, signs of macular degeneration manifest themselves in every third person. In addition, there is the fact of genetic transmission of the disease. The most significant risk factors are:

bad habits - this factor is confirmed by all medical studies;
race - the disease is very common among representatives of the Caucasian race;
diseases of the cardiovascular system;
malnutrition and excess weight;
exposure to ultraviolet rays;
light color of the iris.

Diagnostics

Diagnosis of the disease is based on the collection of anamnesis data, complaints from the patient, information obtained as a result of examination of the eyeball. One of the best methods for detecting the disease is FAGD (Fluorescent angiography of the fundus). When checking vision using this technique, special substances are used that are injected into the eyeball, and then a series of photographs of the fundus is taken. These images can also be used as initial data to monitor the processes occurring in patients with a diagnosis of dry macular degeneration of the retina. Optical tomography is also used to assess the state of the reticular region and changes in the macula, thanks to which it is possible to detect changes that have affected the structure of the eyeball at an early stage of the disease.

With the help of an ophthalmoscope, you can "see" a reliable picture of pathological changes in the organs of vision.

Treatment of dry and wet forms of macular degeneration

Today, the treatment of age-related macular degeneration of the retina is a rather complicated and ambiguous procedure. In the treatment of the dry form of the disease, in order to restore and stabilize the process of exchange of useful elements in the retina, it is necessary to undergo a course of therapy with antioxidants.
People over the age of fifty who fall into the risk group should be aware that the prevention and treatment of this disease cannot take the form of a course. It is necessary to undergo treatment constantly.

Treatment of wet macular degeneration of the retina implies a focus on suppressing the abnormal growth of the vascular system. The ophthalmologist carries out the selection of special medications that allow you to stop the growth of blood vessels and thereby increase the quality of vision.

In contact with

Macular degeneration of the eye is an age-related disease. it pathology of the central region of the retina.

It is characterized decrease in normal blood flow and, consequently, a lack of nutrients in the organ of vision.

However the reasons, along which there is a violation in the blood vessels, that is, a decrease in the lumen in them, can be not only age.

Manifestation of macular degeneration of the retina

The manifestation of macular degeneration of the retina depends on its form. Two types of the disease have been identified, wet (exudative) and dry (non-exudative) the form. Symptoms of dry dystrophy at an early stage are not observed, it can be revealed only when examined by an ophthalmologist.

Photo 1. The fundus of the eye with a dry form of macular degeneration. There are whitish spots in the center of the retina.

With diseases of the organs of vision decrease in the number of cells that react to light, they die. The number of adipose tissues increases, the vessels change and may rupture. As a result of this, a person vision is severely reduced.

Second or intermediate stage It is manifested by a decrease in vision and the appearance of a fuzzy spot in front of the eyes. Such a darkening, up to black, already speaks of a pronounced stage of the disease.

Without taking any measures, a wet form begins to develop, which always occurs against a dry background. Its main early symptom is curvature of straight lines when reading.

Important! The non-exudative form occurs in 10% of patients with diagnosed macular degeneration of the retina. When it comes vision is rapidly lost.

Diagnosis of the disease

The ophthalmologist checks the visual acuity during the examination, examines the retina. If during the procedures signs of macular degeneration of the retina of the eye are revealed, then additional diagnostics are carried out.

The central field of view can be checked with Amsler test. To do this, you need to look with each eye in turn at a picture remote at a distance 35 cm Before this, be sure to put on glasses if the patient uses them. The picture shows a grid like a sheet of a notebook in a cage. With macular degeneration of the retina, the image may blur, the lines are distorted, blurry and dark spots appear.

Photo 2. The process of passing the Amsler test. A sheet with a grid applied to it and a black dot in the center is used.

Perimetry- checking each eye on a special ophthalmological apparatus. Its essence lies in the fact that the patient follows the flashing light and, when it appears in the field of view, presses the button. In this case, it is necessary to fix your eyes on the white dot in the center of the device, around which the lights will appear. The method allows you to determine the location of retinal areas that have lost their function.
Fluorescent angiography. This technique allows you to identify changes in the vessels and capillaries, assess their condition. A special substance is injected into the circulatory system through an injection into the vein of the elbow. Within seconds, the fluorescein fills the ophthalmic artery. When irradiated by the device, the substance glows, and the doctor observes the distribution of contrast in the capillaries of the eye in photographs or by video filming.

Reference. This method has age restrictions.

Another diagnostic method is to generate graphic images based on measuring the period of reflection of light from the retina. It is called optical coherence tomography.

Photo 3. The patient is examined by optical coherence tomography using the CIRRUS HD-OCT machine.

Holding takes about 3 minutes, the procedure is simple and painless: you need to focus on a point in front of a special camera and look without blinking. This method allows you to identify retinal defects, degenerative processes, detect macular holes and edema, the effectiveness of the prescribed treatment (if any).

There is also such a way to assess the state of the retina, as magnetic resonance imaging. The result of MRI allows you to trace the structure of the optic nerve, muscles, to see the pathology of blood vessels and soft tissues of the eye. The disadvantage of the method is that it is not always possible to see a clear picture of the state of the walls of the orbit, as well as the fact that it belongs to expensive procedures.

Treatment of macular degeneration

All methods of treatment of this disease are directed to stop or slow down the growth of the vascular network behind the macula. This is a conservative, surgical, and experimental type of treatment. There are also folk ways to improve the quality of vision in macular retinal degeneration, all types are accompanied by a certain diet, compiled according to the doctor's recommendations.

conservative

Therapy for a disease of a non-exudative form includes immunomodulators, antioxidants, vitamins and other drugs whose action is aimed at improving nutrition and stimulating photoreceptors.

Such treatment takes place at the initial stage of macular degeneration of the retina, but in most cases it is not one hundred percent effective. Conservative treatment allows slow down the development of the disease.

For therapy are prescribed:

zinc preparations;
products containing lutein and zeaxanthin;
vasodilator drugs;
blood thinners;
decongestants.

Based on the results of the examination, the doctor prescribes treatment with injections. A drug that stops the pathological growth of blood vessels is injected directly into the vitreous body of the eye, for example, Lucentis, Macugen, Avastin. After injections, the affected vessel thickens and stops the degeneration of the macula of the eye. Before the procedure, the eyes must be anesthetized.

Intraocular injections are carried out with the aim of treating the wet form of the disease. Thanks to the procedures, the loss of vision slows down, in most cases it stabilizes.

Argon laser photocoagulation

This method is based on the destruction of blood capillaries by the energy of a beam of light. The laser beam simultaneously with the destruction of blood vessels clogs them, preventing bleeding. But this method does not guarantee a complete cure, since it does not affect the cause of the disease, the risk of re-vascularization remains high.

Treatment with laser coagulation of the retina is effective in cases where newly formed vessels have formed some distance from the center of the macula of the eye.

Capillaries located in the macular area of the retina cannot be removed using this method. For greater efficiency, this procedure is carried out in conjunction with the introduction into the eyeball anti-VEGF drugs. That is, those drugs that block the vascular endothelial growth factor.

Attention! During the procedure it is possible damage to the membranes of the fundus.

Photodynamic therapy

This method is an effect on the retina of the eye. cold laser beams after the introduction of a photosensitive substance into the blood. It accumulates only in the affected vessels of the macula of the eye. In abnormal places, under the influence of a laser beam, blood clots form, the vessels gradually stick together, due to which they are excluded from the blood supply system.

Like the laser method, such therapy can slow down, but not prevent vision loss and does not affect the cause of the disease. The results of this treatment are usually are temporary and need to be repeated if necessary.

Reference. The effectiveness of treatment is directly related from the localization and structure of the affected vessels.

Regenerative method

This therapy is one of the most progressive and has a high percentage of favorable outcomes.

It allows you to maintain vision even with macular degeneration of the retina and optic nerve atrophy.

Its essence lies in transplantation of a stem cell transplant person in areas of the eye with pathological changes.

The procedure takes around 10 o'clock. With the help of this method, enhanced tissue regeneration and restoration of their functionality occurs.

Surgical methods

There are several other ways to treat the disease, they are belong to surgical experimental:

submacular surgery. The bottom line is the introduction of a tissue plasminogen activator under the retina, which liquefies clots for an hour, and then is excreted.
Macular translocation. The method consists in moving the macular zone of the retina with a pathologically altered area of the choroid to a healthy one with intact pigment epithelium. For this, an artificial retinal detachment is called.

Important! When using this technique, there is a high probability of complications, such as retinal disinsertion. Gradually, many ophthalmologists are abandoning this method.

transpupillary thermotherapy. Laser radiation is used, the procedure is carried out in two stages. The first stage is aimed at exposure to radiation with a focal spot diameter of more than 1 mm. At the second stage, they begin to use a smaller diameter in those parts of the tissues that have restored their original color after the previous irradiation.
Pneumatic displacement of submacular hemorrhage. In this method, the vitreous cavity is injected C3F8 gas. The procedure is carried out with anesthesia. The patient must keep the head position at a certain angle for several days to move the subretinal hemorrhage.

Folk remedies

Stop the progression of macular degeneration of the retina at an early stage capable of not only medicines, quite effective are folk remedies.

Diet

First of all, you need to revise your diet in such a way that so that the body receives products that contain:

lutein;
carotene;
bioflavonoids;
anthocyanosides;
minerals.

All these components belong to antioxidants- necessary substances to slow down the aging of the body. They prevent the development of age-related macular degeneration. Contained in green vegetables: cabbage, herbs, spinach. Many useful trace elements are found in blueberries, nettle leaves, cereals.

Reference. It has been proven that with the help of fruits (for example, eating a couple of apples a day) can reduce the risk of developing age-related macular degeneration of the retina.

Recipes for eye treatment

There are also many prescriptions for the treatment of macular degeneration of the retina.

A decoction of needles

Pine or spruce needles are crushed. Thereafter 1 glass component is poured in a saucepan with a liter of boiling water and boiled for 5 minutes. The remedy is infused one night. After that, it is filtered and consumed in small portions. several times a day. You can store the decoction for about 5-7 days, no more.

Whole grain oatmeal

One of the most effective decoctions used in treatment is oatmeal. It is taken orally daily in a warm state. It is prepared as follows: whole grains are washed in an amount 500 gr, then soaked in plain water for 3-4 hours.

Photo 4. Infusion of oat grains for the treatment of macular degeneration of the retina. The liquid turns cloudy-brown in color.

After this time, the water is drained, the grain is transferred to a pan with a volume of 3 liters, fresh water is added to it for the entire volume. The grain is cooked after boiling the liquid about half an hour. Then the broth is filtered and placed in the refrigerator in a glass dish.

Reception involves at least 1 liter per day. For taste, you can add various berries and honey.

Aloe tincture

This tool is used not only inside, the infusion can also be instilled into the eyes. About half a glass of freshly squeezed aloe juice is taken, purified mummy is dissolved in it ( 5 grams), the infusion is stored in the refrigerator. Before use, it is diluted with distilled or boiled water, approximately 1:10.

The drug is instilled into the eyes 2 times a day and take one teaspoon for 1 0 days. After that do 5 day break. Total Required 2-3 courses.

Treatment with leeches

The essence of the method is to use the saliva of leeches. It contains a large number of useful substances that lower blood pressure, relieve pain and inflammation, and improve blood circulation.

Attention! It is only necessary to do the procedures medical leeches under the supervision of a specialist. The use of ordinary leeches is unacceptable, as they can bring infection.

Leeches specially grown under sterile conditions are used just one time, after the procedure, it is eliminated, this excludes possible infection.

The leech sticks to a biologically active point on the skin. Thanks to a special component of saliva, blood clotting slows down.

This the method helps with problems with blood vessels: thrombosis, heart attacks, etc.

Hirudotherapy used in ophthalmology affects the removal of edema and inflammation of the tissues of the eye, improves blood circulation and, as a result, expands the fields of vision, as well as increases its sharpness.

Treatment prognosis for macular dystrophy

The danger of macular degeneration of the retina is that it refers to chronic and progressive diseases, which at an early stage do not manifest themselves in any way. And, if a person is at risk, then he must visit a doctor. In this group are people over 40, especially women, as practice has shown.

Treatment of macular retinal degeneration exclusively at home using folk methods can help only for a short time and to a small extent. For a complete and effective therapy that would exclude the possibility of relapse, regular maintenance treatment prescribed by a doctor is necessary.

Only in this case can one count positive long-term dynamics, especially if the disease has already crossed the early stage.

Must be determined by a doctor.

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 of the 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 central and color vision is disturbed, 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 a brighter light when reading, writing and painstaking 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 recent years there has been 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".

This is how the patient sees the terminal stage of the process when 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 severity of the problem of AMD in recent years, the use of drugs that inhibit endothelial vascular growth factor (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. The maximum effect is usually observed after the first Avastin injections.

With the beginning of the use of 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 anti-VEGF antibody obtained by genetic engineering (recombinant preparation). 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 clinical trial results, in June 2006 Lucentis was approved in the United States 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 the prevention and treatment of the early stages of age-related macular degeneration, paramount importance is given to maintaining a healthy diet, reducing the consumption of foods with high cholesterol levels and mandatory antioxidant protection of the macula, which includes the intake of carotenoids (lutein and zeaxanthin) - red, yellow or orange pigments found in plant foods. 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 your vision and possibly show the first symptoms of age-related macular degeneration.

Put on glasses or contact lenses (if you normally 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 the central parts of the 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.