Senile macular degeneration is a type of retinal degeneration in the yellow dot region that occurs over the age of 55. The disease is progressive, chronic and usually begins without symptoms. Regular ophthalmic examination with dilated pupils reveals initial changes in the macula. Furthermore, they can enlarge, fuse (confluent) and lead to atrophy of part of the retinal layers. This form of senile macular degeneration is called the dry form and typically ends in large zones of geographic atrophy (atrophic changes are described as a geographic map). Numerous studies have investigated a drug that would stop or cure the dry form of senile macular degeneration, but so far, unfortunately, without success.

In an attempt to heal the changes in the retinal layers, the body sometimes develops new blood vessels, which by their shape and location are abnormal, and which leak fluid into the surrounding tissue and bleed easily and often. These blood vessels also pull fibrous tissue and cause a dysfunctional scar to form in the retina. This form of macular degeneration is called the wet form. It is treated with anti-VEGF factors that stop the growth of abnormal blood vessels.

Risk factors

The causes of senile macular degeneration are not surprising. If it is present as a familial disease, the risk of it occurring in future generations is higher. Additional environmental factors that influence the manifestation of the gene for the occurrence of the disease are smoking (doubles the risk), high blood pressure, high cholesterol, poor physical activity, poor diet. An additional factor is UV radiation, hence the recommendation to wear glasses with UV protection throughout the year, and not only in summer.

Diagnosis

Senile macular degeneration is usually detected accidentally at a regular ophthalmologic examination with visual acuity and pupil dilation. Usually at the beginning, there are no symptoms regarding vision. When symptoms are present, it means that the stage is more advanced.

A doctor who has seen changes in the direction of senile macular degeneration recommends a CT scan. OCT imaging is a non-invasive, radiation-free method that works on the principle of ultrasound waves and provides three-dimensional data for all retinal layers. It thus gives us the opportunity to visualize retinal changes, to measure them (the size of the retina) and to predict further progression based on their appearance. Also, with the help of OCT imaging, we can measure the effects of treatment in order to create a medication application plan that is individual and appropriate for that patient.

For home, the patient receives an Amsler Grid and instructions for its use, in order to check once a week and if they notice a deterioration of the condition to report in time for a control examination.

Treatment

Anti-VEGF therapy (Eylea, Avastin, and Lucentis) in the form of injections that are given directly into the eye, is a very successful way to treat the wet form of senile macular degeneration. Injections stop the growth of abnormal blood vessels and reduce fluid leakage into surrounding tissues. This reduces retinal swelling and improves vision. The application of injections takes place in a certain rhythm of 4 to 6 weeks depending on the stage of the disease and the type of injection, until the condition stabilizes.

Anti-VEGF treatment, unfortunately, fails to destroy the already grown blood vessels. Hence, it is important to detect the disease as early as possible and start treatment immediately after detection, for best results.

Prevention

Research on different diets promotes the Mediterranean diet as the best way to prevent senile macular degeneration. Regular brushing and maintaining good oral hygiene reduces the risk of cardiovascular disease and senile macular degeneration.

The vitamin complex containing zinc, copper, vitamin C, vitamin E, lutein, zeaxanthin, and vitamin A (beta carotene) inhibits the further progression of the dry form of senile macular degeneration. These vitamin complexes are in the form of tablets or eye capsules and are present in pharmacies in various combinations.

The combination that is right for you should be prescribed by a doctor, who will be informed in advance about your habits. Patients that smoke are not recommended to take vitamin A supplements as this increases the risk of lung cancer. The combination of lutein and zeaxanthin may contribute to worsening prostate problems in men or stress incontinence in women.