The clinical forms

The age-related macular degeneration is manifested in two different forms: · Dry AMD: is identifiable by the presence of particular yellow deposits (drusen) in the center of the retina. They generate a slow atrophy of the affected tissue which is associated with a moderate reduction of vision. This clinical form may progress into more severe neovascular form. · Exudative AMD or wet: is the most debilitating disease, though less common, and is characterized by an abnormal growth and proliferation of new blood vessels (neovascularization) inside and under the retina. These newly formed vessels induce progressive retinal macular lesion area and a dramatic and often irreversible deterioration of visual function.

The alarm AMD

The age-related macular degeneration affects global least 25-30 million people. In industrialized countries, 25% of people over seventy years of age is affected by the disease and provide the most reliable estimates, as a result of the aging population, a number of cases three times the current in the next 25 years. The ubiquity of the phenomenon is dramatically exacerbated by the effects of debilitating disease. The neovascular form of the disease makes it legally blind in a relatively short time, from two months to three years, the majority of those affected. One third of accusing a visual disability as to be incapable of reading a text or recognize a familiar face, with a social and psychological distress often amplified by the concomitant release from the world of production for reaching the limits of age. In the absence of timely diagnosis and treatment many of these people, mainly elderly, will reach a terminal stage of disease, stage where the only remaining remedy is to contact a rehabilitation center or visual assistance for the blind.

The treatment

The initial phase of the disease (non-exudative or dry AMD) can be countered only with oral intake of substances that meet the nutritional deficiencies that promote neovascular processes of the eye (Supplements with Omega 3, Lutein, Zeaxanthin, etc). The most severe form Wet neovascular or exudative is treated mainly with intravitreal injections. The Eye injections are Anti-VEGF medicines – ranibizumab (Lucentis) and aflibercept (Eylea). They stop vision getting worse in 9 out of 10 people and improves vision in 3 out of 10 people u sually given every 1 or 2 months for as long as necessary: drops numb the eyes before treatment – most people have minimal discomfort. Side effects include bleeding in the eye, feeling like there's something in the eye, and eyes being red and irritated. Other techniques, older but still used in specifics cases are: photodynamic therapy and the photo-laser coagulation, or photodynamic therapy ( PDT Photodynamic Therapy) provides for the intravenous administration, by an ophthalmologist expert, of a photosensitive substance can accumulate selectively in the cells of abnormal blood vessels. The eye of the patient is then illuminated by a light source that activates the non-thermal photosensitive substance, with production of oxygen free radicals and consequent destruction of blood vessels targeted. The extreme selectivity of photodynamic therapy, performed in outpatient centers reported only allows you to hit the neovascularization cause the disease, leaving intact the surrounding healthy tissue responsible for the correct view. Stopping the course of the disease, the primary objective of PDT is sometimes associated with visual recovery. The photo-thermal laser coagulation is the treatment of the area affected by the destructive neovascularization in order to stop its progression. Portions of the surrounding healthy retinal tissue undergo similar irreversible destruction that unfortunately permits the application of this practice only in areas of limited size and neovascolarizzate peripheral (10-20% of cases).