Macular degeneration of the eye treatment. Retinal macular degeneration: modern approaches to classification, diagnosis and treatment. Macular degeneration: characteristics of the disease

Retinal dystrophy is a disease in which dystrophic changes in the yellow spot. The cone photoreceptors 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)- nutritional disorder.

The development of retinal dystrophy is associated with atherosclerotic changes in the vessels of the choriocapillaris layer of the eyeball. Impaired blood circulation in the choriocapillaris, which, in fact, are the only source nutrition of the macular area on the background age-related changes in the retina of the eye, can serve as an impetus for the development of the 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 disorder is associated with genetically determined sclerosis of the vessels related to the macula.

The level of macular pigmentation is of great importance in the development of retinal dystrophy. Macular pigment is the only retinal antioxidant that neutralizes the effects 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 suffering from this disease have high risk development of the disease. If you are diagnosed with this, warn your children and grandchildren. They could have inherited structural features of the macula that increase the risk of developing the disease.

With age-related macular degeneration, mainly central and color vision is impaired, so the first signs of the disease are decreased visual acuity and impaired color perception. As a result, difficulties arise when reading, writing, working at a computer, watching television, driving, etc. Peripheral vision does not change with age-related macular degeneration, due to which the patient can freely navigate in space and cope with everyday tasks. The patient needs brighter light when reading, writing and painstaking work. Very often, people do not notice the deterioration of their vision for a long time - after all, with one normally seeing eye you can read and do small work.

At further development disease, a spot appears in front of the affected eye, letters and lines are distorted, vision deteriorates sharply.

The older a person is, 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 may develop 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 (presence of the disease in relatives);
white skin color and blue iris;
cardiovascular diseases (arterial hypertension, cerebral atherosclerosis);
unbalanced diet;
high blood cholesterol levels;
overweight, obesity;
smoking;
frequent and prolonged stress;
deficiency of vitamins and antioxidants in food;
low carotenoid content in the macula;
irradiation of the eye with the ultraviolet part of the spectrum of sunlight;
bad ecology.

With age-related macular degeneration, complaints about a noticeable decrease in vision appear, as a rule, only in late stages diseases.

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 occurs with minor functional and visible impairments. Most patients retain fairly high visual acuity (0.5 or higher).

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

Formation of neovascular membrane

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

Symptoms "wet" form AMD:

Decreased visual acuity (the decrease in visual acuity can be gradual in patients with the “dry” form and sharp in the case of the “wet”).
Difficulty reading, inability to improve vision with glasses correction.
Blurred vision, weakened image contrast.
Dropout of individual letters or bending 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 layer of choriocapillaris of the choroid, grow through defects in the Bruch membrane under pigment epithelium retina and/or neuroepithelium. Ophthalmologists classify this situation as the formationsubretinal(i.e. located under the retina)neovascular membrane.

Blood plasma begins to leak through the wall of the newly formed vessels that make up the subretinal neovascular membrane, and deposits of lipids and cholesterol 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 disruption of retinal nutrition, stimulate the development of fibrosis (replacement connective tissue). The outcome of the exudative form of AMD is the formation of a subretinal scar. Above the scar area, 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; dark spot(absolute scotoma). The peripheral field of vision 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 terminal stage process at age-related macular degeneration.

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

TREATMENT

Common for modern ophthalmology methods of treating exudative form of AMD include laser photocoagulation, photodynamic therapy (PDT), transpupillary thermotherapy (TTT), and removal of 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 successful treatment sick. The names of these drugs: Avastin, Lucentis, Macugen.

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

The anatomical effects of Avastin include thinning of the retina at the macula and stabilization of the subretinal neovascular membrane. Fluorescein angiography shows a decrease in fluorescein extravasation.

Injection of the drug into the cavity vitreous almost completely eliminates the risk of systemic side effects due to the micro-dosage required for targeted treatment (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 at intervals of three to four weeks. Maximum effect, as a rule, is 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 improvement 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 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 are part of the subretinal neovascular membrane).
Based on positive results clinical trials, in June 2006, Lucentis was approved in the United States for the treatment of choroidal neovascularization associated with neovascular (wet) AMD. It was then approved for use in EU countries. Authorized and registered in Russia on June 16, 2008. (registration number LSR-004567/08) for the treatment of neovascular (wet) form of AMD. Then, by the Decision of the Ministry of Health and Social Development of the Russian Federation dated February 28, 2011. No. 31-3-400730 authorizes 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 report improved visual acuity, Lucentis cannot restore parts of the retina that have already been lost as a result of the disease. Lucentis also cannot prevent relapse of the disease and further deterioration of visual acuity as a consequence of relapse.

To prevent and treat the early stages of age-related macular degeneration, adherence to healthy eating, reducing the consumption of foods with high cholesterol levels and mandatory antioxidant protection macula, which includes the intake of carotenoids (lutein and zeaxanthin) - pigments of red, yellow or orange color, found in plant and animal tissues, as well as minerals, zinc, selenium, vitamins C, E and anthocyanosides.

Lutein and zeaxanthin are the main pigments of 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 the eye tissue. 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 include egg yolks, broccoli, beans, peas, cabbage, spinach, lettuce, kiwi, etc. Lutein and zeaxanthin are also found in nettles. seaweed and the petals of many yellow flowers.

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

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

AMSLER test (macular degeneration test)

The simplest and fastest way to test the central field of vision(time to carry it out is 10-15 seconds). Perform it regularly (even daily) to evaluate your vision and the possible appearance of the first 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 your gaze on the central point, without taking your eyes off the central point, evaluate the rest of the grid.

Are all grid lines straight and level?
Are all the lattice squares the same size?
Are there any areas where the drawing is distorted, clouded, or 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 smooth, without distortions, spots and curvatures, which corresponds to the norm. If changes are detected, consult 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 mandatory regular visits to an ophthalmologist for patients over 50 years of age.

Vision is one of the greatest gifts for a person, and losing it is a great tragedy. A person who has never seen feels much better than someone who has seen and then gone blind. Unfortunately, acquired blindness of varying severity is one of the most likely outcomes of certain eye diseases. Therefore, for a disease such as macular degeneration of the retina, treatment is an opportunity to preserve a person’s vision for as long as possible.

Anatomical features of the retina

‒ this is the deepest located structure of the eyeball, a light-sensitive organ containing great amount receptors. Well known cones and rods ‒ nerve cells, capable of perceiving light or color stimuli. A beam of light hitting the retina activates the receptors and they conduct this signal, converted into a nerve impulse, through the optic nerve and subcortical structures to the main brain centers of vision.

If we roughly describe the retina, then it is a yellowish-red circle (this is how doctors see it during ophthalmoscopy). It clearly shows blood vessels, the place of penetration optic nerve, so-called disc, as well as the macular area, slightly off-center. The macula is the area in which the concentration of receptor cells is maximum. This is where light rays are focused and this area is responsible for bright, clear, clear central vision.

What is macular degeneration of the retina?

Macular degeneration, macular degeneration, degeneration of the corpus luteum are all synonyms that describe a condition in which the nutrition of the macular area suffers. Central vision becomes blurred, it is impossible to distinguish small details and people's faces, reading and watching movies becomes inaccessible. Features of the disease are the possibility of hallucinations not related to mental illness and those who are not, as well as preservation of peripheral vision.

The disease is widespread throughout the world and is an age-related pathology, affecting elderly and senile people age period, and the incidence of the disease is directly dependent on age.

Risk factors

Despite the fact that the disease develops in many older people, it is not a necessary companion to old age. There are some factors that increase the likelihood of developing macular regeneration.

Table. List of main risk factors.

Risk factor	Characteristic
	Over 50 years old
	This judgment has a certain evidential basis: the pigment, due to which the eyes become darker, plays the role of a protective mechanism. However, there is no conclusive evidence of this yet.
	In people who smoke, macular dystrophy develops two to three times more often than in those who are not prone to this kind of habitual intoxication. Nicotine and other components tobacco smoke have a significant toxic effect on the retina.
	Persistent hypertension, as well as a large difference between systolic (“upper”) and diastolic (“lower”) blood pressure ( high values pulse pressure) are serious risk factors.
	An increased level of fat in the blood, an imbalance of lipids, as well as excess cholesterol several times increases the likelihood of developing macular degeneration. It is important to understand that saturated fats, trans fats, and omega-6 fatty acids are “harmful,” but monounsaturated fats and omega-3 acids are “healthy” and not only reduce the risk of developing the disease, but are also one of the elements of its treatment .
	Some drugs include mention of macular degeneration as part of their side effects. For example, this is chloroquine, an anti-malaria drug, phenothiazine, an antipsychotic substance, chlorpromazine and some others.
	Presence of macular degeneration in parents or close relatives.
	The presence of a certain genetic anomaly, the presence of certain specific genetic markers.

How does the disease develop?

The pathogenesis of age-related macular degeneration is not known with certainty, although a number of theories have been put forward, including oxidative stress, mitochondrial dysfunction and inflammatory processes.

An imbalance between the production of damaged cellular components and their degradation leads to the accumulation harmful products, for example, intracellular lipofuscin. Incipient atrophy is accompanied by thinning or depigmentation of the macular area. At more serious stages, new ones develop blood vessels(neovascularization), and all factors together lead to the death of photoreceptors and loss of central vision.

There are two variants of the disease - “dry” and “wet” macular degeneration. In the dry (non-exudative) form, cellular pathological inclusions called drusen accumulate between the retina and choroid, causing atrophy and scarring of the retina. In the wet (exudative) form, which is more severe, blood vessels grow from the choroid (neovascularization) behind the retina, which is accompanied by exudation and can also cause hemorrhage.

Stages of disease development

Knowledge of the disease development process is important, since the treatment method will be selected depending on the stage at which the pathology is detected.

The pathology begins with small deposits in the macular area, between the epithelium and the main choroid. In the vast majority of cases, vision does not suffer at all during this period, and it is difficult to detect an incipient pathology, and even more difficult to suspect. This period of time is not even considered the disease itself, but rather some kind of “prodromal period”.

Early stage

It is diagnosed when the formed drusen are of medium size (this is considered the approximate size human hair). There are no symptoms during this period either.

Intermediate stage

During this period, drusen become larger, and any abnormalities in retinal pigmentation also appear. Visual impairment is possible here, but people often attribute them to age-related hypermetropia, insufficient lighting, fatigue and other similar factors.

Late stage

When the retina is significantly damaged, there is symptomatic loss of central vision along with large drusen. It is at this stage that the disease begins to be divided into dry and wet subtypes, and it is now that the main treatment tactics are determined.

Symptoms of the disease

First of all, it should be noted that macular degeneration “does not hurt.” This is very important for differential diagnosis, and the appearance of pain is a symptom of anxiety that requires urgent medical intervention. Among the symptoms of macular degeneration are the following.

At "dry" dystrophy the predominant one is:
1. blurred vision (cells are destroyed slowly, and central vision slowly and steadily becomes less clear);
2. the appearance of a dark spot in the very center of the field of vision;
3. gradually central vision completely disappears.
At "wet" macular degeneration:
1. a feeling that all straight lines are becoming wavy (liquid exudate collecting under the macula raises it slightly, contributing to image distortion);
2. the appearance of a small dark spot;
3. gradual loss of central vision as the dark spot grows.

Other signs of macular degeneration (common to both types):

slow recovery of visual function after exposure to bright light;
a sharp decrease in visual acuity even in the absence of a spot in front of the eyes;
change in color perception;
decreased sensitivity to contrast.

Treatment of retinal macular degeneration

Today, unconditionally effective therapy does not exist. Treatment largely comes down to improving the quality of life of patients; there are both conservative and surgical techniques help. But first of all, all patients, regardless of the form and stage of the disease, are given general recommendations.

Nutrition. If you are overweight, you need to correct it by reducing the amount of calories and fat in your diet. In addition, it is necessary to monitor the amount of cholesterol, trans fats, fast carbohydrates. Suggested to consume more fish(such as salmon) which is high in omega-3 fatty acids. There should be no shortage of fresh vegetables and fruits and herbs. They contain lutein, which has a protective effect on the macula. It is important to control your sugar levels, because... joining diabetes with his retinopathy will significantly worsen the condition.
Active lifestyle. This is useful both for weight loss and for maintaining body tone, improving microcirculation, strengthening cardiovascular vascular system. Intense visual stress should be excluded, but adequate visual strain should be present.
Light restrictions. It is recommended to avoid ultraviolet radiation, use high-quality sunglasses, and visiting a solarium is prohibited.
Control blood pressure . This recommendation must be followed, since one of the target organs when arterial hypertension is precisely the retina of the eye. Vascular disorders in the fundus will aggravate the situation and may cause serious complications, for example, retinal detachment and bleeding (especially important for “wet” macular degeneration).
Quitting smoking and alcoholism.

Specific treatment

Both conservative and surgical treatment should depend on the stage of the disease and its type.

Early macular degeneration

At the stage of early macular degeneration of the retina, treatment is usually not carried out, if only because it is almost impossible to “catch” the disease during this period. But even if the diagnosis was made at the very beginning of the development of the disease, there is no specific treatment method. During this period, it is necessary to adjust risk factors as much as possible, and you can also resort to some conservative therapy:

B vitamins, vitamin A, vitamin E;
microcirculatory protectors;
antioxidants.

It is important to undergo timely examinations with an ophthalmologist, especially for people over the age of 50, so as not to miss the disease at more serious stages.

Transitional and severe macular degeneration

Dry macular degeneration is very difficult to treat. Method applied laser correction, which is based on the removal of overgrown drusen. But at the same time, photoreceptor cells cannot be restored, and therefore vision cannot be restored. Wet dystrophy is slightly more treatable. But this does not mean that you can completely stop the process - it is only possible to slow it down as much as possible in order to delay blindness. The main direction is to stop neoangiogenesis.

Injections of narcotic analgesics into the eyes.
One of the progressive directions is biological therapy - administration of vascular endothelial factor inhibitors. These are substances released during the formation of blood vessels. These inhibitors (for example, bevacizumab, ranibizumab, lapatinib and others) block the growth of new blood vessels, which contributes to a significant inhibition of degradation processes. Inhibitors are administered by injection, usually requiring several injections.
Photodynamic therapy. The drug verteporfin is injected intravenously, and then a laser effect is added, aimed at the abnormal vessels. The laser activates the injected substance, and it begins to destroy the newly formed vessels.
surgical methods . Laser ray high intensity is directed at abnormal blood vessels. This method can be used when there are still few new vessels and they are located in a strictly delimited area.

Application of adaptive devices

Since it is impossible to completely restore vision, but at the same time, absolute blindness does not occur, palliative methods of correcting the condition take place. Macular degeneration does not affect peripheral vision, so patients can learn to use this part of visual functions to a greater extent than ordinary people. Special devices are used to help patients:

magnifying glasses, spectacle lenses;
special screen reading devices that can expand certain sections of text or pictures;
voice guidance for computers (screen reading), voice control.

Thus, Macular degeneration of the retina is a serious disabling disease. It is completely impossible to cure it, and all treatment methods are aimed only at improving people’s living standards. However, many adapt to new conditions, actively use adaptive devices and lead an active lifestyle.

Video - Macular degeneration of the retina

Content

With macular degeneration, the central or peripheral tissues of the retina “die off”, which leads to a progressive decrease in vision. The rate at which it worsens depends on the type of disease. Macular degeneration is considered an age-related pathology, since it occurs more often at the age of 45-50 years. Without treatment, the disease leads to blindness.

Treatment of macular degeneration of the retina

The main sign of macular degeneration is distortion of the grid on a special Amsler test, when the gaze is focused on the central point. Macular degeneration cannot be completely cured. Therefore, therapy for this disease is symptomatic. The goal of treatment is to stop the development degenerative changes retina. Principles of therapy depending on the form of macular degeneration:

In the dry form, normalization of metabolic processes in the retina is necessary. This is achieved through courses of antioxidant therapy.
At wet forms e treatment is aimed at suppressing the growth of abnormal blood vessels.

Please note that age-related macular degeneration can recur even if treatment has been successful. Therefore, the patient should be constantly monitored by an ophthalmologist.

The main methods of treating macular degeneration:

Conservative. This includes taking medications, physiotherapy courses, folk remedies and some minimally invasive procedures.
Surgical. Surgery is suggested depending on the clinical picture diseases.

Drug treatment

For macular degeneration, medications are used in the form of tablets, eye drops, intraocular injections that are given directly into the vitreous body. Pharmacological groups medications used:

Group of drugs	Mechanism of action	Names of drugs	Price, rubles
Antiplatelet agents	Prevents the formation of blood clots in blood vessels.	Acetylsalicylic acid
Antiplatelet agents	Prevents the formation of blood clots in blood vessels.	Clopidogrel
Angioprotectors and vasodilators	Helps strengthen and dilate blood vessels.	Papaverine

		Askorutin
Hypolipidemic	Helps lower cholesterol levels.	Simvastatin
		Methionine
		Atorvastatin
Polypeptides	Improve vascular permeability, restore retinal function.	Retinalamine	4400 for 10 pcs.
Corticosteroids	Stops the inflammatory process.	Dexamethasone
Intraocular injections	Prevents the development of new blood vessels in the retina.	Lucentis
Intraocular injections

Vitamins

Reception vitamin complexes in case of macular degeneration of the retina, it is necessary to restore its functioning. Vitamins A, B, and E are beneficial for the eyes. They help improve the nutrition of eye tissue and slow down the progression of macular degeneration. The following complexes will help provide the body with these vitamins:

Blueberry-Forte;
Okyuvit-lutein;
Vitrum Vision;
Lutein-Intensive Evalar;
Complivit Oftalmo.

Physiotherapy

Physiotherapeutic procedures help strengthen the muscles of the eye and retina. They are prescribed in combination with medications. Physiotherapy helps reduce unpleasant symptoms macular degeneration. TO effective procedures This disease may include the following:

Ultrasound therapy. This is a treatment technique using ultrasonic waves that improve metabolism in the eye tissues.
Electrophoresis. During the procedure into the body through electric current medications are coming. For macular degeneration, Heparin, No-shpa, and Nicotinic acid are used.
Intravenous laser irradiation of blood. This is the purification of the systemic bloodstream through exposure to light energy.
Phonophoresis. The essence of the procedure is acoustic exposure to ultra-high frequency vibrations with the simultaneous use of medications.
Magnetotherapy. Impact magnetic field on the body helps to normalize the functioning of basic biological fluids.
Photostimulation of the retina. This is a procedure in which light signals are applied to the eyes to train the retina.
Electrical stimulation of fiber. It consists of strengthening the motor muscles of the eye by applying pulsed electric current.

Laser coagulation

Course fee laser coagulation for macular degeneration can vary greatly depending on the location. average price is 5-30 thousand rubles. The essence of the procedure is the impact on the retina of the eye with a laser beam: krypton, diode or argon. It stimulates antioxidant activity eye tissues, helps remove decay products from them.

After the procedure, tissue swelling in the macula area decreases and the membranes formed by new vessels are destroyed. Indications for laser coagulation:

A non-exudative form of macular degeneration, in which there are no large retinal drusen.
Exudative macular degeneration.
Exudative-hemorrhagic macular degeneration.

Surgery

If conservative methods treatment is not given for a long time positive result, then the doctor decides on surgical intervention. Treatment of age-related macular degeneration is carried out using vasoreconstructive and revascularization operations. The first involves the restoration of the normal microvascular bed of the eye, the second - the complete destruction of abnormal vessels. Main types of prescribed operations:

Vitrectomy. Is it partial or complete removal vitreous to gain access to the retina. In it, the doctor removes the subretinal membranes that impair vision. The vitreous tissue is replaced with a special liquid or gas. Price – 50-75 thousand rubles.
Retinotomy. This is an operation to remove subretinal hemorrhages. After cutting the retina, the doctor removes the blood that has leaked underneath it. Clots are eliminated by administering special medications. Price - about 15 thousand rubles.
Change in position of the macula. It is performed through subtotal vitrectomy and a circular incision in the retina. It is then peeled off to move it in the desired direction. The price of the operation can vary from 10 to 60 thousand rubles.

Folk remedies

Since age-related macular degeneration is a serious disease that can lead to blindness, folk remedies are used only as an addition to the main treatment. Judging by the reviews, good effect bring the following recipes:

Pour 1 tbsp. l. caraway seeds with a glass of boiling water, simmer for several minutes over low heat. Next add 1 tsp. cornflower blue, let cool completely. Strain the broth and drop 2 drops into your eyes. Carry out the procedure in the morning and evening.
Pour 1 tbsp. l. dry celandine 0.5 tbsp. water, put on fire, boil for a couple of minutes. Allow to cool, then strain. Place 3 drops into eyes 3 times a day. for 1 month.
Take homemade goat milk, dilute half with water. Place 1 drop into the eyes 2 times a day. The course of treatment lasts 1 week.

Video

Macular degeneration of the retina - a disease better known as AMD(Age-related macular degeneration). It affects the central, one of the most important areas of the retina - the macula, which has a significant impact on visual perception.

The reason why quality decreases is called degeneration of the macula - one of the important areas of the retina of the eyeball. The retina is the layer of the eyeball that is 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, since the percentage of the population at risk is growing every day. The level of complexity of the disorder is primarily determined by the form of macular degeneration.

Macular degeneration is one of the main causes of the irreversible process of vision loss; the risk group is considered to be the category of people who have reached the age of fifty years.

Macular degeneration of the retina -
degeneration or degeneration of the optic spot

Constant exchange of nutrients in retina promotes the emergence of free radicals, which subsequently provoke an increase in destructive processes due to disruption of the functioning of the antioxidant system. At the same time, drusen (a polymer structure that cannot be split) form in the retina of the eyeball.

The formation of drusen leads to atrophy of the layers bordering the retina, and vessels begin to form in the retinal epithelium. 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 disease – dry and wet macular degeneration.

Dry form of retinal macular degeneration diagnosed much more often. The disease is characterized by the appearance yellow spots in the pupil. As the disease progresses, patients 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 can develop, and subsequently complete blindness.

Despite the enormous advances in medicine over the past few decades, radical measures there is no impact on the disease yet. Scientists have proven that the use of certain vitamins can slow down the progress of the disease, expressed in dry form. From the same studies we can conclude that the use special additives in food, 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 will protect their eyes from the harmful radiation of the sun.

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

Wet form of retinal macular degeneration– has become much less common among the population. The disease develops rapidly and entails significant vision loss. During the wet form of macular degeneration of the retina, vascular growth begins. Neoplasms are defective due to the thinning of their structure. The blood circulating through them is passed into the gap located under the retina, which causes disruption of the cells of the retina. The result is blind spots in the central vision area.

The unhealthy course of neovascularization is explained by the body’s incorrect attempt to create another circulatory network to obtain a full amount of oxygen and nutrients from 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 is transient. IN initial stage, symptoms of macular degeneration of the retina, have the following form:

distortion of perception;
significant deterioration in the quality of vision at night;
loss of clarity of the “picture”;
emergence various spots before your eyes;
loss of color perception.

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

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

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

Scientists have been struggling 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 as characteristic of ninety percent of cases.

Macular degeneration usually affects both eyes, but it does not occur at the same time.

Age. One of the main reasons for the development of the disease. In average 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 sought the help of an ophthalmologist. At a later age, signs of macular degeneration appear 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 confirmed by all medical studies;
race – the disease is widespread among representatives of the Caucasian race;
diseases of the cardiovascular system;
poor nutrition and excess weight;
exposure to ultraviolet rays;
light color of the iris.

Diagnostics

Diagnosis of the disease is based on the collection of medical history, complaints from the patient, information obtained as a result of examination of the eyeball. One of the best methods for detecting the disease is considered to be FAGD (Fluorescein angiography of the fundus). When testing 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 diagnosed with dry macular degeneration of the retina. Also, to assess the condition of the retinal area and changes in the macula, optical tomography is used, thanks to which it is possible to identify changes affecting the structure of the eyeball, on early stage diseases.

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

Treatment of dry and wet forms of macular degeneration

Today, therapy for age-related macular degeneration of the retina is a rather complex and controversial procedure. When treating the dry form of the disease, to restore and stabilize the metabolic process useful elements in the retina, it is necessary to undergo a course of antioxidant therapy.
People over the age of fifty who are at risk should know 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 retinal macular degeneration involves focusing on suppressing abnormal growth of the vascular system. The ophthalmologist selects special medications that stop the growth of blood vessels and thereby increase the quality of vision.

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5199 08/02/2019 6 min.

After fifty years of age, many people's visual acuity begins to decline. Most often this occurs due to the development of macular degeneration, which affects the central part of the retina due to oxygen starvation.

Macular degeneration can cause a person to lose central vision and be unable to read, handle small objects, or drive a vehicle. But this disease cannot lead to complete loss of vision.

Definition of disease

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

Degeneration can be caused by intense metabolism in the retina, which provokes the formation of free radicals, but only if the antioxidant system is not functioning sufficiently. Under the influence of oxygen and light, non-cleavable drusen (polymers) consisting of lipofuscin are formed. Because of this, the adjacent layers of the retina atrophy, and the number of pathological newly formed vessels increases. Scarring then begins, resulting in the loss of many photoreceptors in the retina.

With macular degeneration, a rapid loss of central vision occurs and overall 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 declines relatively slowly. Sometimes dry macular degeneration can turn into wet macular degeneration. Stages of dry macular degeneration:
- Early. Drusen no more than two. There are no symptoms of the disease.
- Intermediate. The drusen become larger and increase in size. A dark spot appears in the central zone. For comfortable reading, an additional lighting source is required.
- Expressed. The retina is destroyed. The dark spot enlarges 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 vision impairment. Kinds:
- Hidden. There are few fragile blood vessels, and hemorrhages are almost invisible.
- Classic. Blood vessels enlarge. Scarring of the eye tissue occurs. Visual acuity decreases.

Causes

With age, problems with health and vision in particular, for example, inevitably begin. 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 these age-related diseases also retinal dystrophy (about retinal dystrophy symptoms we'll tell you 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, since they lead to oxygen starvation of the tissues.

There are a number of risk factors that can weaken natural defense mechanisms and contribute to the development of retinal macular degeneration. 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 are age-related macular degeneration, are more likely to develop this disease.
Gene mutations. There is a high probability of developing macular degeneration if there are changes in certain genes (CFH gene, BF and C2 genes, LOC gene).
Cardiovascular diseases. It has been proven that with atherosclerosis, the risk of developing this disease increases three times, and if there is hypertension– seven times.
Smoking. This bad habit increases the risk of developing retinal macular degeneration.
Direct exposure to sunlight.
Excess body weight.
Unbalanced diet.
Light iris.
Cataract. Surgical removal Cataracts can cause the development of the disease in people who already have changes in the macular area.

Read about how to treat cataracts.

Symptoms

Macular degeneration slowly but irreversibly leads to vision loss. It is painless.

In the initial stages, macular degeneration can be suspected based on the following symptoms:

The appearance of dark spots in central vision.
Loss of image clarity, its distortion.
Deterioration in color perception.
Sharp deterioration of 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 central vision to become blurred. How fewer cells in the macula works normally, the more problems with vision.

Read about the treatment of macular degeneration of the retina.

When there are very few light-sensitive cells, a dark spot appears in the middle of the visual field, which increases over time.

The main symptom of wet macular degeneration is the curvature of straight lines. This happens due to the fact that fluid sweating 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 lines blurred or wavy, and dark spots appear in their vision.

Possible complications

Macular degeneration is not the cause total loss vision. Because of it, only central vision can be lost.

This disease has a negative impact on the quality of life, making it impossible to work, read, watch TV, and so on. Even in everyday life, 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 broth. Rinse whole oat grains (volume - half-liter jar), soak them for four hours. After this, drain the water, pour the grain into a three-liter saucepan, add water and bring to a boil over medium heat. Cook 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, chokeberry or a little honey.
Calendula infusion. Pour one tablespoon of calendula flowers into a glass of boiling water and leave for fifteen minutes. Cool, strain and drink a quarter glass three times a day. Simultaneously with internal administration, you can drip two drops of infusion into the eyes. The course of treatment lasts six months.
Infusion of aloe and mumiyo. Dissolve fifty grams of mumiyo in one hundred milliliters of aloe juice. Drink ten milliliters of infusion twice a day and drop one drop into the eyes. The course of treatment lasts ten days.
A decoction of pine needles, rose hips and onion peels. 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, add a liter of water. Drink one and a half liters of broth every day.

Ointments, drops

Cumin drops. Pour one tablespoon of cumin into 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.
Celandine drops. Pour one teaspoon of finely chopped celandine into one hundred milliliters of water. Hold over the fire for just a few seconds and leave. Strain and put in the refrigerator. Drip three drops three times a day for one month.
Goat milk drops. Mix equal amounts of milk and water. Place one drop into the eyes. Put on dark bandage on your eyes and rest for thirty minutes. Drip for a week.

Compresses

Lily of the valley and nettle compresses. Pour one third of a glass of nettle and a teaspoon of finely chopped lilies of the valley into a glass of water, add half a teaspoon of soda. Leave for nine hours in a dark and dry place. Apply the compress twice a day.
Leeches. The saliva of leeches contains useful substances that reduce intraocular pressure, reduces pain and improves blood circulation.

Prevention

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

They include:

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

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

Vegetables and fruits are rich in vitamins, nutrients, microelements 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 tissue.

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conclusions

Start taking care of your vision as early as possible. Take preventive measures 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 with timely treatment, the chance of saving vision is much higher.

Read about what presbyopia and optic atrophy are.