Macular Degeneration (AMD)

What is Macula?

The macula or macula lutea ("yellow spot") is part of the eye, more precisely the retina. In the eye, the retina is used to convert incident light into electrical signals through a complicated chemical process. The optic nerve then transmits these signals to the brain, where they are converted into visual information.

The macula contains most of the sensory cells responsible for the perception of colors, the cone cells. The center of the macula is the so-called fovea centralis, the place of sharpest vision.

What Is Macular Degeneration?

The most common cause of macular degeneration is age. Therefore, it is generally also called age-related macular degeneration or AMD. The retina is made up of several cell layers. Only one of them is formed by the above mentioned sensory cells. Another one is the retinal pigment epithelium. Among other things, it serves to supply the sensory cells with nutrients and to absorb the metabolic products produced when visual signals are generated. With increasing age, more and more of these metabolic products are deposited in the pigment epithelial cells until they can no longer carry out their function. As a result, the sensory cells can no longer be fed and die, which ends in massive vision impairment, even blindness.

The form of AMD described above is the so-called "dry" macular degeneration. In addition, the "wet" age-related macular degeneration exists. It occurs far less frequently (the ratio is about 1:10), but it is more aggressive and progresses faster. In wet AMD, blood vessels sprout from the retinal tissue layer, the choroid, which supplies the retina with blood. This process is probably caused by the epithelial growth factor (VEGF). VEGF is a messenger substance of the body that occurs in almost all tissues and controls growth processes. The blood vessels prove to be unstable and tear. The hemorrhages damage the sensory cells, often resulting in a sudden (partial) loss of vision.

Macular Degeneration Symptoms

AMD's symptoms are reduced visual acuity and the ability to see colors, as well as central visual field loss, which makes it difficult for those affected to read, find their way around, and recognize people.

What Causes Macular Degeneration?

The death of the sensory cells is caused, as described above, by the loss of the retinal pigment epithelium function. At the moment, it can only be speculated about the causes of this function loss. In recent years, however, researchers have identified several risk factors that could favor AMD development.

These include diseases that affect small blood vessels (including choroidal ones), such as arteriosclerosis and diabetes. Age and lifestyle also play an essential role. Smoking is regarded as particularly unfavorable in this context, but an unbalanced diet and high-fat food can also forward AMD, leading to a lack of specific vitamins.

AMD Therapy: How Is Macular Degeneration Treated?

First of all, the diagnosis must be secured, which is relatively quickly by looking at the back of the eye, because deposits in the cells or bleeding into the retina can be detected.

Today a laser regeneration therapy with a nanolaser can delay the progression of dry AMD. It is currently the only form of treatment in the early stages of macular degeneration. It is also tried to slow down the course of the disease by adjusting diet and lifestyle and possible underlying disorders with medication.

For wet AMD there anti-VEGF therapy can be attempted. In this therapy, an active substance opposite to VEGF is injected directly into the eyeball to reduce the growth-supporting effect. A combined treatment of laser and drugs, and surgical removal of vascular neoplasms, is also possible and depends on the individual case.

Which Doctors and Clinics Are Specialized in Treating AMD in Germany and Switzerland?

Those who need a doctor want the best medical care. Therefore, the patients are wondering where to find the best clinic for macular degeneration. Since this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on the doctor’s experience. AMD specialists are ophthalmologists who have specialized in diagnosing and treating diseases of the posterior eye segment.

We can help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in macular degeneration and are awaiting your inquiry or treatment request.

Sources:

augenchirurgie.clinic/erkrankungen/makula/altersbedingte-makuladegeneration-amd

Lüllmann-Rauch, Renate und Friedrich Paulsen: Taschenlehrbuch Histologie, Thieme 2012