Age-related macular degeneration

"The treatment of macular degeneration in its wet form is carried out, fundamentally, with the intraocular injection of antiangiogenic drugs".

DR. ALFREDO GARCÍA LAYANA
DIRECTOR. OPHTHALMOLOGY DEPARTMENT

Macular degeneration is a degenerative alteration of the central part of the retina known as the macula, which is responsible for central vision. Its cause is unknown, although it is known that the age of the patient is the main risk factor.

The macula is the part of the retina that allows reading, watching television or recognizing people's faces. Currently, it is the main cause of legal blindness in people over sixty. However, peripheral vision remains unchanged, so patients can manage without aids for everyday tasks such as wandering.

The Ophthalmology Department of the Clinic carries out early auto-detection programs for patients at risk using the Amsler grid, offering the possibility of immediate consultation where the necessary tests will be carried out to reach the diagnosis and apply the antiangiogenic treatment in the same day, without the need to go several days for the same process.

We have advanced technology for the diagnosis of macular degeneration, such as wide field fundus cameras and different models of OCT, including angiography by OCT that allows, in a matter of seconds, to visualize with a maximum degree of detail, the different vascular plexuses of the retina, without the need to use contrast media.

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What are the symptoms of macular degeneration?

Some symptoms of macular degeneration are distorted vision of objects and the appearance of black spots. If you have any of these symptoms, it is important to see an ophthalmologist for an evaluation.

This disease only affects central vision. Its loss will prevent reading with that eye or recognizing people's faces. The rest of the retina normally remains functional, thanks to which adequate peripheral vision is achieved, allowing the patient to manage in the street or at home even without assistance. Patients never go blind to the point of not being able to help themselves.

Dry macular degeneration, with a slower course, produces atrophy of the macular area. The wet form, faster and worse prognosis, accumulates fluid under the macula.

The most common symptoms:

  • Twisted or distorted vision of objects.
  • Appearance of black spots in the central vision, which do not change position.
  • Decrease or loss of central vision: difficulty in reading, watching television or recognizing people's faces.

In the face of any of these symptoms, it is important to go to the specialist in Ophthalmology within a few days, so that he can make an assessment. Even if you do not notice any change in your eyesight, it is advisable to make regular visits.

Do you have any of these symptoms?

You may have macular degeneration

What are the causes of AMD?

The causes of this disease are unknown, but age is the main risk factor. In addition, there is a clear family predisposition that can be inherited from parents to children.

The Clinica Universidad de Navarra has developed a genetic test which allows us to know if those affected can transmit this predisposition to their children or, on the contrary, if the children have inherited this predisposition from their affected parents.

In addition to age and genetics, there are environmental factors that predispose to the disease: the most important are tobacco and diet. Diets rich in vitamins, minerals, lutein and omega 3 have a protective effect, while tobacco doubles the risk of suffering the disease, so it is recommended to quit smoking, especially for those people with a family predisposition to AMD.

Types of macular degeneration

Dry form
This type of macular degeneration is the most common. It develops more slowly and, during its evolution, atrophy of the macular area occurs.

Wet form
Its evolution is much faster and has a worse prognosis since, in the process, fluid accumulates under the macula. 

Among the symptoms, the wavy vision of the straight lines and the decrease of the central vision stand out.

You may also notice changes in reading the newspaper, watching television or looking at people's faces. If you notice crooked objects or black spots that do not change position, you should arrange a visit within a few days.

How is macular degeneration diagnosed?

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At the first symptoms, such as loss of vision, a fundus examination will be performed to check for changes in the macula. In addition, it is important to determine the extent of the disease.

The Clínica Universidad de Navarra is a pioneering center in Spain in the use of optical coherence tomography (OCT). It detects microscopic amounts of liquid in the macula to differentiate the dry form from the wet form, since the latter requires treatment within a few days of its diagnosis.

There are early auto-detection programs for higher risk patients, such as the Amsler grid: this is a grid in which, by observing the central point with each eye separately, straight lines without defects must be seen. In cases of macular disease, the squares are observed crooked or distorted.

How is macular degeneration treated?

In the dry form, there is no treatment, except the recommendation of a diet rich in omega 3 and specific vitamins for the retina (lutein and zeaxanthin), or the intake of vitamin supplements for this purpose. 

In the humid form, there are diverse treatments to stop the advance of the disease that can stabilize the vision, or even, to improve it.

The treatment of choice consists of the intraocular injection of antiangiogenic drugs periodically, with OCT being a fundamental tool for deciding exactly the need to portray the lesions, avoiding unnecessary injections.

In the Clinic's Ophthalmology Department, intraocular injections are performed in the outpatient area, thus reducing the time between diagnosis and treatment, and minimizing the possibility of the pathology worsening.

Other treatments for complex cases would be based on treatment with different types of lasers alone or in combination with anti-angiogenic therapy (photodynamic therapy, argon laser or transpupillary thermotherapy).

Where do we treat it?

IN NAVARRE AND MADRID

The Department of Ophthalmology
of the Clínica Universidad de Navarra

Equipped with the latest technology, the Department of Ophthalmology has the necessary equipment, both technical and human, to offer comprehensive and specific assistance to each patient.

We are one of the few centers that have a microsurgery laboratory for the improvement of clinical practice.

Organized in specialized units

  • Cornea and eye surface
  • Retina
  • General Ophthalmology
  • Refraction defects
  • Oculoplastic
  • Pediatric ophthalmology
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Why at the Clinica?

  • More than 25 years of experience.
  • Experts in the diagnosis and treatment of ocular pathologies.
  • With the security and guarantee of a prestigious hospital.

Safer than ever to continue taking care of you

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