Macular degeneration (AMD)

Macular degeneration affects central vision seriously but peripheral vision remains, and therefore it never produces total blindness. In many cases, the patient has metamorphopsias or image distortions. It affects 20-30% of people over 65 years. There are an atrophic or dry form, which is the most common (90% of cases), and an exudative form with subretinal neovascular membranes that bleed and destroy the macula.

dmae_01

Metamorphopsias or image distortion caused by macular degeneration.

It is often necessary to perform an optical coherence tomography of the macula (macular OCT) to determine the location and extent and determine whether the patient can benefit from treatment. In some cases you also have to do some contrast tests, such as fluorescein or indocyanine green angiography. Recently in our clinic, we have used non-invasive angiographic OCT, which allows us to make a thorough examination of the macula without the need to introduce dye into the veins. This technology is completely safe and non-invasive, as it also is not necessary to dilate the pupils.

fluorescein angiography
Optical coherence tomography (OCT)

Since 2005, we have used antiproliferative drugs, which are effective in stopping and even improving macular degeneration (AMD). Exudative forms are treated with intravitreal injections of antiproliferative drugs (ranibizumab, bevacizumab, aflibercept). Treatment with the vast majority of cases is stabilized and a significant percentage improves. Treatment should be done as soon as possible since it is only more effective in recent membranes and does not improve the old scars or dry forms. Recurrences are frequent and sometimes the response is partial, which makes it necessary to perform several reinjections.

dry or atrophic macular degeneration
wet or exudative macular degeneration