Overview
Macular degeneration is an ocular pathology that impacts the macula, a highly specialized region of the retina that is responsible for visual acuity and central vision. The condition results in a loss of visual acuity, specifically the inability to see objects in front of the viewer. This degenerative disease is age-related and commonly affects individuals aged 50 and above. Despite its impact on central vision, macular degeneration does not cause complete blindness and peripheral vision remains intact.
Causes
- Age: The risk of macular degeneration increases with age. It is most common in people over the age of 50.
- Genetics: Certain genetic factors can make individuals more susceptible to macular degeneration. This is particularly true for individuals with a family history of the disease.
- Smoking: Smoking is a significant risk factor for macular degeneration. People who smoke are more likely to develop the condition and may experience faster progression of the disease.
- Obesity: Obesity is another risk factor for macular degeneration. Maintaining a healthy weight through diet and exercise can help reduce the risk of developing the disease.
- High blood pressure: People with high blood pressure are more likely to develop macular degeneration, particularly the wet form of the disease.
- Sunlight exposure: Prolonged exposure to sunlight and UV rays may increase the risk of macular degeneration.
- Nutritional deficiencies: A diet lacking in certain nutrients, particularly antioxidants, and saturated fats, particularly omega-3 fatty acids, may contribute to the causes of macular degeneration.
- Cardiovascular disease: People with cardiovascular disease, such as high cholesterol or heart disease, may be more likely to develop macular degeneration.
Prevention
- Quit smoking: Smoking increases the risk of developing macular degeneration, so quitting smoking can help reduce the risk.
- Exercise regularly: Regular exercise can help maintain a healthy weight and limit the causes of macular degeneration.
- Eat a healthy diet: Eating a diet rich in fruits, vegetables, and fish can help reduce the risk of macular degeneration.
- Protect your eyes from UV light: Wear sunglasses that block out UV light to reduce the risk of macular degeneration caused by sunlight exposure.
- Control blood pressure and cholesterol levels: High blood pressure and cholesterol can increase the risk of macular degeneration, so it’s important to manage these conditions through lifestyle changes or medication.
- Get regular eye exams: Regular eye exams can help detect macular degeneration early, which can increase the chances of successful treatment.
- Eat a healthy diet: Eating a diet rich in fruits, vegetables, and fish can help prevent the causes of macular degeneration. Specifically, foods high in antioxidants such as vitamins C and E, lutein, zeaxanthin, and beta-carotene are thought to be beneficial. However, it’s important to talk to your doctor before taking any supplements.
Different treatments for wet and dry macular degeneration.
- Wet AMD occurs when abnormal blood vessels grow under the retina and leak fluids, while dry AMD happens when parts of the macula thin out and clumps of a protein called drusen develop.
Treatment
Vascular endothelial growth factor (VEGF)
Scientists have created drugs that interfere with this process by blocking a protein called vascular endothelial growth factor (VEGF). Before the creation of these so-called anti-VEGF drugs, people with wet AMD were almost certain to develop severe vision loss or blindness.
These drugs stabilize or improve vision in the vast majority of patients. But they must be injected into the eye on a regular basis.
Gene therapy
Gene therapy is a promising alternative to ongoing eye injections of drugs such as Eyelea, Lucentis and Avastin. The goal of gene therapy is to provide a ‘one-and-done’ treatment by helping the eye make its own anti-VEGF medicine.
- About 8 out of 10 people with AMD have the dry form. Dry AMD occurs when parts of the macula thin with age, and tiny clumps of a protein called drusen to grow. You slowly lose central vision. Depending on the severity, dry AMD is considered early, intermediate, or late stage.
Treatment
Targetting the immune system
The “complement cascade,” a component of the immune system, has been recognized as a contributor to dry AMD for a long time. Recently, two new drugs have progressed to the final stage of clinical trials. These drugs aim to prevent the complement cascade from attacking the retina. One of the drugs, pegcetacoplan (APL-2), targets a complement protein called C3, while the other drug candidate, Zimura (avacincaptad pegol), targets a distinct protein in the cascade known as C5.
Replacing vision cells in people with dry AMD.
Autologous stem cell transplantation for the replacement of retinal cells lost in advanced dry age-related macular degeneration (AMD) is currently being explored as a potential therapeutic intervention. Various strategies are being developed by medical professionals to facilitate the successful engraftment of stem cells into the retina.
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