Eye disease · Overview

Age-related Macular Degeneration – Therapy and Causes

The diagnosis and treatment of macular degeneration are constantly making new progress. Because many questionable or outdated therapies are also being offered in the meantime, I’d like to give you here a short overview of causes and treatment options for this eye disease.


Causes of macular degeneration

There are various causes of macular degeneration. For one, it frequently occurs in people with high exposure to sunlight who have not sufficiently protected their eyes with suitable UV and blue-filter glasses. This group includes especially outdoor sportsmen like sailors, skiers and pilots. However, smokers also have an increased risk for the disease.


Aside from these factors, a large percentage of patients show a genetic predisposition. By now, there is in fact a genetic test for macular degeneration. Since not all triggering genes are known yet, however, this test is not very diagnostic.



Current procedures for treatment of macular degeneration

Two forms of macular degeneration have been distinguished. The dry and the wet macular degeneration.


Treatment of wet macular degeneration

For treatment of this form of macular degeneration, an injection is given directly into the eye to stop the disease. There are three medications for this purpose with varying lengths of depot effect. The best is Avastin. However, it is not yet approved for this purpose in Switzerland and is thus reclassified for it. The approved Lucentis is about thirty times more expensive. Eyla, which is also approved and about forty times more expensive, is the newest generation. Avastin and Lucentis are made by the same manufacturer and, according to a new large-scale study by the US Food and Drug Administration, do not differ in their effectiveness. The study, carried out against the manufacturer’s wishes, came to the conclusion that both exhibit an identical effectiveness.


Treatment of dry macular degeneration

The mild form of dry macular degeneration is accompanied by few limitations for patients as a rule and is thus not treated in a targeted manner. For the more pronounced form, the only treatments for dry macular degeneration are lutein tablets and special blue-blocking glasses. Research is currently underway on telescopic implants. However, these have not yet been approved. In any case, stem cell research offers the best therapy options in the long term.


Photodynamic therapies that work with light, by contrast, have become outdated. The same is true for treatments of the affected area of the retina with argon lasers or X-ray radiation and for a surgical intervention, associated with divers side effects, in which the healthy part of the retina is shifted – the so-called rotation surgery.


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