Age-related macular degeneration

The precise causes of age-related macular degeneration are not yet fully understood. According to the latest findings, metabolic products are deposited on the macula and damage the photoreceptors over time as the individual gets older. This gradually decreases the visual acuity at the centre of the field of vision. A German study found that the risk of AMD increases with age: around 3.8 per cent of those aged 35 to 44 showed signs of AMD, compared to 24.4 per cent of those aged 65 to 74.

Due to the increasing loss of vision at the centre of the field of vision, objects in the actual focus often appear blurred or distorted. Initially there may also be the impression of a shadow above the focused object. In such cases, persons suffering from AMD often orient themselves based on the perception in the periphery of their field of vision and differences in brightness.

Macular degeneration proceeds in various stages: early, intermediary and advanced AMD. On average, it takes around ten years for the illness to develop from the early to the late stage, with progression varying considerably from one person to another. The early stage only causes limited restrictions to daily life: the central vision area is perceived as shadowy or blurry. However, due to the diminished eye sight, patients suffering from an advanced stage can occasionally neither recognise faces nor read print.

Macular degeneration exists as a ‘wet’ or ‘dry’ form. Dry AMD accounts for 85 per cent of cases and may develop into the wet variant. Dry AMD is also described as geographic atrophy as there is a partial loss of photocells (atrophy) in its course. It is caused by accumulations of metabolic products underneath the retina that increasingly impede the supply of nutrients to the photocells. The gradual loss of cells usually commences in the macula as the photocells are especially active here.

Wet AMD is also known as ‘neovascular AMD’. In this form of the illness new blood vessels are formed in the damaged portion of the eye to counter the decreased oxygen supply caused by the illness. The newly formed blood vessels can cause swelling or even haemorrhaging of the macula. Wet AMD proceeds much faster than the dry form.

The wet form of macular degeneration can be treated with medication. So-called VEGF inhibitors are used, which are intended to prevent additional blood vessels from proliferating in the retina. In addition, they cause the blood vessels that already impair the vision to regress. The medications are repeatedly injected in the eye with local anaesthesia. Today, the wet form of macular degeneration can be arrested for an extended period of time and vision preserved with regular injections of VEGF inhibitors.

For the dry form of AMD there are specially balanced micronutrient combinations that can help increase the supply of nutrients to the eye.

In a series of studies it was found that specific combinations of vitamins and micronutrients can help lower the risk of progressing AMD. These include anti-oxidants such as vitamins C and E that protect the sensitive photocells in the yellow spot of the eye.

Carotenoids have a high anti-oxidant effect. The two carotenoids lutein and zeaxanthin are found mainly in the retina and the macula and protect these structures. While vegetables such as spinach, cabbage or broccoli contain carotenoids, the quantities present are often insufficient to ensure an adequate supply.

Zinc is also one of the micronutrients that help protect cells from oxidative stress. Zinc is administered in combination with copper to prevent copper deficiency.

In addition to a sufficient supply of vitamins and minerals smoking should be avoided. Many studies identified smoking as a high risk factor for the development of AMD and other eye illnesses. Therefore, not smoking can help prevent AMD or minimise the chances of the condition worsening.