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You should know that we need to do regular tests and, if necessary and after consulting a specialist ophthalmologist, do a special test to photograph the fundus, after we administer first a dye, fluorescein. The test is called fluoroangiography. This test allows us to see if there is any damage in the retina and the macula and if pathological vessels are formed under them. This diagnostic method is performed with inserting the dye (fluorescein) in the blood, which allows to photograph the pathological vessels and their exact expanse.
In addition, there is the option of an optical coherence tomography (OCT) of the macula, during which the retina is examined layer after layer, so that lesions can appear in the area of the macula, or neovascular membranes that emanate from the choroid, in the presence or not of fluid; all that without the use of pigment or other substance, without mydriasis and in a very short time. OCT is used to check how is the response to the treatment , as well as the progress of the degeneration with time.
In case of dry macular degeneration, there is no cure. The disease progresses slowly, but we cannot provide medication or propose a surgical solution that will solve the problem. In this case, multivitamin supplements can be administered that would contain lutein and zeaxanthin, since some studies have shown they delay the progress.
In case of wet type macular degeneration and in the presence of a neovascular membrane, the choice therapy since 2005 until today is to administer antineovascularzation medication in the form of intravitreous injections. These drugs (AVASTIN, LUCENTIS) act in such a way that they inhibit the progress of the neovascular membrane and decrease (or even remove) the edema (fluid) in the macular area, which results not only in the stabilization and halting the progress of the degeneration, but also in improving the visual acuity of the patient. These injectable drugs are administered every 4-8 weeks until inhibition of the disorder.
It is applied only for problems adjacent to the macula, practically in a very small number of patients
Photodynamic therapy with Visudyne is done with intravenous injection of Visudyne, a light-sensitive substance that is activated when exposed to light. Visudyne concentrates selectively in the pathological vessels of the retina and is activated with the light of a specially designed laser (that does not produce heat and does not burn the retina). The activated substance causes thrombosis and obstruction of the new vessels, without affecting adjacent tissue, thus inhibiting the progress of the disease..
In special cases, macular degeneration can be surgically treated. Macular translocation is a procedure performed on patients that experience total loss of vision in both eyes after macular degeneration. With macular translocation we manage to place the macula in a new healthy spot in order for vision to be restored in one eye.
In case of advanced degeneration, the patient can also use low vision aids. These are special glasses or special magnifying lenses or closed circuit televisions and computers that help low vision by enlarging objects or increasing the visual field. They are aids prescribed only by the ophthalmologist and only if there is an indication for them; they can be used after training the patient in their function. However, we should mention that they are a serious solution in a difficult problem, especially when all other treatment options have been ruled out.