The Diagnosis and Treatment of Age-Related Macular Degeneration

Major Points and Findings:

Prevalence and Risk Factors:

• AMD is most prevalent in persons over 65 in industrialized countries.
• The number of people with early-stage AMD in Germany increased from 5.7 million in 2002 to around 7 million in 2017.
• The main risk factors for AMD are age, genetic predisposition, and nicotine consumption.

Stages and Symptoms:

• AMD is categorized into early, intermediate, and late stages.
• Early-stage AMD is often asymptomatic, while the other stages can cause distorted vision or central visual field defects.

Treatment:

• Late-stage AMD is divided into dry and exudative (wet) forms.
• The dry form currently has no treatment.
• The exudative form can be treated with intravitreal injections of VEGF inhibitors.

Research Gaps:

• More research is needed for the dry late form of AMD, which is currently untreatable.

Progression:

• In asymmetrically affected patients, the disease often progresses to the better-seeing eye within 5 years in 19% to 28% of cases.
• The rate of progression from intermediate to late AMD is estimated at 28% in five years.

Clinical Manifestations:

• The initial symptoms often consist of distorted vision or visual loss in the center of the visual field.
• The exudative form of AMD is associated with a more rapid loss of vision compared to the atrophic form.

The report concludes that the treatment of exudative AMD is labor-intensive and requires close collaboration between the patient, ophthalmologist, and primary care physician. It also emphasizes the need for more research, particularly for the dry form of AMD.