Exudative Maculopathy

PATHOLOGY

The age related macular degeneration of the neovascular type (Neovascular Age-related Macular Degeneration, nAMD) or more commonly referred to as “exudative maculopathy” is a severe ocular pathology involving the macula, i.e. the portion of the central retina, responsible for fine detailed vision that enables us to recognize a face, read, carry out precision works, drive a car, etc.

In technologically advanced countries, the incidence of the AMD has strongly increased and continues increasing due to the lengthening of the average lifespan and the simultaneous occurrence of other environmental and nutritional factors in addition to the genetic ones sometimes predominant. The AMD strikes, in fact, approximately 11% of the individuals aged between 65 and 74 years and such percentage considerably increases when older age ranges are taken into consideration. As of today’s date the AMD, in more industrialized countries, represents the most common cause of legal blindness and low vision in individuals older than 55 years.

The AMD can have two forms: atrophic AMD (also referred to as non-neovascular or dry) and exudative AMD (also referred to as neovascular or wet). The AMD usually starts in the atrophic form (90% of the cases) and seldom (10% of the cases) in the exudative from. In some patients the atrophic AMD can evolve into the exudative form.

The exudative AMD is caused by the uncontrolled growth of pathologic new vessels under the retina, a process known as pathologic neoangiogenesis.

TREATMENT

The treatment for exudative AMD provides for a series of intravitreal injections with anti-VEGF drugs. Even if this procedure is effective for preventing or delaying the loss of the central vision, it is appropriate to keep in mind that as of today’s date no final treatment exists for exudative AMD and, therefore, prevention represents a particularly effective weapon for defending against this severe retinal pathology.

The inflammatory process that causes the onset of exudative AMD involves a series of biochemical reactions known as complex cascade; this can be modulated thanks to a factor referred to as CFH factor.   The CFH factor regulates the extent of the inflammatory response, which in healthy persons increases or decreases depending on the needs; some variants of the gene that codifies for the CFH factor are related to the CFH factor to modulate – in particular to “break” and keep under control – the inflammatory response; therefore, in those individuals in which there is the presence of one of these genetic variants of the CFH factor, a greater risk exists of developing the AMD (genetic susceptibility).

Since the identified variants of the CFH gene responsible for the genetic susceptibility to AMD are many, several genetic tests are available that make it possible to evidence their presence. The test is recommended above all to individuals who have a family history of exudative AMD inheritance, but also of the atrophic type.  Showing genetic susceptibility for AMD does not mean that one is liable to contracting the disease, but conversely, this information permits to adopt prevention protocols able to reduce the risk that this pathology occurs. The prevention protocols are based on the adoption of very healthy lifestyles, which exclude as much as possible the presence of environmental and behavioral risk factors. In order for these to be of any help, the genetic tests must be rigorously performed and interpreted by expert geneticists.

WE CAN HELP YOU

If you believe that you are suffering from this pathology or you have any doubts that you wish to be clarified you can contact us.

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