Age-related macular degeneration

The beginning of age-related changes of the retina is the appearance of yellowish deposits, which are called "drusen". A few small drusen do not yet lead to changes in visual acuity. As a rule, these drusen become larger with time and their number increases (so-called maculopathy). This early stage of AMD is usually accompanied by mild, but still disturbing symptoms.

In later stages, there are usually distortions of straight lines (see test Amslernetz) and central failures in the field of vision, which patients notice most clearly when reading.

In advanced stages (late stage macular degeneration) degeneration usually leads to thinning and death of light sensitive cells in the macula (so called dry or atrophic macular degeneration. Patients with this dry (or atrophic) form of macular degeneration complain of an enlarged blind spot in the center of their visual field and often lose their central vision completely in the course.

Another late stage of age-related macular degeneration is the so-called "wet macular degeneration". Deposits disturb the oxygen supply of the macula and the eye reacts with a locally excessive formation of new, but inferior blood vessels (so-called neovascularizations). These damage the metabolism of the retina - increasingly in the area of the macula. In the further course, the area of the macula becomes scarred (so-called fibrovascular scar, Junius-Kuhnt) due to locally excessive inflammatory reactions (excessive activation of the so-called complement system). This leads to rapid central vision loss with loss of reading ability and large central visual field loss.

Once destroyed, it is difficult to restore vision. The only safe and so far approved treatment option for the therapy of wet macular degeneration is a costly but efficient injection therapy. Hereby vascular proliferation inhibiting drugs are given into the vitreous cavity (so called intravitreal injections). The treatment is useful and vision returns as long as no scarring of these pathological vascular membranes has occurred. Therefore, it is very important to make the diagnosis early.

Large studies conducted worldwide have revealed a number of risk factors for retinal aging. Known risk factors that we cannot influence are, besides genetic predisposition, female gender, age, light eye and skin color.

On the other hand there are possibilities to reduce the risk of macular degeneration by influencing the way of life. In numerous studies there is epidemiological evidence for a relationship between age-related macular degeneration (AMD) and excessive sun exposure. For a long time, research assumed that the two pigments lutein and zeaxanthin, which are detectable in high concentrations in the macula, have a protective function. This so-called "macular pigment" absorbs the short-wave sunlight similar to "inner sunglasses" and binds free radicals.

The assumption that late stages can be prevented by increasing the concentration of macular pigment (e.g. via supplementation) has unfortunately only been partially confirmed.

Nevertheless, in order to take advantage of these small positive effects, we recommend optimizing one's lifestyle, especially avoiding tobacco products and paying attention to a healthy diet rich in vitamins and good sun protection.

Instead of excessive daily doses of vitamin supplements (as used e.g. in the American studies), we advise a lutein-rich and seasonal diet. That such a fresh seasonal and regional nutrition does not have to be ascetic, we show with the book "Kochen für die Augen" (published by Bayer (Schweiz) AG in cooperation with Retina Suisse).

This is the first time that we have published a cookbook with recipes in German and French that are not only good for the eyes, but also very tasty and easy to cook.