10. tbl 92. árg. 2006


Age related macular degeneration

Aldursbundin hrörnun í augnbotnum

Læknablaðið 2006; 92: 685-96

Age-related macular degeneration (AMD) is the main reason for blindness today in the western hemisphere. According to Björn Ólafsson, who was the first ophthalmologist in Iceland a century ago, this disease was not found in Iceland. In the blindness-registry of 1950 6% blindness was due to this disease. Today, AMD is responsible for 54% of legal blindness in Iceland. The incidence of the disease increases with age. Heredity and environmental factors are thought to influence its etiology. Indirect methods, including twin studies and increased frequency of this disease in some families, have demonstrated that hereditary factors may be important. This has been confirmed recently by demonstrating that genes on chromosome 1 and chromosome10 play a role. This disease is classified as early stage, with drusen and pigmentary changes and insignificant visual loss. Treatment options for this stage are limited. The use of vitamin E and C and Zinc has, however, been shown to delay its progress. The second and end stage involves visual loss, either as a dry form with pigment epithelial atrophy or wet form, with new vessel formation. Treatment options for the dry form are limited. The second form is more common in Iceland than in other countries. Treatment options for the wet form have increased. Localised laser and drug treatment to neovascular membranes, either alone or as a combination treatment with drugs that have anti-proliferate effect on new vessels (anti-VEGF) are increasingly used.

New treatment methods are also used in assisting those that are already visually handicapped. The use of computers is increasing as are the patients? computer skills. As the number of the elderly increases, AMD will be an increasing health problem in Iceland as in other Western countries. It is therefore important to improve the treatment options and the service and counselling of patients.


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