Classification and Clinical Features of AMD

Abstract

Disease was first time described as “Symmetrical central choroido-retinal disease occurring in senile persons” in 1874 by Hutchinson. About 25 years ago, the term "age-related macul‐ opathy" was accepted and end stage of disease was acknowledged as age-related macular degeneration [1]. AMD is leading cause of blindness worldwide in older patient population. The highest risk of developing of AMD is in the population older than 65 years. With ageing of population in many countries, more than 20 % might have the disease [2]. Advanced forms of AMD are associated with visual progressive impairment. Visual acuity of this sub‐ jects decreases to practical blindness. This has big socioeconomic impact. AMD is progressive chronic disease that is located in central retinal area (macula luthea – yellow spot) [2]. Most visual lost is identified in late stages of AMD. There are 2 categories: wet AMD and geographic atrophy. In wet AMD choroidal neovascularization breaks through neuroretina. Leaking vessels, hemorrhages and lipid deposits lead to scarring proc‐ ess in macular area. All retinal structures including photoreceptors are destroyed. In geo‐ graphic atrophy occur progressive atrophy of retinal pigment epithelium and secondary photoreceptors. To the end of 20th century was AMD practically untreatable. However, new pharmaceuticals based on suppression of vascular endothelial growth factor (VEGF) have completely changed the treatment of the disease [2]. Nearly 95 % of patients can be prevent‐ ed from visual lost, and nearly 40 % of them improve vision [2].