Tinjauan atas Age-related Macular Degeneration

Authors

  • Anak Agung Fridami Dewi UPTD Puskesmas Ubud I, Bali, Indonesia

DOI:

https://doi.org/10.55175/cdk.v50i7.953

Keywords:

Age related macular degeneration, anti-VEGF, drusen

Abstract

Age-related macular degeneration (AMD) merupakan penyakit degeneratif makula yang mengakibatkan gangguan penglihatan sentral pada usia lanjut. AMD yang didapatkan pada sekitar 5,8% individu dengan kebutaan, merupakan penyebab kebutaan keempat terbanyak di dunia. Faktor risiko AMD meliputi usia, genetik, merokok, dan nutrisi. AMD diklasifikasikan menjadi AMD non-neovaskular (dry) dan neovaskular (wet). Pada tahap awal AMD sering tidak bergejala, pada tahap lanjut dapat ditemukan hilang penglihatan sentral disertai distorsi visual dengan gambaran drusen, geographic atrophy, atau neovaskularisasi koroid pada pemeriksaan fundus. Pencitraan retina diperlukan untuk menentukan tata laksana sesuai derajat penyakit. Penanganan AMD non-neovaskular saat ini ditekankan pada observasi dan kemampuan pasien untuk mengenali perubahan fungsi visual serta deteksi dini neovaskularisasi koroid. Modifikasi gaya hidup, seperti berhenti merokok dan suplementasi nutrisi, dapat dilakukan untuk mencegah progresivitas AMD. Terapi anti-VEGF (vascular endothelial growth factor) saat ini merupakan pilihan untuk tata laksana AMD neovaskular.

 

Age-related macular degeneration (AMD) is a macular degenerative disease causing impaired central vision in elderly. AMD occurs in approximately 5.8% of individuals with blindness; it is the fourth leading cause of blindness in the world. The risk factors of AMD include age, genetics, smoking, and nutrition. AMD is classified into non-neovascular (dry) and neovascular (wet) AMD. Early AMD is often asymptomatic, loss of central vision with visual distortion can happen in the later stages. Drusen, geographic atrophy, or choroidal neovascularization can be observed in fundus examination. Retinal imaging is needed to determine management according to the stage of the disease. Current management of non-neovascular AMD is emphasized through observation and the patient’s ability to recognize changes in visual function as well as early detection of choroidal neovascularization. Lifestyle modifications such as smoking cessation and nutritional supplementation can prevent the progression of AMD. Anti-VEGF (vascular endothelial growth factor) therapy is currently an option for the management of neovascular AMD.

Downloads

Download data is not yet available.

References

Gheorghe A, Mahdi L, Musat O. Age-related macular degeneration. Rom J Ophthalmol. 2015;59:74–7.

Domalpally A, Clemons TE, Danis RP, Sadda SVR, Cukras CA, Toth CA, et al. Peripheral retinal changes associated with age-related macular degeneration in the age-related eye disease study 2: Age-related eye disease study 2 report number 12 by the age-related eye disease study 2 Optos PEripheral RetinA (OPERA) Study Research Group. Ophthalmology 2017;124:479–87.

Miller JW, D’anieri LL, Husain D, Miller JB, Vavvas DG. Age-related macular degeneration (AMD): A view to the future. J Clin Med. 2021;10:1–4.

Salimiaghdam N, Riazi-Esfahani M, Fukuhara PS, Schneider K, Kenney MC. Age-related macular degeneration (AMD): A review on its epidemiology and risk factors. Open Ophthalmol J. 2020;13:90–9.

Schachat AP, Sadda SR. Choroidal vascular/Bruch’s membrane disease. Ryan’s retina. Elsevier; 2018 .p. 3859–901.

Jonas JB, Cheung CMG, Panda-Jonas S. Updates on the epidemiology of age-related macular degeneration. Asia-Pacific J Ophthalmol. 2017;6:493–97.

Wong WL, Su X, Li X, Cheung CMG, Klein R, Cheng CY, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis. Lancet Glob Health 2014;2(2):106-16. doi:10.1016/S2214-109X(13)70145-1.

Basic and clinical science course TM 12 Retina and vitreous. 2019.

Kanduri S. Current understanding of age-related macular degeneration. Internat J Retina (IJRETINA). 2020 2020;03: 92–103.

al Gwairi O, Thach L, Zheng W, Osman N, Little PJ. Cellular and molecular pathology of age-related macular degeneration: Potential role for proteoglycans. J Ophthalmol [Internet]. 2016. Available from: https://www.hindawi.com/journals/joph/2016/2913612/

Flores R, Carneiro Â, Vieira M, Tenreiro S, Seabra MC. Age-related macular degeneration: Pathophysiology, management, and future perspectives. Ophthalmologica 2021;244:495–511.

Al-Zamil WM, Yassin SA. Recent developments in age-related macular degeneration: A review. Clin Intervention in Aging 2017;12:1313–30.

Zarbin MA. Current concepts in the pathogenesis of age-related macular degeneration. Arch Ophthalmol. 2004;122(4):598-614.

Miller JW, Bagheri S, Vavvas DG. Advances in age-related macular degeneration understanding and therapy. US Ophthalmic Rev. 2017;10:119.

Priya V, Gayathri GR. Age related macular degeneration: A systematic review resorbed ridges view project trabecular implants view project. J Pharmaceut Sci Res. 2016;8:416–20.

Thomas CJ, Mirza RG, Gill MK. Age-related macular degeneration. Med Clin North Am. 2021;105:473–91.

Stahl A. Diagnostik und therapie der altersabhängigen Makuladegeneration. Dtsch Arztebl Int. 2020;117:513–20.

Ruia S, Kaufman EJ. Macular degeneration continuing education activity [Internet]. 2022. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK560778/.

Persatuan Dokter Spesialis Mata Indonesia. Pedoman nasional pelayanan kedokteran degenerasi makula karena usia. Kementerian Kesehatan Republik Indonesia; 2018.

Kim SJ. 2021-2022 basic and clinical science course, section 12: Retina and vitreous. American Academy of Ophthalmology; 2021.

Tadayoni R, Sararols L, Weissgerber G, Verma R, Clemens A, Holz FG. Brolucizumab: A newly developed anti-VEGF molecule for the treatment of neovascular age-related macular degeneration. Ophthalmologica 2021;244:93–101.

Chuan J, Liu L, Feng Y, Wang M, Li G, Lv Q. The efficacy and safety of brolucizumab for the treatment of nAMD: A systematic review and metaanalysis. Front Pharmacol [Internet]. 2022. Available from: https://www.frontiersin.org/articles/10.3389/fphar.2022.890732/full.

Downloads

Published

03-07-2023

How to Cite

Dewi, A. A. F. (2023). Tinjauan atas Age-related Macular Degeneration. Cermin Dunia Kedokteran, 50(7), 354–359. https://doi.org/10.55175/cdk.v50i7.953