[Age-related macular degeneration (AMD)--therapeutic possibilities and new approaches]

Age related macular degeneration (ARMD) is one of the leading causes of irreversible vision loss in patients over 65 years of age. Nearly 30 percent of persons over 75 years of age will suffer from ARMD. The etiology is not yet fully understood. Besides age, many risk factors such as gender, arterial hypertension, arteriolosclerosis, elevated serum lipids, smoking, alcohol abusus, and exposure to UV light are being discussed. Genetic factors are certainly involved as well; familiar predisposition is assumed in more than 50 percent of cases. White individuals are more affected than colored ones. Predisposing ocular signs are macular drusen, focal hyperpigmentation, and light eyes. In this review, anatomical, pathophysiological and fluorescein-angiographic features and the clinical classification of exudative and dry stages of ARMD are described. Concepts of management of ARMD include pharmacological measures, laser treatment, photodynamic therapy, and surgery including excision of submacular choroidal neovascular membranes and macular translocation. Success rates of any therapeutic method are very limited. Low vision aids are promising by improving quality of life in many cases.