[Age-related macular degeneration; therapeutic options]

The prevalence of age-related macular degeneration varies from 1% in patients aged 65 to 74 years, to 10% in patients aged 85 years and older. In the Netherlands, there is now a total of around 55,000 patients with age-related macular degeneration, and this figure is expected to rise to approximately 114,000 by 2025. Loss of central vision is caused by a degeneration of photoreceptors cells and pigment epithelium. Age-related macular degeneration is subdivided into a dry, atrophic form and an exudative form with neovascularisations. Many international studies have been published over the past ten years on potential new therapies for neovascular macular degeneration. For conventional laser treatment, it has been shown that visual loss in the long term is less marked in the treated group than in the observation group, despite the immediate destruction of the retina. Photodynamic therapy seems a promising new form of local therapy with few side-effects. For both therapies, however, the indication is limited to patients with the classic type of neovascularisation. Data on radiotherapy, submacular surgery and macular translocations are not sufficiently well-founded for firm conclusions to be drawn.