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Maculopathies: a risk for over 60s and diabetics

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A media tutorial promoted by Roche underlines the importance of prevention and early diagnosis

Milan – Raise awareness of the impact that age-related macular degeneration and thediabetic macular edema have not only on the lives of those affected, but also on the families of patients. Roche promoted a media tutorial in Milan that led to the discovery of two extremely disabling eye diseases, to the point of making it difficult even to feed. “Living with maculopathy today” was the subtitle of this initiative, which also aimed to tell how healthcare and caregivers take charge of those who are faced with progressive damage to the central part of the retina.

When it comes to age-related macular degeneration (AMD) you have to distinguish between two forms: the first, defined dry, consists in the accumulation of waste under the retina, which undergoes a slow thinning; the second instead has a very rapid course and for this reason it is considered more serious. It’s about degeneration neovascolare, in which blood vessels overgrow under the macula causing swelling that causes dark spots in vision, blurring and distorting shapes and colors. The specific causes that trigger this type of corruption are not known. To date, only the risk factors are known, and the main one is precisely age: patients are mostly over 60. In Italy the most affected group is between 65 and 69 years old, with another peak of cases among the over 85s, also due to the high presence of comorbidities. Smoking and genetics affect the development of the pathology; those already familiar with AMD are more likely to get sick.

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Similar in effect, but different in cause, is thediabetic macular edema (DME). In this case the relationship with diabetes is evident. This means, however, that damage to the retina it can occur at any age. Prevention then becomes fundamental, as he underlined Leonardo Mastropasquadirector of the Ophthalmological Clinic of the “Gabriele D’Annunzio” University of Chieti: “Si should see an eye doctor once a year every year after age 40, but in the case of diabetic patients it is very important to consult specialists. Even if you don’t have symptoms, having an optical coherence tomography means examining the macula to see if there are any changes at an early stage.”

Both in the case of AMD and DME a complete remission of the disease is currently not possible. Since the basis of the two pathologies is the proliferation of blood vessels, the available therapies consist of cycles of intravitreal injections of drugs that block the growth factor of the vascular endothelium. Very often, however, patients decide not to undergo the treatment anymore. “On the one hand there is the fear of pain – he explained Francis Bandello, director of the San Raffaele Ophthalmology Unit in Milan – on the other hand there is the profound discomfort that these people experience both psychologically and at home. In fact, it often happens that the patient says ‘I no longer come to be examined so as not to burden my relatives'”.

The biggest problem AMD and DME cause is disability. Anyone who develops one of the two pathologies experiences the progressive loss of central and detailed vision, with a significant impact both on everyday life and on the psyche. “Perhaps the worst case is that of edema – Mastropasqua continued – because it is not linked to age and therefore also affects young patients who suddenly can no longer work. Of course, neovascular macular degeneration also creates psychological difficulties, because elderly people find themselves in the condition not only of not being independent, but also of not being able to see their grandchildren, for example. There is a lot of suffering. In the centers that take care of these patients, it becomes psychological support is essential“.

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This is also why Roche is carrying out such events. Commitment to communication and scientific research go hand in hand with the aim of spreading knowledge and awareness in those who could develop these pathologies in the future. “Only in this way can delays in the approach of the disease be avoided,” added Bandello. The combination of prevention, cutting-edge therapies and early diagnosis can blaze a new trail for today’s and tomorrow’s patientsaware that living better and better with the pathology is possible.

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