{"id":7681,"date":"2023-04-27T16:35:47","date_gmt":"2023-04-27T14:35:47","guid":{"rendered":"https:\/\/www.institutmacula.com\/patologia\/dmae-exsudativa\/"},"modified":"2025-09-02T19:05:55","modified_gmt":"2025-09-02T17:05:55","slug":"dmae-exsudativa","status":"publish","type":"patologia","link":"https:\/\/www.institutmacula.com\/en\/pathology\/dmae-exsudativa\/","title":{"rendered":"Exudative AMD"},"content":{"rendered":"\n

Age-related macular degeneration (AMD), a progressive degeneration of the macula, is the leading cause of vision loss in the Western world in patients over fifty years old. Currently, more than 25 million people suffer from this condition worldwide, with around 500,000 new cases each year. It is a disease with a genetic basis, although epigenetic factors\u2014such as lifestyle habits and environmental influences\u2014play a key role in modulating the disease, either mitigating or aggravating it. Among the most significant epigenetic factors is the role of gut microbiota. In this regard, the Institut de la M\u00e0cula is a pioneer in researching the impact of microbiota on the progression of different forms of wet AMD<\/strong>.<\/p>\n\n\n\n

There are many subclasses of AMD, with varying degrees of severity, progression, and prognosis. There are 3 stages: early AMD, intermediate AMD, and advanced AMD. In early AMD, small deposits of waste accumulate in the outer layers of the retina due to malfunctioning retinal cells, particularly the retinal pigment epithelium. In intermediate AMD, these deposits become larger, visible degenerative changes appear in the cells, and visual function begins to be affected. In advanced AMD, the final stage is atrophy\u2014cell death in the retina leading to the loss of visual capacity. The speed of this atrophy depends on the subtype of AMD (phenotypes), but in the medium term, it leads to irreversible loss of central vision. This process can take a few years. As a reparative defense mechanism, many eyes develop wet, exudative, or neovascular AMD<\/strong>.<\/p>\n\n\n\n

The term \u201cdry AMD\u201d is often used, but it can be confusing, as some use it to refer to intermediate AMD, while others equate it with atrophic AMD.<\/p>\n\n\n\n

Unfortunately, this reparative attempt by the body to prevent atrophy is almost always out of control. These abnormal neovessels must be treated to prevent the irreversible damage caused by their leakage into the retina. Immediate treatment is required to prevent irreversible destruction of central vision in a short period (weeks or months). However, if these neovessels are treated in time and \u201ctamed,\u201d their previously chaotic exudative nature can become a secondary circulation that helps prevent atrophy\u2014provided they are continuously treated and kept non-exudative over the long term, for years.<\/p>\n\n\n\n

Characteristics of wet AMD<\/strong><\/p>\n\n\n\n

The disease causes bleeding and fluid leakage within the layers of the retina, primarily in the central area, the wet macula<\/strong>. These hemorrhages are caused by small abnormal veins (choroidal neovessels) that invade the retina from the layer beneath it (the choroid), eventually destroying the neural structure of the macula and causing vision loss at the very center of the visual field.<\/p>\n\n\n\n

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