Today, one of the more prevalent eye problems in Thailand is age-related macular degeneration (AMD), which affects 18,700 people a year.[1] and Diabetic Macular Edema (DME), which affects 536,700 people a year.[2] This is due to the stepping into an aged society since 2021.[3] The health problems of the aging population are inevitable about the deterioration of the eyes. coupled with the way of life of the working-age population that may be less active Loves sweet food and beverages. causing high blood sugar levels to cause diabetes Such eye problems can affect vision and daily life. Therefore, it is important to understand the risk factors. Watch out for early warning signs. and regular visits to an ophthalmologist for eye exams therefore it is necessary
Dr. Thanaphong Somkitrungroj, MD. Ophthalmologist in Retina and Iritis Chulalongkorn Hospital, Thai Red Cross Society and Chairman of the Cataract and Refractive Surgery Club of Thailand has shared information about eye diseases, the latest treatment guidelines. Including tips on how to take care of just one pair of eyes to have good vision quality and stay with us as long as possible.
Symptoms and consequences of both macular degeneration (AMD) and diabetic retinopathy (DME) are diseases caused by abnormal blood vessels in the retina. and make vision worse
Age-related macular degeneration (AMD) is caused by abnormalities in the blood vessels beneath the retina. There are two types of macular degeneration: dry (Dry AMD) and wet (Wet AMD or nAMD). The wet type is more common in people aged 55 years and over.
Diabetic macular edema (DME) is caused by high blood sugar levels. causing the blood vessels in the retina to be abnormal resulting in swelling of the retina It is found at any age and is also the number one cause of vision loss in people with diabetes.[4]
disease risk factors
Risk factors for macular degeneration in the elderly There are both inevitable factors such as increasing age. and factors that can be adjusted, such as quitting smoking Risk factors for diabetic retinopathy include duration of diabetes, high blood sugar levels, high blood pressure, obesity, or gestational diabetes.
Medical evolution for more effective results
About 10 years ago The main treatment guidelines for retinal diseases This includes age-related macular degeneration and diabetic retinopathy, namely the use of lasers. Such methods often cannot improve vision much. But the use of lasers can help slow the progression of the disease. In particular, the drug is injected into the vitreous. The drugs, called anti-VEGF drugs, have a mechanism of action to reduce the proliferation of retinal blood vessels. As a result, the patient’s vision quality can be improved. However, effective vision improved. Patients need to be injected into the vitreous, with the frequency of each injection being different. Some patients require frequent injections every 1-2 months, which causes consequences for both the patient and the caregiver. especially those whose distances from homes and hospitals are very far apart. or in each province As a result, patients with poor vision need to rely on the assistance of their caregivers who may need to take time off from work.
Dr. Thanapong explains, “Innovative treatment for macular degeneration in the elderly and diabetic retinopathy with injections has been greatly improved. recently Drugs with a new mechanism of action (mechanism of action) approved by the Food and Drug Administration (FDA) as a dual pathway inhibitor (inhibits both VEGF and ANG 2, which play an important role in the disease process). Helps reduce the proliferation of blood vessels It also helps to reduce the leakage of blood vessels. reduce inflammation of blood vessels and make the blood vessels that supply the retina to be stronger From the point of view of an ophthalmologist This mechanism of action can be considered a major therapeutic change. coupled with the ability to work longer than the original drug thus reducing the frequency of injections. Based on clinical research results[5],[6] It was found that 80% of the patients who volunteered in the study received injections every 12 weeks (every 3 months), while the other 60% received injections every 16 weeks (every 4 months). This new approach can help improve patient care.”
As for safety and side effects Based on clinical trial results in more than 2,300 patients and patients who have experienced real-world drug exposure in the United States for approximately 70,000 doses7 since the drug was approved by the Commission. The US Food and Drug Administration (US FDA) has not found any difference in side effects between new innovative drugs and conventional injectable drugs in the past. Some elderly people in Thailand have had the opportunity to use this innovative drug. but there are not many Because the drug has just been approved in the country. Patients who can use this innovative drug There were both diagnosed patients who had not received any medication before. and in patients unresponsive to the original drug or patients who want to reduce the frequency of injections This is a new hope for patients in these retinal diseases,” Dr. Thanapong added.
cases of diabetic retinopathy If the patient is treated with new innovations along with controlling blood sugar levels Symptoms tend to improve within 3-5 years, and there is a high chance that patients will be able to stop taking the medication. For patients with macular degeneration in the elderly Although the likelihood of discontinuation of the drug was less than in patients with diabetic retinopathy. But drugs that can reduce the frequency of injections. It helps to make the quality of life of patients much better.
In the future, it is believed that there will be continuous innovations and new technologies in the treatment of this disease, such as longer-acting drugs, drugs with a different mechanism of action than existing drugs, surgery to insert tools that help. in drug release This made it possible to reduce injections to one to two times a year, using treatment planning technologies such as AI (Artificial Intelligence) to see which patients would respond to which drug classes. All of which result in a better quality of life for patients.
Eye diseases that can be prevented
Dr. Thanapong said, “Both diseases are caused by abnormalities in the blood vessels in the retina. This is likely to happen suddenly and may only occur in one eye. Some patients may not feel pain or pain in the eye area. And if observed from the outside, they may not be able to notice abnormalities in the eyes. Therefore, eye disease is considered a silent threat. Because most patients understand that blurry vision is a result of a change in eye or eyeglass settings.”
For people with risk factors for macular degeneration in the elderly and diabetic retinopathy Behavior and disease control should be adjusted as well. Avoid eye rubbing or eye massage, refrain from smoking, maintain a healthy weight, control blood sugar levels.
How can people assess visual impairment on their own?
“Anyone can easily screen for vision disorders on their own by simply closing their eyes one at a time. Then look at the edge of the door or window frame. If you see distorted lines or blurry spots Should consult an ophthalmologist immediately. If over 45 years old, should have regular eye exams with an ophthalmologist at least once a year to get access to treatment in a timely manner. and reduce vision loss Because clear vision is crucial to quality of life.”
Dr. Thanapong concluded with Dr. Thanapong Somkitrungroj Ophthalmologist in Retina and Iritis Chulalongkorn Hospital, Thai Red Cross Society and Chairman of the Cataract and Refractive Surgery Club of Thailand