The Macular Degeneration related to the Age is the cause of the evil clairvoyance the most spread in the developed countries. She(it) would reach(affect) the 20 % of the population according to certain estimations.
This dimmed vision appears generally after the age of 50 years; she(it) is due to the destruction of cones and sticks, when dirtied her(it) is reached(affected) it is the loss of the vision fine as the reading and the writing or the vision of the TV screen.
Dirtied her(it), trained(formed) only by cones, is the part(party) of the retina situated in front of the pupil(ward). In the visual axis, she allows to see the finest things. It is her(it) who assures(insures) the reading and the writing. The rest of the retina, trained(formed) essentially by sticks, assures(insures) the overall view, the movements, the visual field.
In practice, the subjects never become blind, they keep(guard) a visual field allowing them to attend to their daily activities(occupations), excepted(except) any fine vision as the reading and the writing.
The real cause of the disease remains hypothetical:
* A vascular cause seems undeniable. A general vascular problem, a cardiac problem, a problem blood pressure, have a major role.
* Several environmental factors were incriminated: the smoking, the high rate of cholesterol and the photo toxicity by sun exposure (action(share) of the free radicals).
* Recently a genetic factor was suggested on three essential arguments: ‘ observation(case report) of the homozygous twins, a family aggregation for the disease, and the link enters drusen dominant and drusen aged-related. This genetic peculiarity would be located(localized) on the gene AB CR.
This death of the visual cells is secondary in the degeneration of the cells of the pigmentary epithelium. In fact the name of DMLA includes this process of change of the cells of the pigmentary epithelium, the sticks and the cones, of the membrane of BRUCH and the production of drusen (verrucoses body colloids), as well as neovessels under retinal which appear to a late stage. It is these neovessels which we treat(handle) by the photocoagulation in the laser.
These changes are however observed collectively, in a lesser degree, in the eyes of practically all the elderly subjects and increase in intensity with the age. To some subjects, they progress up to the stage of cell death, with functional infringement(achievement). The DMLA would thus be a late stage of the process of chorioretinal deterioration arising at all the subjects. His(her,its) clinical expression is more important at the person genetically predestined.
.DMLA and SMOKING(TOBACCO):
In a letter published in British Medical Journal (British Medical Journal, flight(theft) 327, pp.1458-59 – Smoking(Tobacco) News, N°43) Simon Kelly, British ophtalmologist, reminds that ” the smokers present a three times as high risk of DMLA that the non-smokers “. He underlines
He also underlines that if they expose(explain) themselves to a greater risk of DMLA, they may also develop the disease 10 years earlier than the non-smokers. More often thus, but also earlier…
The fact of stopping smoking is always beneficial. ” At the ex-smokers, the risk of DMLA is not more than slightly increased (36 %) by contribution to individuals who have never smoked. ” Let us remind finally that the smoking would be at the origin of 20 % of the causes of blindness to most than 50 years.
