Retinal degeneration usually develops with age and may also be related to genetic causes. As a rule, this pathology is difficult to treat, and visual impairment is considered irreversible. Doctors in Germany use the latest treatment methods that provide good results. Vision can not only be stabilized but also improved. Clinics in Germany use anti-VEGF therapy, gene therapy, retinal cell transplant, stem cell transplant and other methods that are not yet available or are used to a limited extent in countries with poorly developed medicine.
Content
- Standard treatment
- Innovative treatment
- Stem cell therapy
- Treatment of retinal detachment
Anti-VEGF therapy is considered the first-line treatment. Laser photocoagulation is often performed, and retinal detachment may require surgical treatment. Some clinics offer gene therapy for retinal degeneration. If standard methods do not work, ophthalmologists resort to retinal and stem cell transplants.
You can undergo treatment in one of the following hospitals: University Hospital Rechts der Isar Munich, University Hospital Ulm, Charite University Hospital Berlin.
Please leave your request on the Booking Health website by attaching the available medical records to the form. The Booking Health medical advisor will recommend a treatment method, a clinic and a doctor. Travel managers will take care of obtaining a visa, arranging airline tickets and accommodation, medical insurance, interpreter's accompanying and other issues.
Standard treatment
The main treatments for retinal degeneration used in most patients are described below.
Conservative therapy involves the intake of anti-inflammatory drugs, glucocorticoids, carbonic anhydrase inhibitors to reduce edema, antioxidants, and lipid-lowering therapy to improve the condition of blood vessels.
Laser coagulation is used to destroy pathological newly formed vessels. Approximately 20% of cases are considered suitable for laser coagulation. The procedure helps the patient to reduce the risk of retinal detachment.
Photodynamic therapy replaces laser photocoagulation as a safer alternative. Doctors inject a sensitizer and then apply light to the membrane. The procedure is not very common, and it is used only in specialized centers.
VEGF inhibitors are used as first-line therapy in Germany. The drugs are injected into the eye and block the development of new blood vessels. They not only prevent vision loss but also increase its acuity.
Innovative treatment
In severe cases, as well as in some types of retinal degeneration, doctors resort to the use of innovative techniques that can improve vision and stop the progression of the disease.
Gene therapy. Many patients with retinal degeneration have a mutation in the RPE65 gene, which codes for an important enzyme in the visual pathway. With AAV vectors, a healthy copy of the RPE65 gene is introduced into the patients' cells. After a single injection into the subretinal space, vision improves, and the best results are observed in children. These successes have led to the fact that gene therapy drugs are already being used in clinical trials for other forms of retinal degeneration: choroideremia, achromatopsia, X-linked retinoschisis, Stargardt disease, Usher syndrome.
Retinal cell transplant. It refers to innovative treatment methods that have not yet entered into clinical practice but have proven themselves in clinical trials. Doctors perform photoreceptor transplantation. These are light-sensitive cells that transmit visual signals to the brain. They are transplanted from a donor. The procedure is carried out at the advanced stage of the disease.
Autologous retinal transplant. The procedure is carried out in case of large retinal holes for their closure. The operation provides replacement of nervous tissue in the macula, restores the retina's anatomical structure, and improves visual acuity.
Stem cell therapy
A promising area of treatment is the use of stem cells. They can be donor ones or the patient's own cells. Cells can be injected both intravenously and locally (into the eye). Studies show that stem cells increase visual acuity and at the same time, do not cause proliferative changes – pathological tissue growth in the injection area. Complications in the form of the appearance of epiretinal membranes are rare, but they can be successfully treated.
Impressive results were obtained in the Kahraman study. The scientists injected mesenchymal stem cells into the suprachoroidal region. As a result, vision improved in 46% of patients, visual acuity stabilized in another 42% of treated patients, and retinal degeneration stopped.
To date, stem cells are not part of the standard treatment. In some clinics in Germany, they are already used in clinical trials. Cellular therapy is used in cases where other treatment options cannot provide the patient with good results.
Treatment of retinal detachment
Over time, retinal degeneration can lead to retinal detachment. The following methods can be used to treat this condition:
- Extrascleral filling – local or circular. The retinal defect closes, and the organ approaches the choroid due to pressure.
- Cryopexy is the freezing of the posterior segment of the eyeball. As a rule, this is not an independent procedure but an addition to the filling.
- Vitreoretinal surgery is a surgical treatment of retinal degeneration with detachment used in severe cases. During the operation, doctors bring the retina close to the vascular part and fix it.
You can undergo high-precision diagnostics and innovative treatment of retinal degeneration in Germany by booking a medical care program via the Booking Health service. Our website presents current prices. They are reduced for you due to the lack of additional coefficients for foreign patients. On the Booking Health website, you can find out the cost of surgery and conservative procedures in different clinics in Germany to compare the cost and book the medical care program at the best price. Our specialists will help you select an Eye Center and arrange your trip.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Open Ophthalmology Journal
Ophthalmology Times
Medical News Today
