Francesco Guccini and bilateral maculopathy: what is the typical disease of advancing age

It is also called “macular degeneration” and affects the most important part of the retina for vision, ie the central one, called the macula. There are two forms: for one there are effective therapies and for the other not yet

Vera Martinella

“I can’t even read the newspaper anymore and this gives me great suffering, because I read, read, read. My real profession was that of reading books”. Despite the proverbial confidentiality about his private life Francesco Guccini thus reveals, with the frankness that distinguishes him, his disease: bilateral maculopathy. “I see us walking but up to a certain point, and therefore I can no longer read – said the Modenese singer-songwriter, guest of the literary festival The city of readers in Florence -. With the computer I can because it enlarges the letters and I can also write. But how I miss reading a book! I have audio books, but they’re not the same. ”

There are no effective treatments for maculopathy

Guccini, who turns 82 today, June 14, 2022, has for years now abandoned concerts and music to devote himself to writing. Is there really no remedy for the ailment that afflicts him? “First of all, a premise is a must: it is impossible to give a clear and precise judgment without precisely knowing the individual case – he replies Lucio Buratto, scientific director of the Ambrosiano Oftalmico Center (CAMO) -. Also because there are two different forms of maculopathy: the atrophic (or dry) and the neovascular (or wet). The first is more widespread, has a slow progression and today, unfortunately, we still do not have a truly effective and decisive therapy. “Although it is a disease that initially does not create discomfort, maculopathy progresses with time and the progress of age: usually appears from the age of 60 and in Italy it affects over a million people. “Frequently the macular region of the eye (the central one) is affected by the aging processes of the retina and nearby tissues – adds Burattov -: this is why it is commonly called macular degeneration. And it is quite normal for “senile” problems to affect both eyes (as happens for cataracts or glaucoma), perhaps years later, but the disorder ends up affecting both sides “.

Bilateral maculopathy: symptoms

We are talking about a disease that affects the retina, to be exact its most important part for vision, that is the central one, called the macula. “When the cells of the macula deteriorate, the eye loses vision of the central part of the visual field, leaving the peripheral one intact – he explains. Francesco Bandello, director of the Ophthalmology Clinic and the School of Specialization in Ophthalmology of the Vita-Salute University, San Raffaele Scientific Institute of Milan -. Thanks to the macula, distinct vision is allowed, the reading of smaller characters, the perception of colors. In fact, one of the initial symptoms is metamorphopsia: the patient sees crooked lines that should be straight, such as those of the roadway or the joints of the tiles. Symptoms are often absent in the initial forms, but in advanced forms macular degeneration manifests itself with a loss of vision in the center of the visual field “.

Dark spots and trouble reading

Simply put, maculopathy deforms what the patient is observing, changing the shapes and sizes of objects or what he is staring at. Always for the same problem, when he is reading the patient will be able to perceive larger letters and others smaller, as well as placed on a curved line instead of straight. “In front of books and newspapers, then, lines and words can be perceived as not aligned but confused and crooked – continues Bandello -. Another frequent symptom is what in medical jargon is called scotoma: The patient sees a spot in the center of the visual field, which can vary from a simple blurring to a completely dark area. It appears as a more or less circular area, it is fixed (that is, it does not change position when you change where you look) and it is very annoying because it is very central. Reading it overlaps the written letters, hiding them and, if very large, it can cover a large part of faces, objects or what one looks at “.

Causes and treatments of maculopathy

For this reason, if left untreated, macular degeneration can compromise the ability to perform basic activities of daily life. And for the degree of disability that it can determine it turns out to be the leading cause of illness depression in old age. “The causes still need to be studied – explains Lucio Buratto – but many have been identified risk factors: in addition to advanced age, smoking, alcohol abuse, sedentary lifestyle, obesity, diabetes, arterial hypertension, improper diet (rich in saturated fatty acids, low in antioxidants) and high cholesterol levels increase. A genetic origin is also ascertained, given that familiarity is also one of the main risk factors, especially if it is affected by first degree relatives. “And for the treatments?” dry form, we have made many attempts, but for now we have not been able to find a cure that can stop the disease. While for that humid the goal to be achieved is the reduction or disappearance of the formation of newly formed vessels under the central retina (thus making the edema and the central spots that form disappear): today we proceed with intravitreal injections of so-called anti-VEGF drugs ( or that hinder the formation of new blood vessels) for the advancement of maculopathy “. The laser may also be useful, to stabilize the situation and prevent further visual impairment. surgery it is reserved for the most serious and complex cases.

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