Age-related Macular Degeneration (AMD)

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About

The central part of the retina (at the back of the eye) is called the macula and it has an important function as it controls the quality and sharpness of the central part of our vision.

Macular degeneration is a condition that affects the macula resulting in distortion or sometimes loss of central vision (not the peripheral vision) and this can cause problems, when it comes to everyday tasks such as reading and driving.

The good news is that the deterioration of vision usually happens quite slowly.

However, there are two types of macular degeneration – ‘wet’ and ‘dry’ – and what is known as the ‘wet’ form results in a sudden loss of central vision, which is a medical emergency and urgent treatment is needed.

Macula

The macula is a small, extremely important area at the centre of the retina, the light-sensing tissue at the back of the eye and is responsible for seeing fine details clearly.
With AMD (Age-related Macular Degeneration), you lose the ability to see fine details and lose the ability to distinguish details.
AMD (Age-related Macular Degeneration) affects only the central vision. Side and peripheral vision usually remains normal. For example, people with AMD gradually lose the ability to recognise people’s faces.

Types of AMD (Age-related Macular Degeneration)

There are two types of AMD (Age-related Macular Degeneration).

Dry AMD: Most people (about 75%) have a form called “early” or “dry” AMD, which develops when there is a build-up of waste material under the macula and thinning of the retina at the macula. Most people with this condition have near normal vision or milder sight loss in the initial stage. 10% of patients with dry AMD can progress to wet AMD.

Wet AMD: Wet AMD occurs when abnormal blood vessels grow underneath the retina and leak blood and fluid, which can prevent the retina from working properly. Eventually the bleeding and scarring can lead to severe permanent loss of central vision, but the eye is not usually at risk of losing all vision (going ‘blind’) as peripheral vision remains intact. Symptoms of wet AMD include sudden central blurriness and distortion, where straight lines appear as wavy (metamorphopsia).

A late stage AMD is called geographic atrophy, where vision is lost through severe thinning or even loss of the macula tissue without any leaking blood vessels.

Causes

AMD is a result of aging, but it has also been linked to a various other risk factors such as being overweight, having high blood pressure, smoking, and having a family history of the condition.

Symptoms

As AMD progresses, many individuals see a foggy or blurry area close to the center point of their vision. After some time, this foggy area may get larger or you may see empty spots. Things may likewise appear to be less bright than previously.

A few individuals may likewise see that straight lines begin to look wavy. This can be a warning sign for late AMD.

Treatment

Intravitreal injections (injections into the eye) for wet AMD use a medicine called anti-VEGF of which there are 2 licensed versions Eylea and Lucentis.

When anti-VEGF medicines are injected into the eye on a regular basis, it can stop the abnormal blood vessels growing, leaking and bleeding under the retina.

Most people with wet AMD need to have these injections several times a year, so patients need to get their care closer to home. Laser treatment is also available for specific forms of AMD, but is not effective for most cases.

As for dry AMD, there is currently no treatment available. Special blend of vitamins are recommended to reduce the risk of progression.