Age-related Macular Degeneration (AMD)

About Age-related Macular Degeneration (AMD)

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 Age-related Macular Degeneration (AMD)

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.

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.

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.

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.

Age-related Macular Degeneration (AMD) Specialists

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Dubai
Abu Dhabi

Dr. Ammar Safar

Chief Medical Officer and Consultant Ophthalmologist & Vitreoretinal Surgeon

Dr. Ammar Safar is an American Board-Certified Ophthalmologist specialising in vitreoretinal diseases and surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. He is currently an adjunct Professor of Ophthalmology at Mohammad Bin Rashed University and the Chief Medical Officer of Moorfields Eye Hospitals in the United Arab Emirates. Dr. Safar undertook his medical training in Syria before moving to the United States for post-graduate training. He specialised in Ophthalmology at Georgetown University in Washington, DC, where he also served as a Chief Resident. He then acquired an additional 2-year fellowship training in Vitreoretinal Diseases & Surgery at the University of Texas, Southwestern Medical Center in Dallas, Texas, USA. Dr. Ammar then went on to hold the position of Assistant and later Associate Professor and Director of Vitreoretinal Surgery at the Department of Ophthalmology, Jones Eye Institute, the University of Arkansas for Medical Sciences, in the United States. He then relocated to the UAE, where he was a Consultant Vitreoretinal Surgeon and President of Medical Staff at a private general hospital in Dubai. In addition to his work in private practice, Dr. Ammar has undertaken research and clinical trials in areas such as diabetic retinopathy and age-related eye diseases and published and presented extensively. His research has also resulted in advances in retinal vascular diseases (discovering new management options for diabetic retinopathy and vascular occlusive disorders) and macular degeneration (new approaches for treating exudative macular degeneration). Among his many honorary awards, Dr. Ammar was the inaugural recipient of The Martha Wood Bentley endowed Chair of Ophthalmology at the University of Arkansas. He is a member of several professional associations, including the American Academy of Ophthalmology, the American Society of Retina Specialists, the European Society of Retina Specialists, the American Society of Cataract and Refractive Surgery, The Association for Research In Vision and Ophthalmology (ARVO), Arab-American Medical Association, Research to Prevent Blindness, and a fellow of the American College of Surgeons.

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Dr. Fahd Quhill

Consultant Ophthalmologist in Medical Retina and Ocular inflammatory disease (Uveitis)

Dr Fahd Quhill is a Consultant Ophthalmologist specialising in Medical Retina and Ocular inflammatory disease at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr Fahd specialises in the assessment and management of uveitis and inflammatory eye diseases (uveitis, infectious diseases, autoimmune diseases of the eye) as well as medical retinal disease, such as diabetes, macular degeneration, inherited retinal disease and retinal vascular disease. He has broad experience in the diagnosis and management of complex inflammatory eye diseases, including the use of immunosuppression, as well as in treating retinal disease. Dr. Fahd trained in Ophthalmology in the United Kingdom at Oxford, Birmingham and London, completing three Medical Retinal Fellowships in Birmingham, Wolverhampton and Moorfields Eye Hospital, London. He has undertaken research and served as principal investigator in numerous macular degeneration, retinal vein occlusion and diabetic macular oedema trials. He has published 27 research papers on retinal and ocular inflammatory disease in leading journal/s such as Ophthalmology, British Journal of Ophthalmology and Eye, among others. He is a member of several professional bodies, including the Royal College of Ophthalmologists.

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Dr. Luisa M. Sastre

Consultant Ophthalmologist in Medical Retina and Cataract Surgery

Dr. Luisa Sastre is a Consultant Ophthalmologist in Medical Retina and Cataract Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Luisa holds a Spanish medical degree from the Universidad Autonoma Medical School and completed her ophthalmology residency at Hospital Universitario Gregorio Maranon in Madrid, Spain . She is board certified in Intensive Care medicine and ophthalmology. She also holds a PhD from Universidad Autonoma de Madrid and a Master’s degree in Healthcare Organisation Leadership from ESADE Business School. She has more than 20 years of combined regional and international experience in countries including Spain and UAE. She has practised in leading medical institutions such as Hospital Universitario Fundación Jiménez Díaz and Hospital Universitario El Escorial, Madrid, Spain. She has presented various papers in national and international congresses and journals and organised educational courses on cataract surgery and medical retina for peers and opticians. She is a member of “Surgical Eye Expeditions International”, a nonprofit humanitarian organisation that hosts clinic sites worldwide. She is also a member of Sociedad Española de Oftalmologia (SEO). In addition to her clinical work, Dr. Luisa volunteers in various charitable campaigns worldwide to treat patients suffering from cataracts who otherwise have difficulty accessing medical care.

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Prof. Ziad Bashshur

Visiting Consultant Ophthalmologist in Medical & Surgical Retina

Dr. Ziad Bashshur is a visiting Ophthalmologist specialising in Medical and Surgical Retina at Moorfields Eye Hospital Dubai in Dubai Healthcare City. He holds a Doctor of Medicine Diploma from the American University of Beirut (AUB) in 1994. He has also completed an internship in internal medicine at Georgetown/VA medical center (1994-1995) followed by ophthalmology residency training at AUB (1995-1998) and a vitreoretinal fellowship at the University of Virginia, USA. He has more than 22 years of regional/international experience in vitreoretinal diseases and surgery in countries including United States and Lebanon. In his career, he has practiced in leading medical institutions such as American University of Beirut in Lebanon and University of Virginia in the US. He is currently a tenured professor and vice-chairman of Ophthalmology at the American University of Beirut. Dr. Bashshur has undertaken research in retinal diseases and has published over 50 research papers on macular degeneration, diabetic retinopathy, vascular diseases of the retina and retinal imaging in leading journals. In addition, he sits on several advisory boards within the medical industry. He regularly speaks at professional meetings worldwide and serves on the review board of several renowned peer-reviewed ophthalmology journals. He is a member of the American Society of Retina Specialists (ASRS), Retina Society and Alpha Omega Alpha Honor Society

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Dr. Avinash Gurbaxani

Visiting Consultant Ophthalmologist in Uveitis and Medical Retinal Diseases and Cataract Surgery

Dr. Avinash Gurbaxani is a visiting Consultant Ophthalmologist, specialised in Uveitis, Medical Retina & Cataract surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Avinash specialises in the assessment and management of uveitis and inflammatory eye disease (uveitis, infectious diseases, autoimmune diseases of the eye) as well as medical retinal disease, such as diabetes, macular degeneration and retinal vascular disease. He has broad experience in the diagnosis and management of complex inflammatory eye diseases, including the use of immunosuppression, as well as in treating retinal disease. Dr Gurbaxani is also skilled in managing complex cataract surgery associated with these diseases. Dr. Avinash trained in ophthalmology in Oxford and London, working at The Oxford Eye Hospital in Oxford, Kings College Hospital, St. Thomas’ Hospital and Moorfields Eye Hospital in London. He has worked at the prestigious Medical Eye Unit in London as well as completing a Uveitis Fellowship and Medical Retina Fellowship at Moorfields London and the Sydney Eye Hospital in Australia, before returning to Moorfields London as a locum consultant. Dr. Avinash is experienced in initiating research projects and running clinical trials, and has regularly published and presented papers at national and international conferences. He is a member of several professional bodies including the Royal College of Opthalmologists (RCOphth), Royal College of Surgeons of Edinburgh (RCS) (Ed), American Academy of Ophthalmology (AAO).

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Dr. Wajiha Kheir

Visiting Consultant Ophthalmologist in Medical Retina and Ocular Oncology

Dr. Wajiha Kheir is a visiting Assistant Professor of Ophthalmology and Consultant Ophthalmologist, specialised in Medical Retina and Ocular Oncology at Moorfields Eye Hospital Dubai in Dubai Healthcare City. Dr. Wajiha completed her undergraduate studies and medical education at the American University of Beirut, Lebanon. She was awarded the BSc degree in Biology (2009) with high distinction and the Penrose Award, and the MD degree (2013) with induction to the Alpha Omega Alpha (AOA) – Honor Medical Society. She then completed a year of Internal medicine Internship followed by three years of Ophthalmology residency at the American University of Beirut Medical Center (2017). Her subsequent sub-specialty training includes one year of Medical Retina fellowship and one year of Ocular Oncology with Clinical Pathology Concentration fellowship, both at the Duke Eye Center, Duke University School of Medicine. She has more than five years of regional and international experience in Medical Retinal and Ocular Oncology in the United States and Lebanon. In her career, she has practiced in leading medical institutions such as Duke University Health System and the American University of Beirut Medical Center. Dr. Wajiha has eighteen peer-reviewed journal articles and 10 book chapters published. To date, her research work has been presented in over twenty posters and/or paper presentations at regional and international conferences. Her research interests relate to age-related macular degeneration, ophthalmic oncology, radiation retinopathy as well as retinal degenerations and electrophysiology of vision. She is a member of the AOA Medical Honor Society, the American Academy of Ophthalmology, the American Society of Retinal Specialists and the International Society of Ocular Oncology.

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Dr. Ramzi Ghanem

Consultant Ophthalmologist in Medical Retina, Vitreoretinal and Cataract Surgery

Dr. Ramzi Ghanem is a Consultant Ophthalmologist with extensive experience in cataract surgery as well as medical and surgical retina including the full spectrum of vitreoretinal surgery, intravitreal drug injection and laser treatment. Dr. Ramzi is a graduate of the University of Leipzig, Germany and completed his 2 doctoral thesis on anti-VEGF isomers in AMD (Age-related Macular Degeneration) at the University of Leipzig and predictors for short term visual outcome after anti-VEGF therapy of CSME due to CRVO at the University of Bern, Switzerland. He has more than 20 years of experience in Germany, Switzerland and UAE. He has researched extensively, conducted clinical trials, published and lectured on his areas of expertise. He has been a HAAD consultant and examiner for licensure in ophthalmology.

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