Macular Degeneration

What is Age-related macular degeneration (AMD or ARMD)?

Age-related macular degeneration (AMD) is a condition that typically affects older people, usually over the age of 60 years. It is the leading cause of blindness for this age group.

Macular degeneration (MD) causes a painless loss of central vision, with possible distortion (straight lines look bent, words jumbled) affecting the ability to see fine detail, drive, read and recognise faces. Peripheral vision (side vision) is not affected.

There are two forms of macular degeneration: Dry and Wet

Dry MD:

When cells in the retinal pigment epithelium die, the retinal cells above them also die, leading to patches of “missing” retina, known as atrophy. This is Dry AMD. It is a slower form of the disease that causes a gradual loss of vision over months to years. It does not cause a sudden vision loss so if you have Dry AMD and you notice a sudden change in vision then this may indicate you are developing wet MD. It is important you see your Ophthalmologist immediately.

Wet MD:

This form of the disease occurs when the retinal pigment cells fail to stop the choroidal blood vessels from growing into the retina. When these cells enter the retina, they grow wildly and they leak fluid and blood into the retina, leading to scarring and loss of vision. If left untreated, rapid and severe loss of central vision can occur within a short period of time. However, with newer treatments the loss of vision can often be slowed and in many cases reversed.

What are the risk factors for MD?

Although the exact cause of AMD is unknown, the main risk factors appear to include:

  • Increasing age
  • Smoking
  • A family history of MD

What are the symptoms of MD?

Depending on the specific form of MD symptoms can vary. Some possible symptoms include:

  • Blurred vision
  • Distorted (wavy) vision
  • Patches or shadows of missing areas of your vision
  • Loss of colour perception

What are the treatment options for MD?

Currently there are no medical treatments available for Dry MD, however there is treatment for Wet MD. Therefore treatment is aimed at prevention and early detection of Wet MD.

Prevention:

It is possible to reduce the risk and progression of Dry MD by:

  • Ceasing smoking
  • Eating a diet rich in fresh fruit and dark green leafy vegetables (spinach, brussel sprouts, broccoli) as well as brightly coloured fruit and vegetables (corn, capsicum, carrots)
  • Increasing your uptake of omega 3 rich foods, such as fish
  • In consultation with your ophthalmologist supplementing your diet with vitamins, minerals and antioxidants
  • Controlling cholesterol and blood pressure levels

Early Detection:

Early detection of Wet MD is vital because we now have treatment options available that give excellent results if implemented early in development. The earlier Wet MD is detected, the better the visual prognosis. Self-monitoring of your central vision with an Amsler grid is an excellent way to detect a change in your macula’s health.

Wet MD treatment

Anti-VEGF Treatment (Lucentis/Eylea/Avastin): A chemical in the body called vascular endothelial growth factor or VEGF, is critical for causing the growth of abnormal blood vessels under the retina. Recently, Scientists have developed different drugs (called anti-VEGF) that can block the VEGF. Blocking the VEGF reduces the growth of abnormal blood vessels, slows their leakage and helps to slow vision loss.

The eye is made numb with local anaesthetic and the anti-VEGF drug is be injected into the jelly (vitreous) of the eye with a very fine needle. Usually patients receive multiple anti-VEGF injections over a period of many months to help improve vision and slow vision loss. As with any procedure there is a small risk of complications, usually resulting from the injection itself. For most people the benefit of the treatment outweighs the risk involved. The overwhelming majority of patients are treated with these injections.

Download an Amsler grid (pdf)

Download this information: Macular degeneration (pdf)