Macular Degeneration (AMD)
Age Related Macular Degeneration (AMD) Treatment
Age-related macular degeneration (AMD) is a progressive condition affecting the macula - the central part of the retina that gives us fine detailed vision. As we age, there is a slow deterioration of the macula and the underlying eye wall which supports it. As a result, central vision declines. AMD is now the most common cause of visual loss in people aged 50 and over. There are two types of AMD, ‘dry’ and ‘wet’.
Dry AMD
This is the most common form of AMD and accounts for around 90% of cases. It occurs when light sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. Although usually only slowly progressive and frequently mild, it can cause profound visual loss.
Wet AMD
This is far less common but potentially more severe than dry AMD, accounting for approximately 10% of cases. It is characterised by the growth of abnormal blood vessels (choroidal neovascularisation or CNV), which leak, causing the retina to lift away from the eye wall. The macular retina then becomes swollen and vision is impaired. The earliest feature of wet AMD is an awareness of straight lines becoming distorted. In the later stages, the abnormal blood vessels can haemorrhage, producing dramatic central visual loss. Once vision is destroyed, it cannot be regained.
Living with AMD
AMD is not painful, so presenting symptoms are sometimes ignored. In the early stages of dry AMD, central vision may be blurred or distorted. People with wet AMD will see straight lines as wavy or fuzzy, while those with advanced AMD often notice a blank patch or dark spot in their central vision. Some people see lights, shapes or colours that are not there. These symptoms make it difficult to read or recognise faces. Eventually all central vision may be lost, although peripheral vision remains and patients maintain independence.
The Optegra treatment
Dry AMD
There is no actual treatment for dry AMD, but the condition can be controlled by reducing risk factors such as smoking and high blood pressure. You should protect your eyes from exposure to harmful sunlight by wearing sunglasses outdoors, and eat a diet rich in foods containing antioxidants and naturally occurring pigments, such as those found in brightly coloured vegetables like peppers, broccoli and spinach. Scientific studies have shown that, if caught in the early stages, high doses of vitamins A, C and E (together with zinc) can substantially lower the risk of both worsening of dry disease and the development of wet AMD. It is common now for these vitamin preparations to be supplemented with the protective pigments lutein and zeoxanthin. Your dedicated Optegra AMD Consultant will be able to advise you.
Wet AMD
Treating wet AMD is a highly specialised area, so you will be reassured to know that Optegra’s AMD Consultant is one of the most experienced in modern treatment techniques. In the past, the only available treatment to seal leaking blood vessels was laser surgery. This was suitable for just a small percentage of sufferers and succeeded only in limiting visual loss. The alternative now is a course of injections of an anti-VEGF drug. VEGF (vascular endothelial growth factor) is a protein that stimulates the formation of new blood vessels. Anti-VEGF drugs work against it, inhibiting vessel growth and reducing scarring. Optegra offers the most effective anti-VEGF drugs available and your AMD Consultant will discuss the best option for you. The injection procedure itself is quick and painless - the appointment usually lasts just 15 minutes. The eye is first numbed with drops. The Consultant then injects the drug through the white of the eye. Immediate blurring is common after treatment, but this soon clears.
Follow-up and aftercare
It is essential to use antibiotic drops for five days following injection, but no other special precautions are required. An improvement in vision may become apparent after the first few days, but this varies from person to person. Overall, around 90% of patients will benefit from a stabilisation in the level of vision and 30% will notice a substantial improvement.
Enhancing damaged sight
Treatment for wet AMD can halt the condition’s progress, but cannot replace lost vision. It is common for a cataract to co-exist with AMD and, whilst cataract extraction may do little to help reading vision, the improved illumination following surgery can provide a substantial benefit to overall visual function. Cataract surgery in the presence of AMD can now be enhanced by the implantation of telescopic lens systems - the so-called Intra-ocular Lens for Visually Impaired People or 'IOL-VIP'. This offers a radical and innovative solution to a previously untreatable problem.
Frequently asked questions?
Does AMD lead to blindness?
AMD almost never leads to total blindness because only the central retina is affected. However, if left untreated, it can result in only outer peripheral vision remaining, with black holes or dim images at the centre.
Is there anything I can do to avoid AMD?
People over the age of 40 should have regular eye tests every 1 to 2 years. Reducing the risk factors by eating a healthy diet, keeping blood pressure down and stopping smoking will all help prevent AMD.
What are the symptoms of dry AMD?
The most common symptom is slightly blurred vision. You may have difficulty recognising faces and need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.
What are the symptoms of wet AMD?
Distortion of central vision with straight lines appearing wavy are the cardinal symptoms. Change should be reported as a matter of urgency as the success of treatment depends upon prompt intervention.
