Age Related Macular Degeneration

Have you heard of age-related macular degeneration (AMD)?

Understanding Age-Related Macular Degeneration (AMD)

Age-Related Macular Degeneration (AMD) is a leading cause of sight loss in the UK, affecting millions of people, particularly those over the age of 50. It is a condition that can cause the central vision to deteriorate, impacting everyday activities like reading, driving, and recognising faces.

What is Age-Related Macular Degeneration (AMD)?

AMD is an eye condition that affects the macula, the small central part of the retina responsible for sharp, detailed vision. As people age, the cells in the macula may break down, leading to a loss of central vision. AMD does not affect peripheral (side) vision, meaning those with the condition can still see objects around them, but central vision may become blurred or distorted.

Generally we describe AMD as having two main types: Dry AMD and Wet AMD.

Types of AMD

1. Dry AMD (Non-neovascular AMD)

Dry AMD is the most common form, accounting for about 85-90% of cases. It develops gradually over time as the macula becomes thinner and small yellow deposits called drusen accumulate under the retina. This gradual thinning leads to slow vision loss in one or both eyes. Although dry AMD progresses slowly, it can eventually cause significant central vision impairment.

2. Wet AMD (Neovascular AMD)

Wet AMD is less common but more severe. It occurs when abnormal blood vessels grow under the retina and leak fluid or blood. This causes rapid damage to the macula and can lead to a sudden and severe loss of central vision. Wet AMD often starts as dry AMD and can progress into wet AMD if left untreated.

Symptoms of AMD

The symptoms of AMD can vary depending on the type and stage of the condition. Common signs include:

Blurry or distorted central vision
Difficulty recognising faces
A dark or empty area in the centre of vision
A change in the way colours appear, often appearing less vibrant
Straight lines may appear wavy (known as metamorphopsia)

It’s important to note that AMD usually affects one eye first, but it often progresses to the other eye over time. People with early stages of the condition may not notice any symptoms, which is why regular eye checks are essential.

If you ever experience a sudden drop in vision or increase in distortion from one or both eyes, please contact your optometrist immediately to report a sudden change in you symptoms to allow prompt examination.

Risk Factors for AMD

Several factors can increase the likelihood of developing AMD, particularly as people age. These include:

Age: AMD is most common in people over 50, with the risk increasing as people age.
Family history: Having a close relative with AMD can increase the risk.
Ethnicity: People of Caucasian descent are more likely to develop AMD, while those of African or Asian descent have a lower risk.
Smoking: Smoking increases the risk of developing AMD by up to four times.
Obesity: Being overweight can increase the risk of AMD, particularly for those with high blood pressure.
Diet: A diet lacking in certain nutrients, including antioxidants, can increase the risk.
Exposure to sunlight: Long-term exposure to UV light may increase the risk of AMD.

Diagnosis of AMD

To diagnose AMD, an eye care professional will conduct a comprehensive eye exam, including:

Amsler grid test: A grid with straight lines that can help detect visual distortions.
Dilated eye exam: To inspect the retina for signs of AMD, such as drusen or abnormal blood vessels.
Optical coherence tomography (OCT): A non-invasive scan that creates detailed images of the retina to detect any fluid or damage.
Fluorescein angiography: A dye is injected into a vein in the arm, and images are taken to assess blood flow in the retina and any leakage from abnormal blood vessels (used for wet AMD diagnosis).

Treatment and Management of AMD in the UK

While there is no cure for AMD, there are treatments and lifestyle changes that can help manage the condition and slow down its progression.

Dry AMD Treatment

There are no specific treatments for dry AMD, but research suggests that certain lifestyle changes and nutrients may slow its progression. The most effective approach includes:

Diet and nutrition: A diet rich in antioxidants, especially vitamins C and E, zinc, and omega-3 fatty acids, may help protect the retina. Supplements designed for AMD, such as the AREDS (Age-Related Eye Disease Study) formula, have been shown to reduce the risk of progression in some cases.
Healthy lifestyle: Quitting smoking, managing weight, and maintaining good overall health are essential steps in managing dry AMD.

Wet AMD Treatment

Wet AMD can often be treated more aggressively, and early detection is key to managing the condition. The most common treatments include:

Anti-VEGF injections: These injections block the growth of abnormal blood vessels in the eye and are the most effective treatment for wet AMD. They can help prevent further vision loss and, in some cases, restore some lost vision. Injections are typically administered at regular intervals by an eye specialist.
Photodynamic therapy: This treatment uses a special light-activated drug to target and destroy abnormal blood vessels.
Laser therapy: In certain cases, laser treatment may be used to destroy abnormal blood vessels, although this is less commonly used today due to the success of anti-VEGF injections.

Living with AMD

Living with AMD can be challenging, but there are numerous resources and support available to help individuals adapt to the condition:

Low vision aids: Magnifiers, large-print books, and screen readers can help individuals with AMD retain independence.
Support groups: The Macular Society in the UK provides support and information for people living with AMD, including advice on coping strategies, community events, and emotional support.
Eye health checks: Regular eye exams are essential for people at risk of AMD. Early detection significantly improves the chances of preserving vision and quality of life.

Useful Websites for further information:

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