Retina & Macula
Age related macular degeneration:
Age-related macular degeneration (AMD) is the leading cause of visual loss in England and Wales and affects around 600,000 people in the UK
What is the macula?
The macula is a small part of the retina at the back of the eye. It is responsible for our central vision, colour vision and fine detail.
What is AMD?
AMD usually affects people over the age of 60 but can happen earlier. It affects your central vision but does not cause complete loss of vision. There are two forms: dry and wet. The most common type is dry AMD. This causes a gradual deterioration of the central vision due to degeneration of the retinal cells at the macula.
10-15% of cases are wet AMD. In wet AMD abnormal blood vessels grow into the macula which leak and bleed. This eventually leads to scarring of the macula and rapid loss of central vision. If you are concerned that you may be developing this condition you must see your optometrist or GP as soon as possible and seek urgent referral to an ophthalmologist.
What causes AMD?
There are a number of risk factors which increase your chance of developing AMD, but the exact cause of the disease is currently unknown. Some risk factors are modifiable and others we cannot control.
Non-modifiable risk factors:
Non-modifiable risk factors:
What are the symptoms?
The main symptoms involve problems with the central vision:
Is there any treatment for AMD?
Currently, there is no cure for dry AMD but research has shown that nutrition plays an important role in the development of the disease. Antioxidants, especially Lutein and zeaxanthin, are essential for the health of the retina. Leafy, dark green vegetables such as kale and spinach contain high levels of these antioxidants. Other minerals and vitamins such as copper, zinc, vitamin A, C and E have also been shown to be beneficial in slowing down the progression of dry AMD. Supplements containing these ingredients can be bought commercially.
Anti-VEGF (vascular endothelial growth factor) drugs are used to treat wet AMD. The treatment works by stopping the growth of the new blood vessels. The drug is delivered by injection directly into the eye. After administration of anaesthetic drops, the injection is given into the corner of the eye. Some people notice swirls or floaters in their vision after the injection which resolves after 2-3 days.
Following diagnosis people will usually have a number of injections in the first year. Subsequent reviews are then needed to assess whether 'top-up' injections are required.
The treatment has a high success rate with most patients experiencing stabilization of their vision and 25-30% will notice an improvement.
The most important complication of this treatment is infection which is rare and occurs in less than 1 in 1000 cases. Treatments are available if this occurs.