Age-Related Macular Degeneration (AMD)

What is Age-Related Macular Degeneration?

Macular degeneration is used to describe a group of degenerative retinal conditions whereby there is progressive loss of central vision, while preserving peripheral vision. This commonly occurs in older people, and is therefore referred to as age-related macular degeneration.
Dry AMD is the more common form (85-90%). This happens when waste products and debris is deposited at the macula as you age. These appear as yellowish spots known as drusen. There is no effective treatment for this but the risk of vision loss is usually low.

About 10% of dry AMD can progress to the more serious form of wet AMD. In wet AMD, abnormal blood vessels grow beneath the retina, leaking blood and fluid which cause irreversible scarring and damage to retinal cells, resulting in severe central vision loss.

Risk Factors

Aging, heredity, smoking, obesity and inactivity, and high blood pressure.

Treatment for Age Related Macular Degeneration

Eating a generally healthy diet with vegetables rich in antioxidants, and having a healthy lifestyle with adequate exercise can help to protect your eyes from AMD.

Several large clinical trials (the Age-Related Eye Disease Study AREDS in 2001 and a follow-up study AREDS2 in 2013) have shown that nutritional supplements containing vitamins, certain minerals and antioxidant like Lutein and Zeaxanthin, can reduce the risk of dry AMD progressing to wet AMD.

For patients with wet AMD, intravitreal injections of anti-vascular endothelial growth factors (anti-VEGFs) has become the mainstay treatment option in recent years. Medications include Lucentis (Ranibizumab), Eylea (Aflibercept), and more recently Vabysmo (Faricimab). Some pathology may be amenable to laser therapy like photodynamic therapy (PDT) to improve treatment outcomes.

Occasionally, in severe cases with bleeding into the vitreous cavity or accumulation of blood under the macula, surgery in the form of a vitrectomy may be indicated.
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