Age-Related Macular Degeneration
What is Age-related Macular Degeneration?
Age-related Macular degeneration (AMD) is a group of chronic, degenerative retinal eye diseases that cause progressive loss of central vision. AMD is the leading cause of legal blindness and severe vision loss in Australia, responsible for 50% of all cases of blindness.
Who are at risk of Age-related Macular Degeneration?
Age-related Macular Degeneration is usually related to ageing and most frequently affects people over the age of 50. However, it is not a normal or inevitable consequence of aging. Certain forms of the disease can also affect younger people.
What are the impacts of Age-related Macular Degeneration?
Age-related Macular Degeneration causes the loss of central vision, but leaves the peripheral vision intact. AMD affects the ability of an individual to:
- Read and Drive
- Recognise faces
- Perform activities that require detailed vision
Types of Age-related Macular Degeneration
There are two types of Age-related Macular Degeneration: Dry and Wet.
The dry form results in a gradual loss of central vision. Although there is currently no treatment, the following can help slow disease progression and vision loss:
- Lifestyle modifications (including the use of an appropriate supplement)
The wet form is characterised by a sudden loss of central vision, which is related to abnormal blood vessels growth under the retina. There are a number of new treatments available for wet AMD. While these treatments cannot cure the disease, they aim to stabilise and maintain the best vision for as long as possible, and these treatments can usually help to improve vision.
How is Age-related Macular Degeneration diagnosed?
The early detection of any form of AMD is crucial to saving sight. Difficulty with vision should never be dismissed as just a part of getting older. In its early stages, AMD may not result in noticeable visual symptoms but it can be detected with an eye test. The earlier that AMD is detected the earlier that steps can be undertaken to help slow its progression and save sight through treatment and/or lifestyle modifications.
How can Age-related Macular Degeneration be prevented?
The following preventive measures have been suggested for slowing down the progression of Age-related macular degeneration:
1. Lifestyle modifications:
- Quit Smoking - Smoking is the most important modifiable risk factor for AMD development and progression. Studies have shown that smokers can have a three-fold increase in the risk of developing AMD compared with people who have never smoke.
- Sun protection - It is important to protect your eyes from UV light, and all individuals should wear a hat, and suitable sunglasses when outdoors.
- Weight control and regular exercise
- Limit the intake of fats and oils
- Eat a healthy, well-balanced diet
- Eat dark green leafy vegetables and fresh fruit daily
- Eat fish two to three times a week
- Choose low glycaemic index (low GI) carbohydrates instead of high GI
- Eat a handful of nuts a week
3. Vitamin Supplements
- Supplements may be of value if diet is inadequate. Supplements are vitamins, minerals or other substances taken in tablet form.
- The use of supplements for macula health is broadly divided into two areas: supplements for the diet and Age-Related Eye Disease Study (AREDS 2) supplements.
- The AREDS study shows that taking the AREDS formula may reduce the risk of progression; it does not stop or reverse damage caused by the disease.
- The AREDS 2 formula consists of Zinc (as zinc oxide) 80mg, Vitamin C 500mg, Vitamin E 400IU, Copper (as cupric oxide) 2mg, Lutein 10mg and Zeaxanthin 2mg.
It is essential to speak to a healthcare professional about the most appropriate supplement for your individual needs
What are the current treatments for Wet AMD?
There are a number of medical treatments available for wet AMD. These treatments do not cure the disease but aim to stabilise and maintain the best vision for as long as possible. In some people, treatment can help to improve vision.
Anti-Vascular Endothelial Growth Factor (Anti-VEGF)
A protein called Vascular Endothelial Growth Factor, or VEGF, is predominantly responsible for the leaking and growth of new blood vessels that result in rapid and severe vision loss, which if left untreated, becomes permanent. To slow or stop this process, various drugs that block the protein, called anti-VEGFs, may be injected into the eye. Currently, there are several anti-VEGF drugs available for treating wet age-related macular degeneration in Australia. The choice of the most appropriate drug should be discussed with your ophthalmologist.
The treatment regimen for macular degeneration usually:
- Begins with monthly injections for three months
- Then, to control the disease, injections are typically continued on a treat and extend basis
- The interval between ongoing injections is determined by the ophthalmologist in consultation with the patient
Injection treatment is not a long procedure and can usually be performed in the ophthalmologist’s rooms. A topical anaesthetic is given before the injection, therefore very little discomfort should be experienced during the procedure.
It is essential not to miss your appointments with your ophthalmologist, even if there does not appear to be any problem with your vision.