Age Related Macular Degeneration
Age-related Macular Degeneration (AMD) is a common eye condition that affects the central vision in one or both eyes.
Central vision is what allows us to perform most daily tasks that require the vision of details such as reading, watching TV, or distinguishing faces.
What Causes Age-Related Macular Degeneration?
AMD occurs due to changes to the macula (the central part of the retina), which causes it to malfunction.
There are two types of AMD: ‘Dry’ Atrophic AMD and ‘Wet’ Exudative AMD.
This is the most common form of AMD, also known as Geographic Atrophy. AMD can progress into Geographic atrophy, whereby the cells within the macula region responsible for central vision are unable to function.
It causes a gradual loss of central vision due to the deterioration of the cells responsible for vision in the macula.
Wet AMD is the less common form of AMD and usually develops faster than dry AMD.
Wet AMD occurs when abnormal blood vessels develop in the macula. The leaking of blood and fluid from these blood vessels usually damage the macula and result in decreased vision.
Signs And Symptoms
You should seek urgent medical advice: if your vision gets worse, you notice blind spots or, images become distorted.
How Is AMD Diagnosed?
Prof. Stanga uses innovative technology for the early diagnosis of this condition, such as the new higher resolution Swept-Source Optical Coherence Tomography (OCT) and Angiography, as well as Optos® Ultra-Widefield Multi-Wavelength retinal imaging.
AMD is diagnosed through:
Fundus Fluorescein Angiography (FFA): A small amount of yellow fluorescein dye is injected into a vein in your arm. The dye travels to your eye, where it highlights the blood vessels. It is particularly useful in showing leaking blood vessels as well as highlighting areas of poor blood supply. Photographs of the back of the eye are taken while the fluorescein is flowing. Prof. Stanga uses Optos® Ultra-Widefield technology which allows for the visualisation of a significantly larger area of the retina compared to standard photography.
Optical Coherence Tomography (OCT): This is a non-invasive test similar to an ultrasound that uses light instead of sound. An OCT can show whether there is fluid accumulating in the macula, as well as help to monitor progress after treatment by measuring the thickness of the retinal tissue. This test is performed at every visit. Prof. Stanga uses the new higher resolution Swept-Source OCT technology which also allows the visualisation of abnormalities in the retinal vessels.
Fundus Auto Fluorescence (FAF): This is a non-invasive test which uses the light of a specific wavelength or colour to highlight the presence of dry AMD before it is visible by normal examination. This test is also helpful in assessing the progression of the disease. Prof. Stanga also uses the Optos® Ultra-Widefield technology for FAF imaging.
Treatment Of AMD
- There are currently no treatments available for Dry AMD, however, we are taking part in clinical trials to perhaps slow the progression of the ‘late’ Dry Age-related Macular degeneration (Geographic Atrophy).
- If you are interested in partaking in research at The Retina Clinic London for Geographic Atrophy, then please navigate onto the ‘patient studies’ page for more information. Otherwise please note that Dry AMD must still be monitored regularly as it can change into the Wet form AMD.
Wet AMD can be treated by injecting the eye with anti-vascular endothelial growth factor (anti-VEGF) drugs. These drugs can stabilise your vision. Improvement in vision can sometimes be achieved if treatment is started early. Early detection of wet AMD is therefore paramount for reducing the risk of severe vision loss.
Wet AMD before treatment (left) and Wet AMD after treatment (right)
Reducing Your Risk
It is not always possible to reduce the risk of developing Macular Degeneration as it is closely linked to your age and likely has a genetic factor. However, you may be able to reduce your risk of developing this condition by consuming a healthy and balanced diet and not smoking.
According to the Macular Society, smokers are more likely to develop AMD up to 10 years earlier than those who have never smoked. Their AMD is likely to progress faster and be less responsive to treatment. Second-hand smoke is also likely to increase the risk of AMD. People who are most in danger of getting AMD are people who smoke and who also have particular genes. For example, research suggests that smokers who have mutations to the HTRA1 gene are 20 times more likely to get AMD than non-smokers. Overall, it is estimated that as much as one third of all AMD is a result of the combination of genetics and smoking.