Macular Degeneration

What are the symptoms of macular degeneration?

• Loss of central vision over time
• Blurry, wavy or dark spot in the central vision
• Peripheral vision remains intact
• Impact on one or both eyes.

You may not have any symptoms at all in the early stages
of AMD. But as it progresses, you may experience distortion
or wavy lines in your central vision.

This can progress to central vision loss.

Types of macular degeneration

There are two types of AMD: Dry and Wet. In Dry AMD there is a build up of pale yellow waste material called drusen under the macula. These can impact vision and can cause macular cells to die (atrophy) in areas and cause central vision changes. In Wet AMD, symptoms can be a more sudden onset if left untreated and can lead to central vision loss much faster. It is caused by blood vessels that grow under the macula and leak fluid or blood. This can lead to a macular scar forming, which impairs central vision.

What causes macular degeneration?

There are a number of known risk factors for macular degeneration.

• Age
• Smoking
• Obesity
• Lack of regular eye examinations
• Family history
• High blood pressure
• Poor diet, low in antioxidants

How we treat macular degeneration

There is no cure for macular degeneration but there are ways that have been shown to slow its progression.

Dry AMD

• Minimise risk factors such as high blood pressure, obesity and smoking
• Eat a diet rich in antioxidants such as dark-leafy vegetables, yellow fruits and vegetables and oily fish
• Take special vitamin tablets (Macu-Vision or Macu-Vision Plus) if advised
• Monitor your vision with an Amsler Grid regularly

Wet AMD

There are medical treatments for Wet AMD that can reduce its progression and protect further central vision loss. Some can improve vision for some people.

Intravitreal Injections

These anti-VEGF injections act to remove fluid in the retinal layers and help stop the unhealthy blood vessel growth under the macula. There are currently 4 available anti-VEGF drugs:

• Lucentis (ranibizumab)
• Eylea (aflibercept)
• Avastin (bevacizumab)
• Beovu (brolucizumab)

The injections initially start monthly and can progress to about quarterly once the fluid or blood vessel leakage has stopped. While the goal is to stop injections without Wet AMD coming back, most patients need maintenance injections for long-term control.

Photodynamic Therapy

Since the development of intravitreal injections, photodynamic therapy is only used rarely. It involves injecting a light activated drug called Verteporin into the bloodstream. The macula is then treated with a “cold laser” to activate Verteporin, which works to seal off abnormal blood vessels and resolve retinal fluid.

Laser Treatment

Laser treatments are uncommon in contemporary practice. They can be used for lesions that are leaking or bleeding and are located in a safe position. Before photodynamic therapy, lasers were commonly used to treat AMD.

Do you have a question or concern about your eye health? To discuss your condition with an experienced ophthalmologist or optometrist, please contact The Eye Health Centre