Age Related Macular Degenerations (AMD) is one of the leading causes of vision loss amongst older Australians. It consists of a number of disease processes that affect the macula, that part of our retina which subserves central vision and enables us to perceive detail.
Macular Degeneration is broadly classed into two clinical groups – ‘wet’ or ‘dry’ macular degeneration.
Dry Macular Degeneration
As we age, the supporting structures for our retina, namely the Retinal Pigment Epithelium (RPE) and the choroid undergo changes that may result in disease. These changes can be seen clinically as changes in the pigmentation pattern of the RPE, and through deposition of ‘drusen’, a waste product from the RPE.
In dry AMD, such changes may be accompanied by ‘atrophy’ where patches of the RPE effectively ‘die off’, followed by irreversible changes in the outer retina. Dry AMD is a very slowly progressive disease, but one which doesn’t currently have any treatment..
Wet Macular Degeneration
Wet macular degeneration is a rapid onset disease characterized by central visual blurr and often distortion of shapes. The disease is cause by the development of abnormal vascular tissue (CNVM) in the layers under the retina.
These vessels leak and cause fluid to accumulate underneath and within the structure of the retina. If untreated, these changes may lead rapidly to scar formation, which is irreversible.
What treatments are available for Macular Degeneration?
Currently, there are no treatments which alter the course of the atrophic forms of macular degeneration. Lifestyle changes such as stopping smoking and eating a healthy diet may reduce progression to the wet form of AMD. Certain vitamin supplements may also reduce the risk of progression to wet AMD.
We encourage you to discuss this issue with your ophthalmologist.
In recent years treatments with laser and photodynamic therapy have mostly been replaced by regular injections into the eye of drugs which block VEGF – a biochemical messenger inside the eye that promotes the formation of CNVM.
This treatment has revolutionized the management of wet AMD, meaning that timely diagnosis and intervention carries an excellent prognosis for preserving central vision.
What is it like to have an injection in the eye?
Most of us shudder at the thought of receiving a needle into the eye. The reality however is much more benign. The instillation of local anaesthetic means that the procedure is often pain free. Careful technique also means that it is a very low risk procedure. After in injection the eye may be red for a number of days.
The vision may also be extra blurry, often with floaters for a few days after the injection.
Injections can be given in our practice, and patients may leave a matter of minutes after receiving their injection.
These modern therapies have revolutionized the treatment of wet AMD and transformed the prognosis of this disease.