Age-Related Macular Degeneration Ophthalmology & Visual Sciences What is it? Age-related macular degeneration (AMD) is the leading cause of blindness in individuals over the age of 65 in developed countries. It is due to ageing and deterioration of the central portion of the retina (macula) at the back of the eye. AMD affects central vision necessary for recognising faces, driving, reading and looking at details. There are two types of AMD, the dry and the wet type. Dry AMD is the more common of the two. It usually progresses slowly and vision loss is not severe except at very advanced stages. It is characterised by yellowishwhite deposits (drusen) and loss of retinal cells resulting in changes in central vision. Wet AMD is less common, but it often results in severe loss of vision. Abnormal blood vessels grow in the eye, which leak fluid and blood.
Figure 1. Normal Macula (right eye)
Figure 2. Dry AMD - Multiple drusen in the macula (right eye)
Figure 3. Wet AMD Abnormal new blood vessels under the macula (right eye)
Figure 4. Wet AMD - Severe bleeding from abnormal new blood vessels under the macula (same eye as Figure 3)
Figure 5. Late Wet AMD Scarring of the macula due to wet AMD (left eye)
What are the risk factors? The risk factors for AMD are as follows: onset of old age; being female and being a member of a lightly pigmented race. Additionally, some other lifestyle factors also affect the likelihood of developing AMD. These are smoking and a lack of antioxidants in the eye. What are the symptoms? The following symptoms indicate the development of AMD: blurring, distortion or dark spots in the central vision. If detected early, treatment for AMD may be effective in correcting or preventing further loss of vision. What are the treatments for AMD? You must see an eye specialist as soon as possible if you experience the above symptoms. The specialist will assess your eyes and explain the problem and the necessary treatments.
It is recommended to have regular eye screenings every 2 years if you are above 55 years old. For Dry AMD, there is no known effective treatment. Progression of the disease may be slowed through the use of antioxidants (e.g. zinc, lutien) and vitamins A, C and E. Quitting smoking is also known to reduce the risk of AMD. For Wet AMD, vision may be saved with treatment during the early stages. However, at the late stage, visual loss is unlikely to be recovered. Treatment is aimed at managing the condition with: • Injections of anti-vascular endothelial growth factor (VEGF) agents into the eye to shrink abnormal blood vessels and reduce leakage. • Cold laser (Photodynamic Therapy or PDT) treatments to destroy abnormal blood vessels. • Hot laser (Laser Photocoagulation) treatments for abnormal blood vessels located away from the centre of the retina.
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
OVS.DE.06.0517