Age Related Macular Degeneration

Which part of the eye is the macula?

The inner surface of the eye is lined by a thin layer of light-sensitive tissue called the retina. The retina is like the "film" portion of a camera, and processes images seen by the eye and sends them to the brain. The macula is the centre of the retina, and is responsible for sharp central vision.

What is age-related macular degeneration?

The macula, which is the centre of retina, can get damaged with age. In age-related macular degeneration, as the centre of the retina is affected, central visual loss occurs such that a dark patch is seen in the centre of one's visual field.

Age-related macular degeneration is the leading cause of vision loss and legal blindness in the elderly in the Western population, and is a significant cause of blindness locally too.

 

WET AGE-RELATED MACULAR DEGENERATION

 

DRY AGE-RELATED MACULAR DEGENERATION

I've heard of "dry" and "wet" forms of age-related macular degeneration. How do they differ?
Dry age-related macular degeneration results from ageing and thinning of the macular tissue. Deposition of pigment called drusen occurs in the macular region. Although there is no known effective treatment for dry age-related macular degeneration, gradual central loss of vision is usually not severe. The dry form is more common than the wet form. Wet age-related macular degeneration is less common, however, central vision is usually more severely affected. Development of abnormal vessels (known as choroidal neovascularization) under the retina can lead to fluid and protein leakage or bleeding in the eye. Another form of degeneration is polypoidal choroidal vascularization, which also leaks and bleeds, and is common in Asians.
What are the symptoms?
Blurring of vision Loss of central vision Distortion of vision Viewing a chart of black lines arranged in a graph pattern (called the Amsler Grid) is one way to tell if you are having these vision problems. See how an Amsler Grid works here.	CENTRAL VISUAL DISTORTION

What are my treatment options for dry age-related macular degeneration?

Two large, five-year clinical trials — the Age-Related Eye Disease Study (AREDS 2001) and a follow-up study called AREDS2 (2013)— have shown nutritional supplements containing antioxidant vitamins and multivitamins that contain lutein and zeaxanthin can reduce the risk of dry age-related macular degeneration progressing to the sight-threatening wet form.

What are my treatment options for wet age-related macular degeneration?

Treatment for wet age-related macular degeneration is aimed at preventing further deterioration, and to pick up early signs of the disease in the other eye as age-related macular degeneration is commonly a bilateral problem.

If detected early, treatment offers a better chance of visual recovery or maintainence.

If detected late when severe scarring has occurred, vision is unlikely to improve.

• In mild cases, observation and regular follow-up
• In wet age-related macular degeneration,
  intraocular injections of anti-vascular endothelial growth factor drugs eg: Avastin (Bevacizumab),
  FDA-approved drugs Lucentis (Ranibizumab) or Eyelea (aflibercept); or
  destruction of the abnormal vessels using laser or Visudyne photodynamic therapy
• Occasionally, surgery may be required to remove the bleeding underneath the retina or macula
• Nutritional supplements with lutein, zeaxanthine, omega-3 fatty acids

What should I do if I think I have macular degeneration?

At Focal Eye Centre, we will perform a comprehensive eye examination supplemented with state of the art optical diagnostics. If required, to further delineate the disease, an optical coherence tomography scan of the macula will be performed. Injection of dyes coupled with multiple photos of the retina (fundus fluorescein angiography and indocyanine green angiography) may be required to localize the source of leakage amongst the abnormal vessels prior to treatment.