What Is Age-Related Macular Degeneration? Know the Signs

Age-related macular degeneration (AMD) is, as its name suggests, a disease that occurs due to the aging process. It is found in people over the age of 50 but more commonly occurs in those over 65 years old. Once upon a time it was only picked up when it started affecting a person’s sight, but fortunately now with eye scanning technology available at your local opticians more people are being diagnosed at an early stage.

How Does AMD Affect Eyesight?

AMD causes the loss of vision in the centre of the eye. The part of the retina responsible for central vision (the macula) is damaged over time. In the early stages people might notice that their vision is a bit blurry, that it’s harder to see in dim light and light colours like pastels become harder to distinguish from one another. As the disease progresses it becomes difficult for people to recognise faces, to read, thread a needle or drive. Straight lines can appear wavy and central vision appears distorted. AMD can progress to a total loss of central vision where the centre of vision has a dark, empty area or blind spot.

What Does The Optometrist Look For To Diagnose Macular Degeneration?

There can be several changes to parts of the eye that indicate macular degeneration. On testing the optometrist might see:

• the presence of ‘drusen’ which are small, yellow, fatty deposits that build up under the macula
• thinning, thickening or swelling of the retina
• pigment changes (dark clumps of pigment in the macula)
• abnormal or leaking blood vessels¹.

Is There A Cure For AMD?

Unfortunately there is no cure for AMD. Some treatments can slow down disease progression, but it depends on the type of AMD a patient has and the stage at which they are diagnosed. There are two types of AMD²:

Dry AMD – this is the most common type, accounting for around 80% of AMD cases. This is where the macula thins and deteriorates with a corresponding loss of central vision. It has been found that a particular combination of vitamins and minerals that are beneficial for eye health can slow down the progress of this type of AMD for some people. The Age Related Eye Disease Study (AREDS and AREDS II)³ looked at a supplement containing lutein, zeaxanthin, zinc, copper, Vitamin C and Vitamin E that has good results in slowing down AMD progression.

Wet AMD – This is the less common type of AMD, and there is treatment for it, however it is the more severe form of the disease. With wet AMD, abnormal, tiny and weak blood vessels grow under the retina leaking fluid and blood. This leakage causes scarring and loss of vision. Scientists have discovered a protein called vascular endothelial growth factor (VEGF) that causes these blood vessels to grow under the retina. Anti-VEGF medicines (aflibercept and ranibizumab) have been developed that block VEGF, slowing down the growth of new blood vessels in the retina, helping decrease further scarring and vision loss. These medicines are injected directly into the eye (intravitreal injection) by an ophthalmic specialist once a month for three months then every one to three months as ongoing treatment depending on response, to control the disease.

Using lasers is another form of treatment for wet AMD to destroy new blood vessels and stop any leakage.

Risk Factors For Developing AMD:

• age over 50
• family history
• smoking
• high blood pressure
• being overweight
• ethnicity (Caucasians have a higher incidence)
• sex (females have a higher incidence, likely because of living longer than men)
• light coloured eyes
• high cholesterol
• high sun exposure
• poor diet.

Are There Any Other Ways To Slow Down Progression Of The Disease?

Healthy living choices are a way to slow down the disease. All the advice that can help prevent other age-related conditions apply here:

• exercising regularly
• keeping cholesterol and blood pressure well controlled
• eating a well-balanced diet full of leafy greens, fish and avoiding highly processed foods
• wearing sunglasses to prevent UV exposure to light.

One of the most damaging things for eyes is smoking – so giving up smoking can be of huge benefit. Smokers are four times more likely to develop AMD than non-smokers, and smoking not only makes AMD progress faster but it makes any treatment less effective. Smoking kills the retinal cells, damages blood vessels and decreases the delivery of oxygen and nutrients to the eye.

Early Detection Is Important

A general eye exam is recommended by the age of 45 and then at least every five years until the age of 60 – more often if there have been any changes to your eyes or vision. Early detection of AMD is vital to preserve eyesight. Book an eye examination if it has been over five years since your eyes were checked.