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Age-Related Macular Degeneration
Age Related Macular Degeneration
Macular degeneration is a condition of the eye where the macula deteriorates. The macula is the central portion of the retina responsible for central vision, which helps in focusing and viewing details and colours. This central vision helps us read, recognize faces and drive. Degeneration of the macula makes these daily activities difficult.
Overview
- Slowing progression. Supplements and lifestyle changes can slow down the disease
- Dry AMD has no widely available treatments although photobiomodulation is demonstrating some benefits in treating early disease.
- Minimally invasive Anti-VEGF injections for wet AMD are a very successful treatment and are quick, virtually painless and minimally invasive.
- Regular monitoring and follow-up treatments can manage disease recurrence.
What is Macular Degeneration
Learn about Macular Degeneration
Overview
Macular degeneration is age-dependent, causing loss of vision in people 60 years and older.
2 Types
Dry macular degeneration
characterized by the presence of one or many small round yellow deposits (drusen) under the retina. Drusen result due to the degeneration of the light-sensitive cells in that region. There is a spectrum of dry macular degeneration from mild to a severe form called Geographic Atrophy. It can also progress to wet macular degeneration.
Wet macular degeneration
occurs due to the abnormal growth of blood vessels under the macula. These new blood vessels develop to replace the damaged ones, but are fragile and may leak blood and fluid, affecting the normal functioning of the macula. This form accounts for only a small percentage of macular degeneration, and can progress more rapidly to cause significant loss of central vision, sometimes within a few days or weeks.
Causes & Symptoms
Are you at risk of Macular Degeneration?
Causes
The cause for macular degeneration is multifactorial. There are certain genes that can make you more susceptible and it may be related to the environment. The chances of macular degeneration increase with age, and can be associated with obesity, high blood pressure, certain medications, exposure to sun and smoking.
Symptoms
Blurred or reduced vison
Blurred or reduced vision close-up and distance vision
Scotomas
Blind spots
Metamorphopsia
Straight lines seem bent or irregular
Micropsia
Colour, size and shape of objects differ in each eye
Treatment
How is it Treated?
Dry Macular Degeneration
Currently, there is no widely available treatment to cure dry macular degeneration, but there are promising developments. Vitamin supplements such as antioxidants and zinc, alongside a healthy diet rich in fruits, vegetables, and omega-3 fatty acids, can slow disease progression. One emerging treatment option showing potential is red light therapy, also known as photobiomodulation.
Red Light Therapy (Photobiomodulation)
Red light therapy is believed to improve blood flow, reduce inflammation, and boost mitochondrial function in the retina. Suitable patients typically have early or moderate dry AMD and a visual acuity of 6/36 or better in at least one eye. The therapy consists of three treatments per week for three consecutive weeks, with follow-up cycles every four to six months.
Wet Macular Degeneration
The treatment for wet macular degeneration focuses on halting the abnormal growth of blood vessels beneath the retina and preventing further damage. Several options are available, including lasers, photodynamic therapy, and injections of anti-VEGF drugs.
Anti-VEGF Injections
Anti-VEGF (Vascular Endothelial Growth Factor) injections are the mainstay of treatment and are administered directly into the eye to block the growth of new abnormal blood vessels and reduce leakage.
Common current Anit-VEGF injections include Eylea, Lucentis, Avastin & Vabysmo. They are very successful at treating wet AMD but often have to be given on a regular basis
Laser Therapy
Laser treatment is used to destroy abnormal blood vessels, though it is only effective when these vessels are located away from the centre of the macula and is now not commonly used.
Photodynamic Therapy
Photodynamic therapy (PDT)involves injecting a light-sensitive drug into the bloodstream. When it reaches the eye, light is shone onto the macula to activate the drug, which selectively destroys abnormal blood vessels without damaging surrounding tissue. PDT is mainly used for variants of wet AMD such as polypoidal disease.
Frequently asked questions
Treatment can slow down the progression of the disease, but is not a cure. In spite of treatment, the disease may reappear. Regular monitoring of the condition of the eye is important and a follow-up treatment may be required.