Macular Degeneration

Macular degeneration is used to describe a group of degenerative retinal conditions whereby there is progressive loss of central vision, while preserving peripheral vision. This commonly occurs in older people, and is therefore referred to as age-related macular degeneration.

Risk factors include ageing, heredity, smoking, obesity and inactivity, and high blood pressure.

Types of Age-related macular degeneration (AMD)
Dry AMD

Dry AMD is the more common form (85-90%). This happens when waste products and debris is deposited at the macula as you age. These appear as yellowish deposits known as drusen. There is no effective treatment for this but the risk of significant vision loss is usually low.

Wet AMD

About 10% of dry AMD can progress to the more serious form of wet AMD. In wet AMD, abnormal blood vessels grow beneath the retina, leaking blood and fluid which cause irreversible scarring and damage to retinal cells, resulting in severe central vision loss.

Preventive therapy to reduce the risk of the progression to late AMD

  • Several large clinical trials (the Age-Related Eye Disease Study AREDS in 2001 and a follow-up study AREDS2 in 2013) have shown that nutritional supplements containing the AREDS 2 formulation such as Antioxidants (Vitamins C, E, Zinc and Copper) Lutein and Zeaxanthin can reduce the risk of dry AMD progressing to wet AMD
  • Cessation of smoking
  • Healthy lifestyle with balanced diet rich in fruits and vegetables
  • Regular Amsler grid monitoring is vital for those with early AMD, with detection of any distortions; call the clinic to schedule for an appointment.

For patients with wet AMD, intravitreal injections of anti-vascular endothelial growth factors (anti-VEGFs) has become the mainstay treatment option in recent years. Medications include Lucentis (Ranibizumab), Eylea (Aflibercept), and more recently Vabysmo (Faricimab). Some pathology may be amenable to laser therapy like photodynamic therapy (PDT) to improve treatment outcomes.

Occasionally, in severe cases with bleeding into the vitreous cavity or accumulation of blood under the macula, surgery in the form of a vitrectomy may be indicated.

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