Macular Degeneration

Age-Related Macular Degeneration (AMD) is a progressive eye condition which affects central vision. It is one of the leading causes of vision loss worldwide1, accounting for 8.7% of blindness cases2 and is more prevalent in those over 60 years old1, hence the name “age-related”. This article will explore what AMD is, its symptoms, risk factors and treatment options.

What is AMD?

AMD is an eye condition that affects the eye’s macula, the sensitive area on the central retina responsible for sharp central vision. This small area is crucial for activities like reading, driving, and recognising faces. Although it may not cause complete blindness, as peripheral vision usually remains intact, AMD has been shown to have profound consequences on psychological well-being due to its debilitating nature3.

Types of AMD:

AMD is normally categorised in one of two forms:
  • Dry AMD: Where yellowish deposits known as drusen accumulate beneath the retina. This causes gradual breakdown of light-sensitive cells in the macula which leads to vision loss. Dry AMD accounts for about 80-90% of AMD cases4.
  • Wet AMD: Where abnormal blood vessels grow beneath the macula and leak blood and fluid. This type can cause sudden and more severe vision loss. Although less common, the most severe cases of vision loss are due to Wet AMD.

Symptoms

Depending on the type of macular degeneration present and the severity of the disease, the symptoms may differ. As AMD usually progresses slowly, an individual may not notice significant vision changes in early stages, however some common symptoms include:
  • Gradual or sudden changes in central vision.
  • Blurred or distorted vision.
  • Straight lines such as door frames/ pages appear wavy.
  • Difficulty recognizing faces.
  • Difficulty reading or seeing fine print.
  • Dark or blurry areas in the central vision.

Risk Factors6

The three main risk factors for AMD are:
  • Age: The risk increases with age, especially after 60.
  • Genetics: Family history of AMD can increase the risk.
  • Smoking: Significantly increases the risk of AMD.

Treatment7

Currently there is no treatment for dry AMD, although supplements like vitamins and minerals may slow its progression. Vision rehabilitation programmes or low vision devices such as magnifiers may help when day to day tasks become difficult to perform due to vision loss in later stages of AMD.
For wet AMD, the main treatment is Anti-VEGF (anti- vascular endothelial growth factor) medication injections into the eye which can help prevent abnormal blood vessel growth.
Across the world, ongoing research explores new treatments and interventions such as laser treatment, photodynamic therapy and implantable miniature telescopes.8 Advances in gene therapy and stem cell research also show promise for future treatments.9
It’s important to consult your eye care professional to determine the most appropriate treatment plan for the type and severity of macular degeneration. Regular eye examinations are essential for monitoring the condition and adjusting the treatment approach as needed.

Tips to Maintain Eye Health:

  • Regular Eye Exams: Comprehensive eye exams can detect AMD in its earliest stages, even before symptoms are present.
  • Nutrition: A diet rich in antioxidants, vitamins, and minerals may support eye health and slow the progression of AMD.
  • Exercise: Whilst physical activity alone is not a direct treatment for AMD, maintaining a healthy lifestyle can contribute to overall health and well-being.
  • Quit Smoking: Smoking cessation is advised as it is one of the most significant risk factors for AMD development and progression.

Myopia and AMD

There are strong links between the risk of macular degeneration and increasing levels of myopia.10 As the rate of myopia progresses in Singapore11, addressing and managing myopia becomes crucial not only for maintaining clear vision but also for reducing the risk of developing serious eye conditions like macular degeneration.

See our article “A Comprehensive Guide to Myopia Control”.

Conclusion

AMD is a prevalent and potentially debilitating eye condition, particularly among older adults. Early detection, lifestyle modifications, and timely intervention can significantly impact the course of the disease and support the quality of life of affected individuals. Regular eye check-ups and maintaining a healthy lifestyle are crucial in monitoring and managing AMD.

Get in Touch

If you are concerned about your own or your child’s vision it’s best to book an eye examination to have this properly tested and diagnosed.
Book an Appointment

References

  1. S. Ruia, E. J. Kaufman. Macular Degeneration. National Library of Medicine (2023).
  2. W. L. Wong, X. Su, X. Li, C. M. G. Cheung, R. Klein, C-Y Cheng, T. Y. Wong. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Epub (2014). doi:10.1016/S2214-109X(13)70145-1
  3. V. R. Cimarolli, R. J. Casten, B. W. Rovner, V. Heyl, S. Sörensen and A. Horowitz. Anxiety and depression in patients with advanced macular degeneration: current perspectives. Clin Ophthalmol (2016) doi:10.2147/OPTH.S80489
  4. N. M. Schultz, S. Bhardwaj, C. Barclay, L. Gaspar, J. Schwartz. Global Burden of Dry Age-Related Macular Degeneration: A Targeted Literature Review. Elsevier (2021). doi:10.1016/j.clinthera.2021.08.011.
  5. Johns Hopkins Medicine. Age-Related Macular Degeneration (AMD). Health, Conditions and Diseases.
  6. A. Stahl. The Diagnosis and Treatment of Age-Related Macular Degeneration. Dtsch Arztebl Int (2020). doi:10.3238/arztebl.2020.0513.
  7. T. A. Cabral de Guimaraes, M, D, Varela, M.Georgiou, M. Michaelides. Treatments for dry age-related macular degeneration: therapeutic avenues, clinical trials and future directions. B. R. J Ophthalmol (2021) doi:10.1136/bjophthalmol-2020-3184
  8. M. Haddrill, C. Slonim. Macular Degeneration Treatment, FDA Approved. All About Vision (2019)
  9. American Academy of Ophthalmology. New Treatments for Age-Related Macular Degeneration. Eye Smart (2023).
  10. K. Williams and C Hammond. High myopia and its risks. Community Eye Health (2019). PMID:31409941
  11. I. G. Morgan, K.Ohno-Matsui, S. Saw. Myopia. Lancet (2012). doi: 10.1016/S0140-6736(12)60272-4