Understanding Age-Related Macular Degeneration (AMD): A Family Guide

Age-related macular degeneration (AMD) is a degeneration of the macula of the eye, the part of the retina responsible for the sharp, central vision needed to read, recognizes faces, watch TV or drive. Because the macula is predominately affected in AMD, central vision loss may occur. In AMD only the central vision is affected and it the rarely leads to complete blindness.

AMD is the most common cause of poor sight in people over 60. The exact cause of AMD is not known. However, a number of environmental factors are known, in particular cigarette smoking, and poor nutrition. Individuals with family history of AMD have increased risk of developing AMD in later life.

AMD occurs in two forms: wet (neovascular) and dry (non-neovascular). In dry AMD, there is extensive atrophy (degeneration) of retinal cells that progresses slowly, whereas the wet form can lead to a rapid worsening of vision because of extensive damage to vascular network and retinal cells. About 85-90% of all diagnosed AMD cases are dry AMD.
See the section on Steps we can take to safeguard our sight bu clicking here.

There are a number of treatment options available for wet AMD. These mainly work by stopping the growth of new blood vessels in the retina of the eye. This means that treatments usually need to be injected into the eye and given fairly quickly once the blood vessels start to grow in your eye. If the blood vessels are allowed to grow for too long the blood vessels may scar the retina and this scarring cannot be treated and can lead to rapid loss of vision in as short as three months period.
Although research is continuing to find a treatment for dry AMD, nothing is available yet. This is because dry AMD doesn’t involve new blood vessels growing.
Treatments for wet AMD: Anti-VEGF treatment
The most recent treatment available for wet AMD is a class of drugs known as an anti-vascular endothelial growth factor (anti-VEGF) drugs, such as Lucentis. Anti-VEGF treatments are usually the first treatment offered to people with wet AMD.
As new blood vessels form in your eye, your body produces a chemical which stimulates further new blood vessel growth. Anti-VEGF drugs interfere with these chemicals and stop the vessels from growing. By stopping blood vessels growing and leaking, further damage to your sight is prevented.

Photodynamic therapy
Anti-VEGF treatments are usually the first treatment offered to people with wet AMD. However, sometimes it may be necessary to try a different treatment called Photodynamic therapy (PDT). This is a type of laser treatment which uses a combination of a light sensitive drug (Verteporfin) and a low energy (cold) laser to stop new blood vessels growing. Within your retina, a reaction between the drug and the laser causes a reaction which seals off any new blood vessels that may be growing.
These medications must be injected into your eye, a procedure that is called an intravitreal injection. Usually more than one injection is needed and your eye doctor will determine this after an initial three monthly injections.
Usually anti-VEGF treatments have a high success rate and in most people they stop sight getting worse. About 40 per cent of people also see an improvement in their vision.
This treatment needs to be given at the early stages of the blood vessel growth so that it can prevent the new blood vessels causing damage.

Treating dry AMD
Unfortunately at the moment there is no way to treat dry AMD. Although research is going on to try and find out why the cells of the macula stop working, this hasn’t yet lead to a treatment.
There is some evidence that high doses of vitamin A, C, E and the minerals zinc and copper when taken together may help slow down the progression of dry AMD, particularly if someone already has changes to their vision because of AMD in one eye.
There are a number of vitamin products available which have been designed for people with dry AMD. Learn more about Eye health and supplements by clicking here:

A balanced diet with plenty of fresh fruit and vegetables is good for your general health and may also help your eye health. To learn about Simple lifestyle tips for eye health click here.

Both types of AMD can cause severe problems with your central vision. However, most people with AMD have some vision that they can use everyday and using your vision won’t make your AMD worse.
Being diagnosed with an eye condition can be very upsetting. You may find that you are worried about the future and how you will manage with a change in your vision. All these feelings are natural.

There are lots of things that you can do to make the most of the vision you have. This may mean making things bigger, using brighter lighting or using color to make things easier to see. Use magnifiers to help with reading and try to make the most of your peripheral vision for everyday tasks to help make the most of your sight.

References:
http://www.rnib.org.uk
http://www.macularsociety.org