Age-Related Macular Degeneration (AMD)

Macular degeneration affects your macula, the central part of your retina. Your retina is in the back of your eye and controls central vision. People with macular degeneration aren’t completely blind. Their peripheral vision (ability to see things off to the sides) is fine.

It blurs the central vision that is used to see detailed things while reading, driving and sewing. Over the time, the blurred area can grow larger leading to blank spots in the central vision. As the name suggests, AMD occurs in older adults. Diagnosis with OCT, FFA available. Facilities for intravitreal injections are available.

Macular degeneration is an eye disease that affects central vision. This means that people with macular degeneration can’t see things directly in front of them. This common age-related eye condition mostly occurs in people over the age of 50. It may develop in one eye or both eyes with different levels of severity.

Causes:

As the term “age-related macular degeneration” (AMD) implies, macular degeneration is more likely to occur as you get older. However, people can develop macular degeneration at younger ages because of several factors include:

• Having a family history of macular degeneration.
• Being overweight.
• Smoking.
• Having high blood pressure (hypertension).
• Eating a diet high in saturated fats.
• Being white.

Non-age-related Macular Degeneration may be associated with:

• Diabetes.
• Head injuries.
• Infections.
• A diet lacking in required nutrients.

Diagnosis:

• Amsler grid test: An Amsler grid has a grid of straight lines with a large dot in the center. Your healthcare provider may ask you to identify lines or sections on the grid that look blurry, wavy or broken. A lot of distortion may indicate that you have macular degeneration or show that the disease is getting worse. You can use this at home to monitor your symptoms and look for any progression.
• Dilated eye exam: Eye drops dilate, or widen, your pupils. Your provider will give you the drops and dilate your eyes and then will use a special lens to look inside your eyes.
• Fluorescein angiography: Your healthcare provider injects a yellow dye called fluorescein into a vein in your arm. A special camera tracks the dye as it travels through blood vessels in your eye. The photos can reveal any leakage under your macula.
• Optical coherence tomography (OCT): This imaging machine takes detailed images of the back of your eye, including your retina and macula. Optical coherence tomography isn’t invasive or painful. You simply look into a lens while the machine takes pictures.
• Optical coherence tomography angiography (OCTA): This diagnostic tool uses laser light reflection (instead of fluorescein dye) and the OCT scanning device. It takes just a few moments and produces 3D images of blood flow through your eye.

Treatment:

There’s no cure for macular degeneration. Eye Specialist at Shreya Hospital in Ghaziabad can help you relief from the complications. Starting treatments early can slow the progression of the disease and make symptoms less severe. Even with successful treatments, symptoms often return. Depending on the disease type, treatments include nutritional supplements, medications, photodynamic therapy (PDT) and laser therapy.

Nutritional supplements to treat dry age-related macular degeneration (AMD)

The Age-Related Eye Disease Studies (AREDS and AREDS2) found that a combination of vitamins and minerals might slow the progression of dry AMD. AREDS supplements include these ingredients:

• Vitamin C.
• Vitamin E.
• Lutein.
• Zinc.
• Copper.
• Zeaxanthin.

The first version of the supplements contained the antioxidant beta-carotene, but it raises the risk of lung cancer in people who smoke and people who used to smoke. In the newer version, zeaxanthin and lutein are the antioxidants.

Medications to treat wet age-related macular degeneration (AMD)

There are drugs that treat but don’t cure wet AMD. They include anti-vascular endothelial growth factor (anti-VEGF) injections. They block the production of VEGF, which is a protein that produces new blood vessels. Your provider, generally a retina specialist, will numb your eye before giving you a shot into the vitreous (intravitreal injections). Anti-VEGF shots can sometimes improve your vision.

These drugs include:

• Aflibercept (Eylea®).
• Ranibizumab (Lucentis®).
• Bevacizumab (Avastin®).
• Faricimab-svoa (VABYSMO®).
• Brolucizumab (Beovu®).

Photodynamic therapy to treat wet age-related macular degeneration

During photodynamic therapy (PDT), your eye care specialist uses a combination of an injectable light-sensitive drug and a laser to destroy extra blood vessels in your eye. Your provider may combine PDT with anti-VEGF shots.

Laser photocoagulation to treat wet age-related macular degeneration

During this treatment, your provider will use a laser to seal and destroy the leaking blood vessels. This was actually the first treatment for wet AMD.