About AMD

Age-related Macular Degeneration (AMD) is a chronic, degenerative disease of the eye.6 It affects a critical area in the center of the retina called the macula.2,7 The macula’s job is to help us see the fine details in front of us such as the words in a book and the images on a television.6,7 So, while the entire retina lets you see the book in front of you, the macula helps you see the words in it. It is this part of the eye that starts to weaken in some people with age.

There are two types of AMD:1-3 Dry AMD and Wet AMD (nAMD or wAMD).2,4,5

Dry AMD progresses slowly and is less severe than the wet AMD.6 However, both these types of AMD damage the central vision, that helps us see the fine details around us.

In wet AMD, a protein called VEGF (i.e. Vascular Endothelial Growth Factor) causes new abnormal blood vessels to grow in the retina and macular region, which impairs/harms our vision.2,3,6,7,10

AMD remains a leading cause of severe vision loss in people aged over 50 years.1,7,9,10

Wet AMD can be effectively controlled with different treatment options.6

Imagine eye blood vessels as the roots of a tree and concrete as the centre of the back of the eye (i.e retina)2

When abnormal blood vessels grow, they cause distortion in vision, here depicted as cracks in the concrete, eventually leading to loss of vision2

Symptoms

 

Symptoms of AMD include changes in the vision that are given in the sections below:6,17

These changes might first be noticed on doing the Amsler grid test.5,7,9,12

Watch out for these common symptoms

Wavy Vision

Black Spots

Blurry Vision

Risk Factors25,29,30

 

A number of risk factors predispose certain people to the development and progression of the disease, including:

  • Age: Risk increases in patients > 60 years of age
  • Cigarette smoking
  • Cardiovascular disease
  • Gender: Higher incidence and earlier age of onset in females
  • Family history and Genetics: People with a family history of AMD are at higher risk.
 

What Can I Do?

Here are certain measures to safeguard oneself from these risk factors such as -

  • Quit smoking
  • Consume foods high in anti-oxidants7,9,10,16 such as frozen berries, green tea, etc.23
  • Eat bright-coloured fruits and vegetables6,17
  • Avoid excessive exposure to sunlight and wear sunglasses with adequate protection when you go out4,10
  • Take steps to reduce high blood pressure6,7,10
  • Avoid gaining excessive weight6,9,11,13,17

References:

1. Augood CA, et al. Prevalence of age-related maculopathy in older Europeans. Arch Ophthalmol. 2006;124:529-535.

2.Vision Problems in the US: Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America. 4th ed. Prevent Blindness America, 2008.

3. Solomon SD, et al. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration (Review). The Cochrane Library. 2014;8:1-155.

4. de Jong P. Age-related macular degeneration. NEJM. 2006;355(14):1474-l485.

5. Ferris FL, et al. Age-related macular degeneration and blindness due to neovascular maculopathy. Arch Ophthalmol.1984;102:1640-1642.

6. Chopdar A, et al. Age related macular degeneration. BMJ. 2003;326:485-488.

7. Bressler NM. Early detection and treatment of neovascular age-related macular degeneration. J Am Board Fam Pract. 2002;15:142-152.

8. Williams RA, et al. The psychosocial impact of macular degeneration. Arch Ophthalmol. 1998;116: 514-520.

9. American Academy of Ophthalmology. Preferred Practice Pattern. Age-related macular degeneration. 2015.

10. Coleman HR, et al. Age-related macular degeneration. Lancet. 2008;372:1835-1845.

11. Wong WL, et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Global Health.

 2014; 2:e106-16.

12. Fine SL, et al. Age-related macular degeneration. NEJM. 2000;342:483-492.

13. Seddon JM et al. The US twin study of age-related macular degeneration. Arch Ophthalmol. 2005; 123:321-327.

14. Klein R, et al. Ten-year incidence and progression of age-related maculopathy. Ophthalmology. 2002; 109:1767-1779.

15. Klein R, et al. Prevalence of age-related maculopathy. Ophthalmology. 1992;99:933-943.

16. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. Arch Ophthalmol. 2001;119:1417-1436.

17. Moutray T, Chakravarthy U. Age related macular degeneration (AMD): clinical features and clinical management. Intemational Agency for the Prevention of Blindness. 2013.

18. The Amsler Grid. Available at http://www.amd.org/the-amsler-grid; Accessed on Oct 05, 2017.

19. Crossland M, Rubin G; The Amsler chart: absence of evidence is not evidence of absence; Br J Ophthalmol. 2007;91:391-393.

20. Kaiser PK, Treatment of Age-related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: 5-year results of two randomized clinical trials with an open-label extension TAP Report No. 8. Graefe's Arch Clin Exp Ophthalmol. 2006;244:1132-1142.

21. LUCENTIS Summary of Product Characteristics. Novartis AG; Sept. 2015.

22. Brody BL, et al. Depression, visual acuity, comorbidity. and disability associated with age-related macular degeneration. Ophthalmology. 2001;108: 1893-1901.

23. https://www.hsph.harvard.edu/nutritionsource/antioxidants/

24. Macular Degeneration. Available [online] at URL: http://www.northtexasretina.com/macular-degeneration.htm. As accessed on June 19, 2018.

25. Facts About Age-Related Macular Degeneration. Available[online] at URL: https://nei.nih.gov/health/maculardegen/armd_facts. As accessed on June 19, 2018.

26. Age related macular degeneration. Available[online] at URL: http://rgw.com/patient-education/eye-diseases/age-related-macular-degeneration. As accessed on June 19, 2018.

27. About wet AMD. Available [online] at URL: https://www.lucentis.com/wet-age-related-macular-degeneration-information. As accessed on June 19, 2018.

28. Anatomy of the eye. Available [online] at URL: https://www.moorfields.nhs.uk/content/anatomy-eye. As accessed on June 18, 2018.

29. Anatomy of the eye. Available[online] at URL: https://patient.info/health/eye-problems/features/anatomy-of-the-eye. As accessed on June 19, 2018.

30. Care of the Patient with Age-Related Macular Degeneration. Available [online] at URL: https://www.aoa.org/documents/optometrists/QRG-6.pdf. As accessed on June 19, 2018