- Age-related macular degeneration is a condition that affects central vision. It is the leading cause of permanent vision decline in developed countries. In the U.S., 7% of people aged 60-69 suffer from AMD, rising to 35% of people aged 80 and over.
- The macula is the anatomical point of the retina responsible for detailed central vision.
What are the symptoms of AMD?
- Blurred, “foggy” centralvision
- Metamorphopsia (distortion of images, for example straight lines appear wavy)
- Distortion in perception of image size – objects are perceived to be smaller than they actually are(micropsia)
- Possible distortion in color perception
AMD can make everyday activities such as reading, watching TV, driving, and recognizing faces difficult.
AMD does not cause pain. It can be detected at an early stage during eye examination before giving symptoms.
What are the risk factors for AMD?
The exact cause is not clear. Certain population groups are at higher risk of developing AMD:
- Elderly
- Smokers
- Obese
- People who follow a diet with high fat intake and low intake of antioxidants
- People with a family history of AMD
An association with hypertension and other cardiac risk factors has been suggested.
Exposure to sunlight is also considered harmful.
How is AMD diagnosed?
During the eye examination, the ophthalmologist uses mydriatic drops to perform fundoscopy with detailed examination in the macular area.
Imaging tests help both diagnose and monitor the disease. Fundus photography, optical coherence tomography (OCT),OCT-angiography (OCT-A) and autofluorescence (FAF) are non-invasive tests with high sensitivity, which help in staging AMD, determining prognosis and choosing the appropriate treatment each time.
Rarely, in doubtful cases or if the patient does not respond to treatment, the ophthalmologist may need to use classic fluorescein angiography (FFA) or indocyanine green angiography (ICGA), which are invasive tests using intravenous dye.
What are the types of AMD?
| DRY/NON-EXUDATIVE | WET/EXUDATIVE |
| Mostcommon (80-90%) | Rarer (10-20%) |
| Accumulation of material (drusen) | Formation of pathological new vessels |
| Gradualdeterioration (overyears) | Possible rapid progression (especially on hemorrhage) |
| Withouttreatment; administration of supplements if indicated; newer approaches under study | Intravitreal injections of anti-angiogenic agents (anti-VEGF, anti-VEGF+ANG-2)-newer approaches under study |
Note: Vision returns after 3-4 hours of using mydriatic drops. Driving is not allowed during this period. It is recommended to be examined in the afternoon or morning with the use of sunglasses afterwards to reduce photophobia