Age-Related Macular Degeneration
Age-related Macular Degeneration (AMD / ARMD), is the leading cause of blindness amongst Australians who are aged 65 years and above. The incidence of macular degeneration has been increasing over the decades, it is one of the leading causes of blindness in the developed world.
Age-related macular degeneration causes loss of central vision in two main ways: wet or dry forms of macular degeneration.
This is when a blood vessel grows through the normal barrier (Bruch’s membrane) that separates the retina from the choroid. These type of vessels tend to leak and bleed, the result is that the retina becomes “waterlogged”, disrupting your ability to perceive a clear picture from that eye. This would be analogous to soaking the film from the back of a film camera under the tap, and then trying to take a photo. Ten years ago, the mainstay of treatment was to use laser surgery to destroy the abnormal blood vessel in the retina. The overlying and immediately surrounding healthy retinal tissue was sacrificed to limit the vision loss over time, because if left untreated, the natural history is for this abnormal blood vessel to grow, bleed, leak and scar.
The sooner wet macular degeneration is diagnosed, the better the chance of maintaining vision. Wet ARMD needs to be assessed within a week if there has been a change to your vision or Amsler Grid (link to printable Amsler grid). The sooner you are diagnosed and treated for wet macular degeneration, the better the chance at maintaining or improving the vision in your eye. However, some patients will still notice a deterioration of vision over time, despite the optimal treatment.
During your consultation, you will have your vision tested, and an OCT (optical coherence tomography) will be performed, which allows our ophthalmic surgeons to assess your macula in fine detail. If there is concern that you may have wet age-related macular degeneration, then you may need a fluorescein angiogram to confirm or exclude the diagnosis. An angiogram involves injecting fluorescein dye into your circulation via a small cannula in the arm, and photographing the flow of dye through your retina. This allows the abnormal blood vessel to be demonstrated and the diagnosis confirmed. If you are diagnosed with wet age-related macular degeneration, you are likely to receive treatment on the same day. It is advisable to bring someone with you to this appointment. You will need your pupils dilated, and expect that you will be in our offices for approximately 1- 2 hours during your first visit.
Our eye surgeons are able to offer you the revolutionary treatment for wet age-related macular degeneration with injections of anti-VEGF agents into the back of the eye. This can be done with minimal discomfort in our dedicated procedure room.
This is the form of macular degeneration, where the retina starts to thin and die in certain places. This forms “holes in the retina”. This is analogous to taking the film at the back of a film camera and making holes in it. This tends to be a slower process than the wet form of macular degeneration. Your vision, OCT (optical coherence tomography) scans will be assessed and a dilated examination of your eyes will be performed. Some patients with dry age-related macular degeneration can develop wet age related macular degeneration within the remaining retina.
Macular drusen can be seen in some patients, and is sometimes referred to as age-related maculopathy, early age related macular degeneration. It is due to an accumulation of waste product associated with the retinal pigment epithelium. It can precede the development of dry or wet age-related macular degeneration in some patients. However, not all patients who develop macular degeneration will have drusen. The type, extent and location of the drusen can give an indication as to your risk of developing age-related macular degeneration.