Age Related Macular Degeneration

What is age related macular degeneration?

Age related macular degeneration(ARMD) is a disease of the central part of the retina called macula. Macula provides a central sharp vision for reading and facial recognition. Therefore, ARMD causes blurred or distorted central vision. The side vision remains unaffected. In the early stages of the disease, there are often no symptoms. As the name suggests,  ARMD affects people over the age of 50.

What are the symptoms of ARMD?

There are usually no symptoms in the early stages, however, as the disease progresses, patients may experience;

1. Blurred vision.
2. Wavy central vision (straight lines appear wavy).
3. Central black spot in vision.
4. Need for bright light when reading or doing close work.
5. Difficulty in recognizing faces.

What causes ARMD?

The condition develops as the eye ages, mostly occurring in people above 50 years. The risk factor may be higher for people who smoke or have a family history of ARMD.

Smoking is a significant risk factor for macular degeneration

What are the types of age related macular degeneration?

There are two types of ARMD

• Dry (Atrophic) ARMD which develops due to a build-up of waste material under the macula (central part of the retina). Patients with this type of ARMD mostly have mild vision loss. However, some patients may have significant visual problems.
• Wet (Neovascular)  ARMD where abnormal blood vessels grow under the retina and leak fluid (and blood) which may cause permanent loss of central vision.

Most ARMD start as the dry type and in a few cases it proceeds to the wet type. It occurs mostly in both eyes, but the extent of the disease is usually different in each eye (asymmetric disease).

How is ARMD diagnosed?

Your ophthalmologist will usually perform an eye exam and some tests which may include:

1. OCT
2. FFA
3. OCT- Angiogram

Is there a cure for ARMD?

For wet ARMD anti-VEGF injections which are repeated every 4 weeks are recommended. There are mainly 3 types of Anti-VEGF injections currently available in Pakistan: Avastin, Patizra (Lucentis) or Eylea.

So far there is no treatment for dry ARMD. Low vision aids (LVA) are recommended for people with the dry type of ARMD.

Does surgery for macular degeneration help?

Surgery has been attempted in the past to treat ARMD. However, with currently available anti-VEGF treatment, most patients do not require any surgical intervention.

Does ARMD causes complete blindness?

If left untreated, patients with wet ARMD may develop severe, central, irreversible visual loss. ARMD does not cause total blindness as side vision remains unaffected in patients with typical ARMD.