- Treatments & Services
- Consultants & Specialists
- Our Clinic
- Patient Information
- Funding Your Treatment
- Optom & GP Zone
- Contact Us
Age-related Macular Degeneration (AMD) is an eye disorder in which the central retina, the macula, becomes damaged leading to reduction in central vision. AMD is the most common cause of serious loss of vision in Europe and the USA.
It affects the central (detail) vision, but normally leaves the outer (peripheral) vision unaffected. It is classified into two types: DRY which is much more common; or WET which occurs in 10-15% of cases, but is associated with more rapid and more marked visual loss.
Our consultant ophthalmic surgeon Mr Mark Benson explains what Age-related Macular Degeneration(AMD) is and answers some frequently asked questions.
Ageing is such a strong risk factor for development of this disorder, that it is normally referred to as Age-related Macular Degeneration (AMD). Dry AMD is present in over 50% of those aged 75 years and over, mostly in very mild degrees.
Other risk factors for developing it are family history, smoking, long sightedness, and light skin or eye colour. It is uncommon in Afro-Caribbean ethnicities.
For any reduction in vision that cannot be corrected with glasses you should consult your doctor, and consider referral to the Midland Eye. Urgent referral is necessary if any symptoms of the wet type are noticed, such as distortion of images (kinking of straight lines). Tests that may be necessary include the following.
2. Your eye specialist will need to examine the retina in each eye with a bright light, and will use some drops to dilate the pupil, which will make your vision blurred for a few hours.
3. Optical Coherence Tomography (OCT). This special test will be carried out. The machine takes special photographs which can be converted into cross-section pictures of the retina to give a precise anatomical assessment of the macula.
There is little hard evidence that there is any preventative treatment for AMD, although most eye specialists recommend a good balanced diet containing leafy green vegetables, carrots and eggs. There is some evidence that nutritional supplements may be beneficial in preventing AMD progression and there are many different commercial brands now available.
It is probably best to get advice from an impartial source before starting on these and in the UK the Macular Disease Society is an excellent source of information.
In the dry type of AMD Low vision assessment and advice on magnifiers and lighting can be extremely helpful in maintaining reading and close work. In Solihull we are fortunate to have excellent low vision services within the NHS and in the private sector at Midland Eye.
In the past, conventional laser treatment was used to try to limit visual loss from wet AMD, but this has been superseded by newer treatments.
A more gentle type of laser, used in conjunction with an infusion of a photosensitising drug (photodynamic therapy – PDT) has also been used with some success, but again it has been largely replaced by drug treatments (see below).
Before the advent of successful drug treatment for wet AMD, one treatment was to detach the retina and rotate it so that the macula was placed on more healthy underlying tissue (with a corresponding rotation of the eyeball to level up the vision). This complex operation has been replaced by effective and simple drug treatments.
In some situations, where the central vision of both eyes has been lost to AMD, it is possible to improve vision by implanting a miniaturised telescope into one eye. This is only effective for a minority of sufferers, and careful assessment and patient selection is necessary.
The treatment of wet AMD has been revolutionised by the advent of two new drugs: Avastin and Lucentis. These two drugs are very similar. They are both given by injection into the eye, usually as an initial course of three one-monthly injections, followed by top-up injections later if necessary.
Studies comparing these two drugs have consistently shown them to be equally effective, and recent studies have shown that they are both very safe. Both treatments are immediately available at the Midland Eye.
Newer drugs are being developed to treat wet AMD, and the latest, Eylea (aflibercept) is now available at the Midland Eye. This is as effective as Lucentis, but is longer-acting and therefore requires fewer injections.
It is anticipated that other drugs will soon be available to treat wet AMD, in particular a drug called VEGF-TrapEye, and possibly some longer-acting drugs than those currently available. Midland Eye will be in the vanguard of AMD service provision as these new treatments become available.
|adiLP||session||1 day||The adiLP cookie is used to help track visitors who have multiple tabs open in the same browser to prevent errors in tracking.|
|adiS||session||1 day||This cookie is set by software from ResponseTap. The software provides website owners with the ability to link website visitor behaviour to telephone calls made to the company as the result of a visit, in order to understand the effectiveness of the website in encouraging calls from customers.|
|adiV||thirdparty||1 year||The adiV cookie contains an identifier which is used by AdInsight to track a visitor over time. This allows AdInsight to show multiple visits made by a customer over time from the same browser.|
|adiVi||thirdparty||1 day||The adiVi cookie contains an identifier which is used by AdInsight to help track a visitor’s path while they are on the website.|
|cookielawinfo-checkbox-necessary||persistent||1 hour||This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".|
|cookielawinfo-checkbox-non-necessary||persistent||1 year||This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Non-necessary".|
|fr||2 months||The cookie is set by Facebook to show relevant advertisments to the users and measure and improve the advertisements. The cookie also tracks the behavior of the user across the web on sites that have Facebook pixel or Facebook social plugin.|
|JSESSIONID||session||General-purpose platform session cookies that are used to maintain users' state across page requests.|
|NID||Advertisement||5 months||This cookie is used to a profile based on user's interest and display personalized ads to the users.|
|PHPSESSID||persistent||This cookie is native to PHP applications. The cookie is used to store and identify a users' unique session ID for the purpose of managing user session on the website. The cookie is a session cookies and is deleted when all the browser windows are closed.|
|test_cookie||session||15 minutes||This cookie is set by WordPress. The purpose of the cookie is to determine if the users' browser supports cookies.|
|_fbp||2 months||This cookie is set by Facebook to deliver advertisement when they are on Facebook or a digital platform powered by Facebook advertising after visiting this website.|
|_ga||1 year||This cookie is installed by Google Analytics. The cookie is used to calculate visitor, session, campaign data and keep track of site usage for the site's analytics report. The cookies store information anonymously and assign a randomly generated number to identify unique visitors.|
|_gat||Performance||1 minute||This cookie is installed by Google Universal Analytics to throttle the request rate to limit the collection of data on high traffic sites.|
|_gid||1 day||This cookie is installed by Google Analytics. The cookie is used to store information of how visitors use a website and helps in creating an analytics report of how the website is doing. The data collected including the number visitors, the source where they have come from, and the pages visited in an anonymous form.|