Age Related Macular Degeneration
What is maculopathy?
The central region of the retina is the macula. When there is pathological changes in the macula, central vision will be distorted and blurred. In maculopathy, fine vision and reading will be affected most, while peripheral vision is preserved. Frequently such changes are related to ageing, where it is known as age related macular degeneration. Age related macular degeneration usually occurs after the age of 50, and it is a major cause of permanent blindness after the age of 60. At the early stages, the symptoms experienced may not be very obvious. If the maculopathy is the educative type however, vision may deteriorate rapidly during the two years after diagnosis, leading to blindness.
Two types of age related macular degeneration
Dry type
Commoner, with lesser visual deterioration
Yellow white druses spots in the macula
Slow progression
May worsen and develop wet type
Wet type (exudative)
Abnormal blood vessels grow within the macula region, where
Exudation and
Blood may accumulate
Severe worsening of vision, usually irreversible
What are the causes of age related macular degeneration?
It is usually found in patients over the age of 50, more with advancing age, but no sexual predominance. The retinal degenerates with thinning causing deterioration of macular function. Possible factors include familial history, dietary habit, smoking, exposure to excessive radiation, cardiovascular diseases and anxiety.
Treatment of maculopathy
One of the treatment is by photodynamic therapy. A photosensitizing agent is injected which will attach onto the abnormal blood vessels. A low energy laser is then applied locally onto the affected area, and those treated abnormal vessels will stop growing and leaking. The advantages are that there is no damage to the retina and there is no scar formation.
Regular self examination using the Amsler Grid.
Flourescein Angiography Flourescein angiography examines the retinal blood vessels by taking photographic images of the vessels at different time intervals after an injection of dye.
Anti-VEGF injection have been shown to be effective in treating AMD. These injections are usually administered in our day surgery centre, while the injections are given in a sterile and clear setting. Monthly injection schedules are usually tailored-made to the patients conditions in order to achieve the maximum benefits of the anti-VEGF therapy.
How to use the Amsler Grid
Under adequate lighting, place the Grid at 30 cm distance from the eyes.
Wear adequate spectacle correction or reading glasses if required.
With the left eye covered, fixate the right eye onto the central spot on the grid.While fixating at the central spot, note if there is any distortions or defects with the grid.
Repeat with the left eye.
Any distortion may an early warning sign and must be checked by the doctor quickly.
