The macula is the very centre of the retina. You are reading this text using your macula. It is responsible for your central, detailed vision. It is responsible for your ability to read, discriminate colours, distinguish faces, drive a car and any other activities which require fine vision.
Age Related Macular Degeneration (AMD) is the name given to a group of degenerative diseases of the retina that cause loss of central vision.
Although there is no cure for AMD, there are treatment options that can slow down its progression, depending on the stage and type of the disease (“wet” or “dry”). The earlier the disease is detected, the more vision you are likely to retain.
Both wet and dry forms of AMD begin in the Retinal Pigment Epithelium, or RPE, a layer of cells underneath the retina. The RPE is responsible for passing oxygen, sugar and other essentials up to the retina and moving waste products down to the blood vessels underneath.
AMD occurs when the waste products from the retina build up underneath the RPE. These deposits, known as ‘drusen’, are easily seen by your eye care professional as yellow spots.
As AMD progresses, vision loss occurs because the RPE cells die or because the RPE cells fail to prevent blood vessels from the choroid from growing into the retina.
DRY MACULAR DEGENERATION
There are currently no treatments to reverse the effects of dry AMD however you can discuss supplements, diet and your lifestyle with your doctor. It is important to be aware that the dry type can turn into the wet type so it is important to check your Amsler grid on a regular basis and report any changes to your doctor.
WET MACULAR DEGENERATION
Recently intravitreal injections with Eylea and Lucentis have revolutionized the treatment of wet AMD.
Eylea and Lucentis are known as anti-VEGF (vascular endothelial growth factor) substances, which inhibit the abnormal blood vessels which are a feature of wet AMD. Unfortunately they have no benefit for dry AMD. They are usually given as a course of three injections at monthly intervals and after the initial course may need to be repeated as needed.
The injections are given in the rooms as an out patient procedure.
REDUCE THE RISK
There are some positive lifestyle steps that can be followed that may help to reduce the risk of AMD or help to slow down the progression of AMD.
- Don’t smoke.
- Keep a healthy lifestyle, control your weight and exercise regularly.
- Eat a healthy well-balanced diet: Limit your intake of fats
- Eat fish two to three times a week
- Eat dark green leafy vegetables and fresh fruit daily
- Eat a handful of nuts each week
- In consultation with your doctor, consider taking a zinc and antioxidant supplement.
- Provide adequate protection for your eyes from sunlight exposure, especially when young.
Any changes in diet or lifestyle should be undertaken in consultation with your doctor.