Understanding Age-Related Macular Degeneration (AMD): Causes, Symptoms, and Treatment Options

Age-related macular degeneration (AMD) affects 1 in 8 adults over 60 years old and is the commonest cause of irreversible blindness in the over 65. This compares with 1 in 11 adults over 65 who develop dementia. There are 40,000 new cases of AMD per year compared with 47,000 with breast cancer and 42,000 with bowel cancer. AMD is expected to double by 2050, with 400 new cases a day in the UK. Source

What is Age-Related Macular Degeneration (AMD)

We all know that as we age, our brains and nervous tissue deteriorate. AMD is a condition associated with ageing in the eye. It is a degeneration of the light-sensitive retinal cells lining the inside of the eye. The most critical area of the retina responsible for fine vision is the central disc-shaped area called the macula. Hence, macular degeneration. This degeneration generally starts after the age of 50, with early signs for the next 20 to 30 years until it becomes more advanced. When advanced, there are patches of tissues that die (dry AMD) or are leaking because of new blood growing there (wet AMD). Source

What are the Risk Factors for AMD

• Smoking: We know that current smoking increases the risk of progression to late AMD by a factor of 4 times and at an earlier age. If you stop smoking, the risk goes down to the same as a non-smoker in 10 years. Source

• Obesity: If you are obese, this doubles the risk of progression. (The average male, 5ft 9in over 92kg, the average female 5ft 3in over 77kg.) Take steps to lose weight. Simple changes like reducing portion size, choosing more healthy options, and moderate exercise such as walking can be effective, even for 5-minute sessions a few times a day. It also helps to get mental support from a friend or family member to join you on this journey. BMI Calculator

• Poor diet: Have more of a Mediterranean diet, with more oily fish (omega 3) and brightly coloured vegetables. Red wine in moderation and nuts are good. 200g of vegetables, 2 portions of fruit per day, and fish twice a week can significantly reduce the risk. This will also reduce the risk of stroke and heart attack. The antioxidants from these sources help protect from damage within the tissues.

• Vitamin deficiency: The AREDS study looked at vitamin supplements containing C, E beta-carotene and zinc. In a subsequent study they left out beta-carotene as it was not good for smokers and ex-smokers. Lutein and zeaxanthin were added and act as an internal sunscreen. This is the recommended formula and can be taken by smokers and non-smokers alike. It reduces the likelihood of developing late AMD by around 25% in eyes that have moderate or more advanced signs of AMD, but not in the very early stages. These can be obtained over the counter or online and are not routinely prescribable by the GP. You should always take a list of your medications to a pharmacist to check they are safe alongside the AREDS2 supplement. Click for more.

• UV light/LED light: Although there are no studies showing increased exposure to sunlight increases the risk, we know that UV light can cause stress and damage to the retina. So, wear CE-marked protective glasses. Blue light common in LED devices has a toxic effect in the long term. If you have LED light bulbs, choose warm white and low power rather than cold white. Blue light blocking glasses reduce blue light exposure from your computer screen and tablets. These are affordable and widely available. Adjust the displays to turn down the lighting and set to warmer light settings for the evening.

Symptoms of AMD

Early AMD may not cause noticeable symptoms. However, as the condition progresses, you may experience:

• Blurry or distorted central vision, making it difficult to read or recognize faces.

• Straight lines appearing wavy or distorted.

• Difficulty adjusting to changes in light from bright to dim environments.

• A blind spot in your central vision.

Diagnosing AMD

When you see your optician or eye specialist in the hospital, they can identify AMD by examining the back of your eye and using various imaging techniques (photos, OCT scans). The earliest stages just have yellow spots called drusen. These are deposits of protein and fat. This starts inflammation. Retinal tissues start to die off (dry AMD), new blood vessels can grow and leak (wet AMD). Wet AMD needs treatment which is done with injections into the eye (intra-vitreal injections) and helps to stabilise the vision.

Treatment Options for AMD

• For wet AMD: the standard treatment is anti-VEGF injections into the eye. Your optician should refer you to a rapid-access local service within the NHS. Click for more.

• For dry AMD: there are no drugs currently available and approved in the UK. Valeda treatment is a safe alternative that uses low-level light stimulation to stabilise and slow down the dry AMD, often with improvement in vision and function. This does not involve injections. It is currently available at selected private clinics.

Living with AMD

Certain lifestyle modifications can help manage AMD and protect your vision:

• Maintain a healthy diet: Consume plenty of fruits, vegetables, and omega-3 fatty acids found in oily fish.

• Manage weight: Maintaining a healthy weight can reduce your AMD risk.

• Don't smoke: Quitting smoking is essential for preventing AMD progression.

• Protect your eyes from UV light: Wear sunglasses that block UVA and UVB rays.

• Schedule regular eye exams: Regular eye checkups are crucial for monitoring AMD progression and adjusting treatment plans as needed.

Concerned about AMD or experiencing vision changes?

Schedule a consultation with our experts at EyeMedics.

We offer comprehensive eye care and innovative treatments for AMD, including Valeda Therapy. Call us at +44 7388 323270 or email us on contact@eyemedics.co.uk to book an appointment.