All about Age Related Macular Degeneration (ARMD or AMD) - Symptoms, Causes, Types (Dry ARMD, Wet ARMD), Diagnosis, Treatment (Nutritional supplements, Retina injections, Laser treatment)

What is Age Related Macular Degeneration (ARMD or AMD)?

 

Age Related Macular Degeneration (ARMD or AMD) is a disease associated with the macula which is the small central portion of the retina responsible for clear vision in the direct line of sight. The retina is the light-sensing tissue, which is at the back of the eye.

 

ARMD happens when Macula suffers with wear and tear as one ages. Macula helps us in our reading ability, recognizing faces, driving, watching TV, using computer and mobile devices and other vision related tasks which require fine detailing.

 

As per a study published in ‘The Lancet’, it was estimated that 8.7 percent of the worldwide population has AMD. It was projected that around 196 million people will be suffering with ARMD in 2020. This number is expected to increase to 288 million in 2040.

 

What are the symptoms of Age Related Macular Degeneration (ARMD or AMD)?

 

Symptoms of AMD include:

  • Visual distortions, such as straight lines seeming bent

  • Reduced central vision in one or both eyes

  • The need for brighter light when reading or doing close work

  • Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant

  • Increased blurriness of printed words

  • Decreased intensity or brightness of colors

  • Difficulty recognizing faces

The early signs of ARMD may be easily overlooked because symptoms of macular degeneration develop gradually and without pain which is why it is very important to get your eyes examined regularly.

 

What causes Age Related Macular Degeneration (ARMD or AMD)? What are the risk factors for ARMD?

 

Risk factor of ARMD include

  • Age - Ageing is the primary risk factor for developing AMD. This disease is most common in people over 50.

  • Family history and genetics - This disease has a hereditary component. Researchers have identified several genes that are related to developing the condition.

  • Smoking - As per one estimate, Smoking was associated to as much as 25 percent of the cases of ARMD causing severe vision loss. Another study found that people who live with a smoker will have twice the risk of developing ARMD 

  • Obesity - Obese people have higher chances of developing more advanced version of ARMD

  • Inactivity - People who perform high activity tasks are less likely to develop advanced versions of ARMD

  • Cardiovascular disease - Diseases affecting the heart and blood vessels increase the risk of macular degeneration.

  • Race - Macular degeneration is more common in Caucasians

  • High blood pressure

  • Use of certain medications - specialized medications such as anti-psychotic drugs and malaria medicines (e.g. chloroquine) may increase risks of developing AMD

Are there different types of Age Related Macular Degeneration (ARMD or AMD)?

There are two types of ARMD

  • Dry ARMD - Dry macular degeneration is an early stage of the disease. It is the most common form of ARMD and affects 8 out 10 patients who have ARMD. Dry AMD happens when parts of the macula get thinner with age and very small clumps of protein called drusen grows. Patient will slowly lose central vision, however, the loss of vision is not as severe as in wet ARMD.

 

  • Wet ARMD - It happens when new, abnormal blood vessels grow under the retina. These vessels may leak blood or other fluids. The leakage causes permanent damage to light-sensitive retinal cells called ‘photoreceptors’ in the macula. The damage creates a central blind spot called “scotoma” in the affected person’s visual field. Patients lose vision faster with wet AMD than with dry AMD. CNV (Choroidal Neovascularization) is the underlying process that causes the abnormal blood vessel growth. CNV is the human body’s effort to develop a network of blood vessels to supply nutrients and oxygen to the retina but instead CNV leads to scarring and vision loss from wet ARMD.

Krishna Netralaya's team of specialist Ophthalmologists bring together years of experience of treating ARMD.

How is Age Related Macular Degeneration (ARMD or AMD) diagnosed?

 

After reviewing the medical and family history, the eye doctor will conduct a complete eye exam and may also do some other tests, including:

  • Examination of the retina or the back of the eye - The doctor will put dilating eye drop in the patient’s eye, which will widen the pupil and allow the doctor to look inside of patient’s eye using a special lens. He or she will look for a mottled appearance that's caused by drusen — yellow deposits that form under the retina.

  • Amsler grid - During an eye examination, your eye doctor may use an Amsler grid to test for defects in the center of your vision. Macular degeneration may cause some of the straight lines in the grid to look faded, broken or distorted.

  • Optical Coherence Tomography (OCT) - This non-invasive imaging test displays detailed cross-sectional images of the retina. It identifies areas of retina thinning, thickening or swelling.

  • Fluorescein angiography - In this method a yellow dye is injected in a vein (usually in the arm). The dye travels through the blood vessels of the patient. A specialized camera takes photos of the retina as the dye travels throughout the blood vessels into the retina region. This will help to determine whether abnormal new blood vessels are growing under the retina or not.

  • Optical Coherence Tomography Angiography (OCTA) - OCTA is another way get a close look at the retina. A machine scans the retina and provides very detailed images of the retina and macula to better understand the growth of blood vessels in the region. OCTA is like fluorescein angiography, but it does not use a dye.

 

How is Age Related Macular Degeneration (ARMD or AMD) treated?

Treatment for Dry ARMD - As of now the treatment options for dry ARMD are very limited. If the condition is diagnosed early, one can take steps to help slow its progression. It has been found that patients may respond well when prescribed nutritional supplements consisting of Vitamins and Minerals, eating healthy and not smoking.

Treatment for Wet ARMD - There are two broad types of treatment

  • Retinal injections of anti-VEGF (Vascular Endothelial Growth Factor) medication such as Avastin, Eylea, and Accentrix/Lucentis. These drugs help by reducing the number of abnormal blood vessels in patient’s retina. They also slow the leaking from blood vessels.

  • Laser treatment is another option which may be used to treat some types of wet ARMD. The eye surgeon focusses a laser light beam on the abnormal blood vessels. This reduces the number of abnormal blood vessels and slows the leaking in the blood vessels.

 

Low vision rehabilitation - ARMD in advanced stages can reduce or eliminate central vision causing a lot of discomfort in performing basic daily activities like driving a vehicle, reading and even recognizing people's faces thus greatly affecting the quality of life. It doesn't affect your side (peripheral) vision and usually doesn't cause total blindness. A variety of ‘Low Vison Aids’ are now available which may be beneficial to improve the quality of life. These can help you find ways to adapt to your changing vision.

At Krishna Netralaya we take care of your eyes with the best ophthalmic equipment from world's leading companies. 

 

Have more questions about Age Related Macular Degeneration (ARMD or AMD)? Schedule a consultation with one of our Ophthalmologists.

Disclaimer: All information, provided above is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.

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