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What is Age-related Macular Degeneration (AMD)?

Age-related Macular Degeneration (AMD) is a progressive eye condition that affects the macula, the central part of the retina responsible for sharp, straight-ahead vision. The macula is essential for tasks like reading, driving, and recognizing faces. AMD causes damage to the macula, which leads to a gradual loss of central vision. It is a leading cause of irreversible vision loss in people over 50.

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Types of AMD

There are two main types of AMD:

  • Dry AMD

    • Dry AMD is the most common form of the condition globally. It is caused by the gradual thinning of the macula and the buildup of small protein deposits called drusen. This leads to a slow, progressive loss of central vision. In the advanced stage of dry AMD, known as geographic atrophy, the macula's cells die, resulting in significant vision loss.

  • Neovascular (Wet) AMD

    • Neovascular AMD is a less common but more aggressive form of AMD. It is caused by the growth of new, abnormal blood vessels under the retina. These new blood vessels are fragile and can leak fluid or blood, causing the macula to swell and scar. This leads to a rapid and severe loss of central vision.

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Symptoms of AMD

In its early stages, AMD may not have any noticeable symptoms. As the condition progresses, symptoms may include:

  • Blurred or distorted central vision.

  • Straight lines appearing wavy or crooked.

  • A dark or blind spot in the center of your vision.

  • Difficulty reading or recognizing faces.

  • A need for brighter light to perform tasks.

Causes of AMD

The exact cause of AMD is unknown, but it is believed to be a combination of genetic and environmental factors. The primary risk factor is age.

  • Risk Factors

    • Age: The risk of developing AMD increases significantly with age, particularly after the age of 50.

    • Genetics: A family history of AMD increases your risk.

    • Smoking: Smoking can double the risk of developing AMD.

    • Obesity: Research suggests a link between obesity and the progression of AMD.

    • Diet: A diet low in fruits, vegetables, and fish may increase your risk.

    • Cardiovascular Disease: High blood pressure and cholesterol can increase the risk of AMD.

Risk Factors

Diagnosis of AMD

An ophthalmologist can diagnose AMD during a comprehensive eye examination. The diagnosis typically involves:

  • A Dilated Eye Exam: The doctor will use special instruments to view the macula and check for drusen or abnormal blood vessels.

  • Optical Coherence Tomography (OCT): An OCT scan provides a detailed cross-sectional image of the retina, allowing the doctor to see any swelling or fluid buildup.

  • Fluorescein Angiography: In cases of neovascular AMD, a dye is injected into a vein in your arm, and a series of photographs are taken as the dye circulates through the blood vessels of your retina, revealing areas of leakage.

Dry AMD treatment

Management and Treatment

While there is no cure for AMD, various treatments are available to manage the condition and slow its progression.

  • Dry AMD Management and Treatment

    • Nutritional Supplements: A specific combination of vitamins and minerals, known as the AREDS formula, can slow the progression of dry AMD.

    • Lifestyle Changes: A healthy diet, regular exercise, and not smoking can help manage the condition.

    • Low Vision Rehabilitation: For advanced dry AMD, rehabilitation programs can help patients maximize their remaining vision.

    • Stem-cell based retinal cell transplantation: This is a promising area of research aimed at treating advanced dry AMD. It involves replacing the damaged or lost cells of the macula with healthy cells derived from stem cells. While this is an emerging therapy, it offers hope for restoring vision in the future.

  • Neovascular AMD Management and Treatment

    • Anti-VEGF Intravitreal Injections: This is the most common treatment for neovascular AMD. Anti-VEGF agents are injected directly into the eye to block the growth of new, abnormal blood vessels and reduce swelling.

    • Photodynamic Therapy (PDT): A treatment that uses a light-activated drug to destroy abnormal blood vessels.

nAMD treatment
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