Macular degeneration (MD) is the progressive, painless loss of central vision, affecting the ability to see fine detail, drive, read and recognise faces.
Although there is no cure for MD, there are treatment options that can slow down its progression, depending on the stage and type of the disease (wet, dry, and other forms). The earlier the disease is detected, the more vision you are likely to retain.
Both wet and dry forms of MD 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 (these vessels are called ‘the choroid’).
MD occurs when this “garbage collection” breaks down and 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 MD 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.
Breaks occur in the layer beneath the RPE cells . This leads to the development of new blood vessels which haemorrhage and leak fluid under the macula. This causes distortion of the vision in the effected eye. This is best detected by using an Amsler grid. These are available from Armadale Eye Clinic. Patient’s at risk of developing wet-AMD are encouraged to view their Amsler Grid on a daily basis and to report any new distortion as a matter of urgency.
Treatment of Wet MD:
Treatment with eye injections of special “anti-VEGF” agents can reduce size of the offending blood vessel and can help slow-down the progression of the disease.
Eye injections sound dreadful, yet are relatively painless and highly effective. The earlier treatment commences, the better the outcomes with treatment.
The aim of the injection is to inject a substance into the eye which resolves the fluid at the macula, gets rid of the distortion and prevent the vision from getting worse. The vision can improve with treatment in some cases. The injections are well tolerated but have their associated risks: the most important being infection/endophthalmitis which can occur after each injection. The risk of infection with injection is approximately 1:2000/ injection. Steps are taken at the time of injection to reduce the risk of infection.