Age-Related Macular Degeneration (AMD) is a leading cause of vision loss among individuals over 50, affecting the macula—the central part Understanding and Managing Age-Related Macular Degeneration (AMD)
What Is AMD?
AMD is a condition that affects the macula, the central part of the retina at the back of the eye. The macula is responsible for sharp, detailed central vision, which is essential for tasks like reading, driving, and recognizing faces. When the macula deteriorates, it leads to vision loss in the center of the visual field, while peripheral (side) vision remains intact.
Prevalence of AMD in South Africa
In South Africa, the prevalence of AMD is a growing concern. A study conducted in Durban found that among older adults living in low-income old age homes, 3.88% had AMD, making it the third leading cause of visual impairment in this population.
Causes of AMD
The exact cause of AMD remains unclear, but it is believed to involve a combination of genetic, environmental, and lifestyle factors. The macula contains light-sensitive cells that can deteriorate over time, leading to the symptoms associated with this condition.
Symptoms of AMD
Early stages of AMD may present no symptoms. As the condition progresses, individuals might experience:
- Blurred or distorted central vision
- Difficulty seeing in low-light conditions
- Faded or washed-out colors
- A dark or empty area in the center of vision
These symptoms can interfere with tasks like reading, driving, and recognizing faces.
Types of AMD
AMD is categorized into two main types:
- Dry AMD (Non-Neovascular):
The more common form, accounting for about 85-90% of cases. It progresses slowly and features the presence of drusen (small yellow deposits under the retina) and thinning of the macular tissue. Dr Roelof Cronje
- Wet AMD (Neovascular):
Less common but more severe, wet AMD involves the growth of abnormal blood vessels under the retina that can leak fluid and blood, leading to rapid vision loss. Dr Roelof Cronje
Risk Factors
Several factors can increase the risk of developing AMD:
- Age: The risk increases with age, particularly after 50.
- Family History: A genetic predisposition can elevate risk.
- Smoking: Smoking significantly increases the risk of AMD.
- Obesity: Higher body mass index is associated with increased risk.
- Sunlight Exposure: Prolonged exposure to UV light may contribute to AMD development.
Diagnosis
AMD is diagnosed through a comprehensive eye examination, which may include:
- Visual Acuity Test: Measures the sharpness of vision.
- Dilated Eye Exam: Allows the doctor to view the retina and macula.
- Amsler Grid Test: Detects visual distortions.
- Fluorescein Angiography: Uses dye to highlight blood vessels in the eye.
Treatment Options
While there is no cure for AMD, several treatments can help manage the condition and slow its progression:
- Anti-VEGF Injections: Medications like Avastin and Lucentis are injected into the eye to inhibit the growth of abnormal blood vessels in wet AMD. Dr Roelof Cronje
- Photodynamic Therapy: A light-activated drug is used to target and destroy abnormal blood vessels in wet AMD. Dr Roelof Cronje
- Nutritional Supplements: The Age-Related Eye Disease Study (AREDS) found that a specific combination of vitamins and minerals can reduce the risk of progression in intermediate or advanced AMD. Dr Roelof Cronje
Lifestyle Modifications
Adopting certain lifestyle changes can help manage AMD:
- Diet: Consuming a diet rich in leafy greens, fish, and nuts can support eye health.
- Exercise: Regular physical activity may reduce the risk of AMD progression.
- Smoking Cessation: Quitting smoking can significantly lower the risk.
- UV Protection: Wearing sunglasses that block UV light can protect the eyes.
Conclusion
Age-Related Macular Degeneration (AMD) is a leading cause of vision loss among individuals over 50, affecting the macula—the central part of the retina responsible for sharp, detailed vision. This progressive condition can significantly impact daily activities, including reading, driving, and recognizing faces.
