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Guide to AMD Treatment: Managing Age-Related Macular Degeneration

Smiling Elderly Woman
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What is Age-Related Macular Degeneration (AMD)?

AMD is a progressive eye condition affecting the macula, the central part of the retina responsible for sharp, central vision. There are two main types of AMD: dry AMD, which involves the gradual breakdown of cells in the macula, and wet AMD, characterised by the growth of abnormal blood vessels beneath the retina. As AMD progresses, it can lead to blurred or distorted vision, difficulty reading or recognizing faces, and even vision loss.

Common Symptoms of Age-Related Macular Degeneration

  • Blurred or distorted central vision

  • Difficulty reading or performing tasks that require detailed vision

  • Dark or empty areas in the central vision

  • Straight lines appearing wavy or crooked

  • Decreased brightness or intensity of colours

  • Difficulty recognising faces

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​It's important to note that AMD often progresses slowly and may not cause noticeable symptoms in its early stages. Regular eye exams are essential for early detection and timely intervention.

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​​Types and Stages of Age-Related Macular Degeneration

Age-Related Macular Degeneration can be classified into the following types: Early or dry AMD, wet AMD and macular atrophy. Each type has distinct characteristics and can progress through different stages.

Early AMD

Drusen which are yellowish deposits under the retina are hallmarks of AMD. In most cases, patients may be asymptomatic or have slight distortion.

Dry AMD

Dry AMD, also known as non-neovascular AMD, is the more common form of the condition. It occurs when the cells of the macula gradually break down over time, leading to a gradual loss of central vision.

Wet AMD

Wet AMD, also known as neovascular AMD, is less common but more severe than dry AMD. It occurs when abnormal blood vessels grow beneath the macula and leak fluid or blood, causing rapid and severe damage to central vision.

 

Wet AMD can cause sudden changes in vision, such as the appearance of dark spots or straight lines appearing wavy. Without prompt treatment, wet AMD can lead to significant vision loss.

Stages of AMD

AMD can also be categorised into different stages based on the severity of the condition. The stages may vary slightly depending on the classification system used, but they generally include:

Early AMD

Early AMD is characterised by the presence of medium-sized drusen or changes in pigmentation in the macula. Individuals with early AMD may not experience noticeable vision loss or symptoms.

Intermediate AMD

Intermediate AMD is characterised by the presence of large drusen, pigment changes, or a combination of both. Some individuals with intermediate AMD may experience mild to moderate vision loss or distortion.

Late AMD

Late AMD can be further divided into two subtypes: dry AMD (geographic atrophy) and wet AMD (neovascular AMD). Dry AMD (geographic atrophy) is characterised by the development of extensive areas of cell loss in the macula, leading to significant vision loss.


Wet AMD (neovascular AMD) is characterised by the growth of abnormal blood vessels beneath the macula, which can cause rapid and severe vision loss if left untreated. It's essential for individuals with AMD to undergo regular eye exams to monitor the progression of the condition and receive timely treatment when necessary.

Ways to Lower AMD Risk

Lowering your risk for Age-Related Macular Degeneration involves adopting healthy lifestyle habits and making proactive choices to protect your vision. Here are some strategies to help reduce your risk of developing AMD:

Maintain a Healthy Diet

Eat a balanced diet rich in fruits, vegetables, and omega-3 fatty acids, which are found in fish like salmon, mackerel, and sardines. Include foods high in antioxidants, such as leafy greens, citrus fruits, and nuts, to help protect your eyes from oxidative damage. Limit your intake of saturated fats and processed foods, which may contribute to inflammation and increase the risk of AMD.

Protect Your Eyes from UV Exposure

Wear sunglasses that block 100% of UVA and UVB rays when outdoors to protect your eyes from harmful UV radiation. UV exposure can contribute to the development and progression of AMD, so wearing sunglasses can help lower your risk.

Maintain a Healthy Weight

Aim to maintain a healthy weight through regular exercise and a balanced diet. Obesity and excess weight are associated with an increased risk of developing AMD, so maintaining a healthy weight can help reduce your risk.

Manage Chronic Health Conditions

Control conditions such as high blood pressure, high cholesterol, and diabetes through regular monitoring and appropriate treatment. Chronic health conditions like hypertension and diabetes can increase the risk of developing AMD, so managing these conditions can help lower your risk.

Don't Smoke

Smoking is a significant risk factor for AMD and can accelerate its progression. If you smoke, quitting can help reduce your risk of developing AMD and other eye conditions.

Exercise
Regularly

Engage in regular physical activity, such as walking, swimming, or cycling, to promote overall health and reduce the risk of AMD. Exercise improves blood flow to the eyes and may help protect against AMD and other age-related eye conditions.

Get Regular Eye Exams

Schedule comprehensive eye exams with an eye care professional on a regular basis, even if you have no symptoms. Early detection and intervention are key to preventing vision loss from AMD, so regular eye exams are essential for maintaining eye health and detecting any changes early.
 

By incorporating these lifestyle habits into your daily routine, you can help lower your risk of developing AMD and maintain healthy vision as you age.

Treatment

Exploring Treatment Options for Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a progressive eye condition that affects millions of people worldwide, particularly those over the age of 60. As AMD advances, it can lead to significant vision loss and impairment. Fortunately, several treatment modalities are available to manage AMD and preserve vision. Below are the various treatment options, including non-surgical interventions and surgical procedures.

Non-Surgical Treatment Options

Non-surgical treatments for AMD focus on preserving vision and slowing disease progression through lifestyle modifications, dietary supplements, and low vision aids. These interventions are particularly beneficial for individuals in the early stages of AMD or those with dry AMD, where abnormal blood vessel growth is not present.

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  • Lifestyle Changes: Adopting a healthy lifestyle can play a crucial role in managing AMD. This includes maintaining a balanced diet rich in antioxidants, omega-3 fatty acids, and vitamins C and E. Regular exercise, quitting smoking, and protecting the eyes from harmful UV radiation can also help slow disease progression.

  • Dietary Supplements: Certain vitamins and minerals have been shown to support eye health and may help slow the progression of AMD. These include vitamin C, vitamin E, zinc, copper, Zexanthin and lutein. Dietary supplements containing these nutrients may be recommended by healthcare professionals to complement a healthy diet.

  • Low Vision Aids: For individuals with advanced AMD who experience significant vision loss, low vision aids can help improve visual function and quality of life. These aids may include magnifying devices, reading glasses, electronic magnifiers, and adaptive technologies designed to enhance remaining vision.

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Intravitreal Injections

Intravitreal injections of anti-VEGF medications are a mainstay of treatment for wet AMD. These injections are administered directly into the eye to inhibit the growth of abnormal blood vessels and reduce fluid leakage, thereby stabilising vision and preventing further vision loss. Anti-VEGF injections may need to be administered regularly to maintain their effectiveness.

 

A variety of treatment options are available for managing AMD and preserving vision. From non-surgical interventions such as lifestyle changes, dietary supplements, and low vision aids to surgical procedures like photodynamic therapy and laser surgery, individuals with AMD have access to a range of interventions to help maintain their visual function and quality of life. 

 

It is essential to consult with an eye care professional to determine the most appropriate treatment approach based on individual needs and disease severity.

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Consultation and Next Steps

If you or a loved one have been diagnosed with wet AMD or are experiencing symptoms of AMD, it is crucial to seek consultation with an eye care professional for personalised treatment recommendations. 

 

Your eye care provider can assess your condition, discuss available treatment options, and help develop a tailored treatment plan to meet your specific needs and goals. Don't wait until vision loss occurs – schedule an appointment today to take proactive steps towards preserving your vision and maintaining your quality of life.

Recovery and Aftercare

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Depending on your disease, the treatment plan will involve a course of intravitreal anti-VEGF injections. Usually there will be either 3 or 4 loading doses on a monthly basis and Ms Heng will advise a more detailed and personalised treatment plan tailored to your disease and prognosis.

 

During all follow up and injection visits, your eyes will be dilated and vision checked. You will receive topical anaesthetic to numb your eyes so you will not feel any discomfort during the procedure. 

Following the procedure, we may ask that you stay 10 minutes for a post procedure eye pressure check. You will be able to go home on the same day. There will be no bandage nor patch on your eye following the procedure and you can function as normal after that. 

Be careful about the injected eye and avoid swimming, rubbing your eyes. Your eyes may be slightly uncomfortable or you may experience foggy vision for 1 day or 2, but if there is worsening pain or vision, please ring us for urgent advice.

Your AMD Treatment Package

  • Ms Heng’s initial consultation charges are £300 followed by £200 for follow up.

  • There are several different anti-VEGF available and  the treatment package and cost will depend on the chosen treatment plan.

  • The cost per injection starts from £1000 (including surgeon fee).

  • Major insurance accepted.

Frequently Asked Questions

  • What conditions can be treated with retina laser therapy?
    Retina lasers such as panretina photocoagulation remains the gold standard treatment for proliferative retina vascular disease such as diabetic retinopathy and retina vein occlusion. Lasers targeted at the macular , macular laser therapy is often used to treat conditions such as diabetic macular oedema, macular oedema from vein occlusion and certain cases of central serous retinopathy.
  • Is retina laser therapy painful?
    Patients will be given topical anaesthetic drops and will have a contact lens on the eye to keep the eye open during the procedure. You can feel slight discomfort during the procedure and immediately after. Usually paracetamol or NSAID tables over the counter will help to ease the discomfort from the procedure. You should not be experiencing pain beyond a day or two. If not, please seek urgent assistance.
  • How long does a retina laser therapy session typically last?
    Depending on the area to be treated, a session will take from 15 mins to 30 min per eye.
  • Are there any side effects or risks associated with retina laser therapy?
    Whilst laser photocoagulation is effective, there are risks involved , such as: Vision loss: It may cause a blind spot in the area where a scar forms. If the fovea is lasered, this may cause visual loss but this is incredibly rare. Damage to the retina caused by the scar that formed from treatment: This damage may occur right after surgery or years later. Blood vessels that grow again: Retina specialists can remedy this by repeating the laser treatment. Bleeding in the eye Reduced colour vision Lowered night vision
  • What is the recovery process like after retina laser therapy?
    The procedure is a day procedure and you will usually go home after the procedure. You can continue with normal activity following the laser therapy. You might feel slight discomfort for a day or two. The true impact of the laser on the retina vasculature or fluid may take up to 2 weeks or 3-4 months in the case of macular oedema. A follow up appointment will be scheduled to monitor on the status of the retina following the procedure
  • Will I need multiple sessions of retina laser therapy?
    In certain indications of retina laser such as proliferative diabetic retinopathy, several sessions of retina laser therapy will be planned
  • Is retina laser therapy covered by insurance?
    Most indications of retina laser therapy are covered by insurance, please contact your insurance to confirm your eligibility depending on your personal insurance plans.
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