I. What is Age-related Macular Degeneration (AMD)?
Human eye is like a camera, the retina in the eye is like the negative in the camera, macula is a part of the retina, it is the sharpest part of the retina to see things, the most central vision when people see things is the responsibility of macula, so once the disease occurs in this part of macula, it will seriously affect the vision.
Macular degeneration in both young and old people may get macular degeneration, but macular degeneration in young people is mostly related to heredity, and there is no effective way to treat it.
Macular degeneration in the elderly is an aging degenerative change in the macular area, mainly related to age, and the older the age, the greater the risk of occurrence. The main manifestation is the appearance of vitreous warts in the fundus, pigment disorder in the macula, and in serious cases, hemorrhage, edema and exudation in the macula with scar formation, and the patients have symptoms such as serious loss of vision and distortion of seeing. There was no effective treatment for age-related macular degeneration even 10 years ago, but in recent years, there has been a breakthrough in the treatment of age-related macular degeneration, and numerous patients have benefited from it. For detailed information, please read below.
What type of AMD do you have?
AMD is divided into “dry” and “wet”.
1.Dry AMD patients first have vitreous warts in the macular area, which gradually cause atrophy of the macular area, but there is no neovascularization, no bleeding, and the development is slow. It is divided into early, middle and late stages: early stage can be asymptomatic; middle stage can appear blurred dark spot in the center of visual field, leading to more light needed for reading or doing affairs; late stage blurred dark spot becomes bigger and darker, vision decreases, and can cause blindness in serious cases. There is no effective treatment for advanced dry AMD. For mid-stage AMD, taking lutein can effectively slow down its progression to advanced stage.
2. Wet AMD has abnormal neovascular growth in the macular area, leading to bleeding and fluid leakage, which eventually leads to scar formation and rapid development, which can cause rapid loss of central vision, more serious than dry AMD. The photodynamic therapy (PDT) and intraocular injection methods we currently use are for wet AMD.
In addition, some dry AMD can develop into wet AMD, so no matter which type of AMD you have, you need long-term, regular eye exams.
3. How do I know if I have AMD?
Early AMD can be asymptomatic, and it may be too late to get checked when symptoms appear! Therefore, it is recommended that you come in for regular eye exams, especially dilated fundus exams, after the age of 50. Your doctor may recommend the following tests.
1. Visual acuity
Visual acuity tests can help detect vision loss that patients overlook and help your doctor determine the extent of the lesion. AMD patients generally have poor vision, so it is best to use the LogMAR vision chart, which is used internationally for people with low vision.
2.IOP
IOP measurements must be taken before a dilated fundus exam is performed to help your doctor identify patients who are not suitable for dilatation. The pneumatic eye pressure test will not touch your eyes and will not cause any damage to them.
3. Dilated Fundus Examination
This helps your doctor look at your retina to look for signs of AMD and other eye diseases. It is normal for you to have difficulty seeing up close after the dilated pupil. It usually takes about 5 hours for your pupils to return to normal after the test. It is a good idea to bring sunglasses on the day of the exam to avoid the sun’s glare after the dilated pupils.
4.Retinal angiography
This can help doctors determine the location and severity of blood vessel leakage and guide treatment. A special dye will be injected into the blood vessels of your arm and the doctor will start taking pictures when the dye reaches the blood vessels of your retina.
5.Choroidal angiography
It is similar to a retinal angiogram, but it is a deeper choroidal angiogram that can help the doctor determine the location and severity of the leak, rule out other diseases such as PCV, and guide treatment.
6.OCT examination
OCT is a quick and non-invasive test that can detect problems that cannot be identified with the naked eye, and is the most important test for AMD diagnosis and follow-up. The advanced OCT equipment is also crucial. Good OCT equipment with high resolution is more than enough to detect subtle lesions and can record the site of each scan to ensure that the same site is scanned at each follow-up visit, making the comparison more objective.
Fourth, how is wet AMD treated?
The most commonly used treatments are intraocular injection of anti neovascular drugs and photodynamic therapy (PDT), or a combination of the two. Although these methods have achieved satisfactory results in recent years, they cannot fundamentally cure wet AMD! Therefore, even after receiving the above treatments, your lesions and vision loss may still progress.
V. How can patients with AMD take care of themselves?
(1) Change your lifestyle habits: eat more vegetables and fruits, quit smoking, exercise, and control your weight.
(2) Avoid UV damage to the eyes.
(3) Self-monitoring: Check your visual acuity and visual distortion at home with the Amsler square table. If you notice any changes, you should go to the eye exam immediately.
(4) You should have a dilated eye exam at least once a year.