1.What is Age-related Macular Degeneration (AMD)? The human eye is like a camera, the retina in the eye is like the negative in the camera, the 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 macula is responsible for, so once the disease occurs in this part of the 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 AMD even 10 years ago, but in recent years, there has been a breakthrough in the treatment of AMD and countless patients have benefited from it. 2.What kind of AMD do you have? AMD is divided into “dry” and “wet”. Dry AMD patients first have vitreous warts in the macula, which gradually cause atrophy of the macula, but there is no new blood vessel, no bleeding, and the development is slow. There are early, middle and late stages: early stage can be asymptomatic; middle stage can appear blurred and dark spots in the center of the visual field, resulting in more light needed for reading or doing business; late stage blurred and dark spots become bigger and darker, vision loss, and can cause blindness in serious cases. For advanced dry AMD, there is no effective treatment. For intermediate AMD, taking lutein is effective in slowing its progression to advanced stages. Wet AMD has abnormal neovascular growth in the macula, leading to bleeding and fluid leakage, which eventually leads to scar formation and rapid progression, which can cause rapid loss of central vision, more severe 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 come back for a checkup 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: Visual acuity: A visual acuity test can help detect vision loss that the patient has overlooked and help the doctor determine the extent of the lesion. patients with AMD generally have poor vision, so it is best to use the internationally accepted LogMAR visual acuity chart for people with low vision. Intraocular pressure (IOP): IOP must be measured before performing a dilated fundus exam to help the doctor identify some patients who are not suitable for dilatation. Pneumatic eye pressure checks do not touch your eyes and will not cause any damage to them. Dilated fundus exam: 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 pupil. Retinal angiogram: This can help your doctor 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. Choroidal angiography: The procedure is similar to retinal angiography but focuses on the deeper choroidal vessels. It helps the doctor determine the location and severity of the leak, rule out other diseases such as PCV, and guide treatment. 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 instruments are also crucial. Good OCT instruments have high resolution and are more capable of detecting subtle lesions, and can record the site of each scan to ensure that the same site is scanned at each follow-up visit for a more objective comparison. 4. 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. 5.How can AMD patients 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 your eyes; (3) Self-monitoring: check your vision and visual distortion at home with the Amsler scale. 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.