Age-related macular degeneration

Age-related macular degeneration (AMD) is one of the leading causes of blindness in Canada and the world. It is estimated at least 2.5 Million Canadians are living with AMD.

What is AMD?

The disease affects the macula, which is a small, but very important part of the retina that lets you see fine detail in your central vision.

The retina is located in the inner eye and contains cells that receive light (photoreceptors) and nerves that send information to our brain to process our vision. The macula allows you to see facial features, letters on a page, and details on TV anddetail on TV and detail on road signs. AMD is not painful and can occur in one or both eyes. How quickly the disease progresses can vary from person to person and from eye to eye.

When the disease advances rapidly it may lead to sudden and severe vision loss by either turning into geographic atrophy or wet macular degeneration.

Age is the greatest risk factor for AMD and people over 50 are at the greatest risk. Other risk factors include smoking, high retinal UV exposure in a lifetime, cardiovascular disease, high cholesterol, obesity and family history.

Studies show that AMD may be hereditary. It's recommended that anyone with a family history of AMD should have their eyes examined.

There are two types of AMD:

Wet AMD
Dry AMD

About 85-90% of people with AMD have dry AMD. In dry AMD yellow-coloured fatty deposits called "drusen" build up in the layers of the macula. As the size and number of these deposits increase so does your risk of developing wet AMD or dry geographic atrophy.

Symptoms may include blurry vision such as difficulty seeing sharp details both up close and from a distance, visual distortions, difficulty seeing in low light, fading colours, and needing more light when reading. However, many people with early dry AMD have no symptoms at all or do not notice any of these changes in their vision over time.

Geographic atrophy (GA) is an advanced form of dry AMD that affects more than 5 million people worldwide. In GA, photoreceptor cells in the retina start to die, creating areas of cell death or atrophy which causes severe central vision loss.

Wet AMD
Wet AMD

About 10-15% of people with dry AMD progress to a form called wet AMD. In wet AMD, due to the damage to the retinal layers from dry macular degenerative changes, abnormal blood vessels grow and can suddenly leak fluid in the back of your eye without notice. Wet AMD is also known as "neovascular" or "exudative" AMD.

When you have wet AMD your central vision becomes distorted. Symptoms include blurry vision, vision distortion where straight lines look wavy and a dark spot (or spots) in the center of your vision.

Rapid and severe vision loss can happen very quickly if treatment is delayed. Some people may not notice any changes in their vision until significant vision loss has occurred. Early detection of wet AMD allows your doctor to step in sooner so he or she can refer you to a retina specialist for treatment to help preserve your vision.

Both wet AMD and GA can severely impact quality of life and limit independence. It can make many of the activities you enjoy and rely on impossible, like driving, reading, watching television and using a computer.

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How do we detect AMD?

To detect AMD, we use dilated retinal examination, retinal photography and most importantly Optical Coherence Tomography.

Optical coherence tomography (OCT) is a specialized imaging technology that creates cross-sectional images of your macula and retina. OCTs are similar to an ultrasound, but instead of using sound, OCTs use light waves to generate the images of your retina.

This 3D image of your retina allows us to find, define and track diseases such as macular degeneration, diabetic retinopathy and glaucoma.

At Nelson Family Eyecare, we have seen the importance of OCT imaging in detecting eye diseases such as AMD before they are evident with other testing. We now provide OCT testing as part of a full ocular examination for anyone over the age of 50, and can perform on those younger if risk factors or desire warrants it.

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Treatment for Macular Degeneration

For many years, the mainstays of treatment for dry macular degeneration have been modifying lifestyle to decrease the chance of progression, and attempting to slow the progression with vitamins. However, new therapies are emerging that provide improvement in vision for those suffering from dry macular degeneration! Reducing the progression of dry AMD should also decrease the chance of the more severe outcomes of wet AMD and GA.

MacuMira is an in office treatment that involves applying microcurrent to closed eyelids. This stimulates cellular function, aiding in macular waste clearance. Vision improvements are often observed within the first 10 days.

Treatment involves a loading phase of four treatments within 10 days, followed by a maintenance treatment every 2.5 to 3 months.

The main contraindications are having electrical implants such as a pacemaker or cochlear implants.

Wet age-related macular degeneration (AMD) is typically treated with anti-VEGF (vascular endothelial growth factor) injections, which help reduce abnormal blood vessel growth in the retina. These medications are injected directly into the eye to slow vision loss and, in some cases, improve vision. Other treatments may include photodynamic therapy (PDT) or laser photocoagulation, though anti-VEGF injections are the most common and effective method for managing wet AMD. Treatment for wet AMD is performed by ophthalmologists.

MacuMira

Nelson Family Eyecare is excited to be one of the first clinics in the Kootenays to offer MacuMira, the first Health Canada-approved, clinically backed, non-invasive treatment for dry macular degeneration.

Please contact our clinic to learn more and book an assessment or treatment.