WHAT IS AGE RELATED MACULAR DEGENERATION?
The macula is a small central area at the back of the eye on the retina, or visual membrane of the eye. The macula is a very sensitive area, responsible for our sharp central vision. Age related macular degeneration (ARMD) is responsible for a weakening of the macula and loss of central vision due to age related changes. It is a leading cause of blindness in those over 65 years of age.
The changes seen at the macula is usually one of two types, either dry and atrophic, or wet and exudative. In the dry type the diseased cells get weak and thinning takes place with a resulting loss of central fine vision. In the wet or exudative type swelling occurs due to abnormal leaking blood vessels. This swelling enlarges gradually resulting in a progressive larger area being affected and further deterioration in vision. The patients will report a blurring of their central vision, as well as metamorphopsia (straight lines have a wavy appearance or bends out like a barrel shape).
TREATMENT OF ARMD
The Swept Source OCT is very important in both the diagnosis, as well as the further evaluation of the success of treatment. The laser system gives a macroscopic cross section of the macula to evaluate the structures. The OCT angiogram is also used to evaluate the blood vessels of the retina and diagnose the abnormal blood vessels that causes the leakage. The OCT angiogram is a laser enabled imaging of the blood vessels at different layers of the retina to distinguish normal from abnormal leaking vessels.
Stopping smoking is an important lifestyle modification shown to be effective in preventing ARMD. Smoking roughly doubles the risk of ARMD.
The advances in the treatment of ARMD have resulted in a better prognosis for maintaining the essential central vision. Treatment with anti-VEGF (vascular endothelial growth factor) agents has become the mainstay in the effective treatment of this condition. Avastin injections are given in the rooms, and not in the hospital theatre complex. This not only reduces the cost, but also simplifies the logistics enabling a short visit to the practice. The Avastin treatment is very effective in treating the abnormal blood vessels responsible for the macular swelling. The main aim is to prevent further swelling and central vision loss, but with the improvement in the swelling the central vision also improves.