What is AMD – Age-related Macular Degeneration?
Macular degeneration is a condition which occurs in later life and there are two sorts. There is the dry form, where you get gradual and slow loss of vision, and there is the wet form, where you have new blood vessels growing underneath the retina, which produces a more acute form of the condition. And then, in that variant (wet AMD), there can be rapid onset of blurring of vision, of distortion of vision.
One of the problems is, that patients may not notice that this has occurred because we walk around with both eyes open that it only happens that we have to close one eye and then realise that vision has dropped in that eye.
When you do develop a wet macular degeneration, while it’s not an ophthalmological emergency, it needs to be dealt with quickly. And we would like patients to be seen within five to seven days for assessment.
The assessment consists of measuring the vision carrying out retinal imaging, so we do special photography looking at the different layers of the retina and possibly with fluorescein angiography, where dye is injected into the vein and photographed as it flows through the retina and picks out the new blood vessels.
The condition is now treatable. For many years, it wasn’t possible. Then we had laser photocoagulation, but now there is a treatment with injections with a drug that kills off the blood vessels and these injections are administered into the back of the eye. These injections have been shown to be very effective and I think it divides into 3 groups: those that will improve with the injections, those that remain stable and then another third, whom in, whatever you do, the disease will progress and there will be a reduction in vision. That’s a very simplistic way of analysing and there’ve been very many studies which had been done comparing the different forms of treatment and the dosing.
The injections need to be given generally on a monthly basis for three months. And then there are different treatment protocols as to whether you repeat the injections, two monthly intervals or it’s done on a process that’s called ‘treat and extend’ where it depends on the treatment and the response on the initial therapy.
More about Paul Rosen
Paul Rosen is a Consultant Ophthalmic Surgeon at The Grange Eye Consultants. His special expertise is in laser eye surgery, cataract surgery, and the treatment of Age-related Macular Degeneration, glaucoma, and retinal diseases. He has over 20 years experience in treating people with eye problems. Paul is invited to lecture on cataract and refractive surgery both nationally and internationally. He leads clinical trials investigating novel eye treatments. Paul has served as the President of the UK and Ireland Society of Refractive Surgeons and is currently the President of the European Society of Corneal and Refractive Surgery. More recently I’d been appointed as a member of the NICE Cataract Guidelines Committee and also on the Refractive Surgery Subcommittee of the Royal College of Ophthalmologists.