Age-related macular degeneration

Age-related macular degeneration (AMD) is a severe eye disease characterised by progressive deterioration of the macula, the most sensitive central back portion of the retina in the eye. Eight million people are legally blind from macular degeneration worldwide and as the population ages this number is expected to grow. Age-related macular degeneration is a degenerative disorder of the central area of the retina often associated with visual impairment, which is more frequent after 50 years of age.

Although cataract remains the principal cause of blindness in most of the world, Age-related macular degeneration takes the top spot in the most developed countries due in part to the growing number of people aged over 70 years. The World Health Organisation’s global data on visual impairment in the year 2002 show that AMD ranks third after cataract and glaucoma as a leading cause of blindness worldwide. The two-year SNEC hospital incidence rate of Age-related macular degeneration in 1991–1992 was 0.38 percent or equivalent to 3.8 per 1,000 new cases seen at SNEC. The estimated population-based incidence rate of exudative AMD was 0.02 percent.

Why should I be concerned about Age-related macular degeneration if I have loved ones who are elderly?

What is so scary about Age-related macular degeneration is how it affects the person’s entire family and their quality of life. A blind person and his family face major social constraints and blindness affects activities of daily living. Furthermore, poor vision in older persons is associated with myriad problems, including falls, hip fractures, family stress, and depression. In addition, those with AMD present a safety risk to all other drivers and passengers if they attempt to drive.

Is there a cure for Age-related macular degeneration?

Despite the devastating effects of Age-related macular degeneration, there is no definitive curative treatment. Some medical approaches include thermal laser photocoagulation, photodynamic therapy, and antivascular endothelial growth factor injection, have been shown to be efficacious in certain patients only. They may halt or retard the progression of the wet form of the disease but cannot reverse any vision loss that has already occurred.

What causes Age-related macular degeneration and how can it be prevented?

We know cigarette smoking increases the risk of Age-related macular degeneration two- to three-fold. Obesity, hypertension, macrovascular disease, raised plasma cholesterol and fibrinogen levels, cumulative light exposure, and cataract surgery have all been linked with AMD. My opinion is that free radicals have a huge part to play with the integrity of the macular of the eye. There is also evidence from a large randomised controlled trial that high-dose dietary supplements of vitamins C and E, beta-carotene, and zinc can reduce the risk of progression from moderate AMD to advanced AMD.