Age-related macular degeneration (AMD) is a common eye disease that causes deterioration of the
macula, the central area of the retina specially after age of 55 years of age
There are two forms of AMD:
It is possible for a person to suffer from both forms.
This is the most common type of AMD. In this form yellow deposits called drusen (waste products from metabolism) accumulates under the retina. Over time, dry AMD may advance and cause loss of vision.
Wet form occurs when new blood vessels grow. This growth is called neovascularization. These vessels are very fragile and can leak fluid and blood, resulting in scarring of the macula and potential for rapid, severe damage.
It is possible to develop AMD in only one eye. However, as the disease progresses both eyes may become affected. If an individual has macular degeneration in one eye, he or she is more likely to develop it in the other eye than someone who does not.
More light is needed for tasks such as reading
Blurry spot in centre of visual field
Blurry spot becomes larger and darker
Straight lines may appear wavy
Straight-ahead vision becomes distorted or lost entirely in a short period of time
Do not delay in informing your doctor of any changes in your vision, as they may be indicators of potential permanent damage that can happen very quickly
There are various ways:
a) Clinical evaluation : Dilated fundus examination is done by your retina specialist with indirect ophthalmoscope & slit lamp biomicroscopy to pick up the disease.
b) Color photo :
c) Amsler Grid Test
In an eye exam, a doctor may use an Amsler grid to test for defects in the center of your vision. If you have macular degeneration, you may see blurred, faded, broken or distorted lines on the grid.
d) Fluorescein Angiography & Indocyanine Green Angiography
A colored dye is injected into a vein in your arm. The dye will travel to your eye and highlight the blood vessels. By using a special camera, various pictures are taken . The resulting images will show if there are any abnormal blood vessels present or any form of leakage.
e) Optical Coherence Tomography ( OCT)
Noninvasive (No injection given) imaging test. It displays detailed cross-sectional images of the retina. With this test, the doctor will find out if there is thinning or swelling of retina.
f) Optical Coherence Tomography (OCT-A )
Noninvasive (No injection given) imaging test. It displays detailed cross-sectional images of the retina at various layers of retina. This test is very useful in follow ups , as there is no need of doing invasive investigations like FFA / ICG to see the activity of disease.
g) Fundus auto fluorescence : Non-invasive , special investigation to detect early progression of dry AMD.
h) Retro : Unique non-invasive technique which visualizes pathologies / disease of deeper layers which are detected at very early stage ( which are not detected by any other test)
Our centre is the first in Central India & second in India to have this technology.
a) Dry AMD : Early stage à No treatment (follow up)
Intermediate – Anti-oxidants ( green vegetables , yellow pulpy fruits or multivitamin tablets)
Advanced – Low vision aids
Preventive measures :
Avoid smoking ( active & passive )
Anti-oxidant rich food
Low fat & cholesterol diet
Wearing glasses with UV protection
Regular eye examination
b) Wet AMD : Anti VEGF injections in eye. Minimum 3 injections are needed at monthly interval , but depending upon disease, you may need more injections to preserve your existing vision.
Types of anti-VEGF :
- Avastin : Bevacizumab
Not FDA approved
Primarily used in treatment of colon cancer
Used world wide for retinal disorders.
- Accenterix : Ranibizumab
World wide studies have been done regarding its safety & efficacy
- Razumab : Accenterix
Biosimilar : A biopharmaceutical drug designed to have active properties similar to one that has previously been licensed & approved.
DCGI approved in 2015
Phase 3 trial in Indian patient with wet AMD
No world wide trials
- Eylea : Aflibercept
Multicentric trials done
Usually for PCV variant of wet AMD
- Brolucizumab : Most recent drug
Multicentric trials done
For wet AMD only
c) Advanced damage : Low Vision Aids.
Emergency Contact No.
19, Rajiv Nagar, Near Bharat Furniture, Wardha Road, Nagpur – 440 025