Age-related macular degeneration (ARMD)
What is it?
This is the most common cause of blindness in the UK, and is increasingly common with age. There are Dry and Wet variants.
Dry ARMD
What is it?
The macular is the central part of the retina. The retina lines the inside of the back of the eye like wallpaper; and is the tissue which detects light allowing you to see. The macular is the most important part of the retina as this is the only part of the retina which can pick up fine detail like seeing letters in a book.
The Symptoms
Dry ARMD is when the central part of the retina develops patches of worn out retina (geographic atrophy) which can no longer see. These patches of missing vision get gradually bigger and can eventually cause severe central visual loss.
Black patches are damaged retina in a patient with dry age related macular degeneration
How long does it take to become severe?
It usually takes several years.
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What are the treatments?
Traditional treatments aim to be supportive, like magnifying glass clinics (Low Vision clinic).
Photobiomodulation, using light treatment, is a relatively new treatment which has produced positive results in slowing down the loss of vision. This treatment requires three blocks of treatment each year. Each block consists of nine individual short treatment sessions lasting a few minutes. These are administered three times per week, over a three week period.
Wet ARMD
What is it?
The macular is the central part of the retina. The retina lines the inside of the back of the eye like wallpaper; and is the tissue which detects light allowing you to see. The macular is the most important part of the retina as this is the only part of the retina which can pick up fine detail like seeing letters in a book.
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The Symptoms
Early on, a patient is likely to experience mild blurring and distortion of vision. Distortion means straight lines look bent. As the condition progresses, new blood vessels develop scar tissue around them and sometimes bleed; scarring and bleeding can cause permanent severe loss of central vision.
No one ever goes completely blind with this condition, which only affects the centre of your vision. The side vision remains intact; people do not lose their independence. However, poor vision can cause unusual visual symptoms. Cited examples are seeing purple or green flowery patterns, in a brickwork effect, or even as a fully formed hallucinations.
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How long does it take to become severe?
Blindness in the affected eye is pretty much 100% within 5 years without treatment. The risk of the other eye becoming affected is about 8% per year.
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What are the treatments?
Wet ARMD can now be treated by regular injections into the eyeball of Faricimab, Aflibercept (Eylea), Ranibizumab (Lucentis), Brolucizumab (Beovu) or Bevacizumab (Avastin). From this, many patients can improve their vision, and the chance of going blind is significantly reduced. The injections stop the blood vessels from growing and reduce leakage and bleeding. They usually last about 4 to 8 weeks and are used as long term treatments with most patients needing about 7 injections in the first year and 4 or 5 in the second year and onwards. The newer drugs like Faricimab may last up to 16 weeks per injection before they need reinfecting.
OCT scan of patient with early wet AMD
Patient Information Sheet
Intravitreal (Anti-VEGF) Injection