How do I know if I have age-related macular degeneration (AMD)?
If you notice distortion or a blur patch in your central vision, you could have Age-related Macular Degeneration (AMD). It is the leading cause of central vision loss in people over the age of 50 in developed countries, including Singapore. With an average life expectancy of close to 80 years in the country, more than 1 in 5 elderly Singaporeans can expect to develop AMD. Recent studies have also shown that 7% of Singaporean adults who are 40 years and older have AMD.
What is AMD?
AMD is the deterioration in the health of the macula, the most visually important part of the retina that is responsible for sharp central vision. The retina is the light-sensitive layer at the back of your eye that converts light rays into electrical impulses and send them to the brain where visual images are formed.
I heard that there are 2 types of AMD. Is that right?
Yes, there are 2 types of AMD, they are:
Dry AMD occurs when the light-sensitive cells in the macula slowly break down. It accounts for about 90% of all AMD cases. You might not be aware of it in the beginning and that is why eye screening could detect and prevent it from developing into a bigger blur spot in your central vision.
Wet AMD accounts for 90% of severe vision loss from AMD. This loss of vision occurs suddenly. It results from abnormal new blood vessels growing underneath the macula and leaking fluid and blood.
Will I go blind if I get it?
Based on the Age-Related Eye Disease Study (AREDS), the progression to advanced AMD can be slowed down by nutritional supplements. It is a major clinical trial sponsored by the National Eye Institute in the U.S.that closely monitored 3600 individuals for an average of 6.3 years to learn more about the history of and risk factors for, age-related macular degeneration (AMD) and evaluate the effect of high doses of antioxidants and zinc on the progression of AMD.
The study was subsequently followed by AREDS 2, a five-year study with results published in 2013. Apart from showing that the beneficial effects of taking AREDS vitamins are long-lasting, also demonstrated benefits of Lutein and Zeaxanthin in reducing the progression of macular changes to advanced AMD. Supplements containing formulations based on the latest AREDS study (AREDS 2) are available at The EyeClinic.
We can halt or slow down the proliferation of the abnormal blood vessels by one or more of the following treatment methods:
This procedure involves injecting a type of drug known as anti-vascular endothelial growth factors (anti-VEGF) into the eye. The drug aims to block the effects of VEGF that promote growth of new abnormal blood vessels. Injections are typically given monthly for the first 3 months while the response to treatment is being closely monitored. Your eye doctor will then assess the need for additional injections while the eye is being monitored for relapse of the condition. This is a highly effective treatment with more than 2 thirds of patients seeing an improvement in their vision and no worsening of their vision.
This treatment involves infusion of a drug called Verteporfin into the bloodstream followed by application of a low-energy ‘cold’ laser onto the affected area at the macula. This laser activates the drug that has been absorbed by the abnormal vessels in the macula, causes a series of chemical reaction that seals the abnormal blood vessels hence controls the progression of AMD.
This procedure involves the use of a very intense laser beam to destroy the abnormal vessels in the retina. However, as this form of laser also destroys the underlying ‘normal’ retinal tissue, it is performed only in cases where the abnormal blood vessels lie outside the centre of the macula.
How can I prevent it from happening to me?
Early detection plays a very important role in preventing significant vision loss from AMD. You are also strongly advised to quit smoking, start on a diet rich in green leafy vegetables and fruits, exercise regularly, control your blood pressure and keep an ideal body weight. By detecting AMD early, factors such as smoking habits and diets can be modified early along with the intake of nutritional supplements containing lutein and zeaxanthin to slow down its progression.
Why choose The EyeClinic for AMD treatment?
The EyeClinic is equipped with up-to-date equipments for thorough assessments of the retina.
Colour retinal photography
Fundus camera is used to capture high-resolution images of the retina. This is a fast and non-invasive procedure that allows direct visualization of the central retina. The camera used in the clinic is also equipped with Scanning Laser Ophthalmoscope (SLO) technology that allows detection of early macular changes in retinal conditions including AMD. Photographs of the retina are always useful over time as the conditions of the retina can be directly compared.
Optical Coherence Tomography (OCT)
OCT allows high definition scan of the different layers of the retina. It has the advantage of detecting small changes in the layers in the retina hence allowing early detection of the macular changes that may be the signs of AMD. Furthermore, the OCT in the clinic is equipped with features to analyse the changes in the macular thickness over time, so it is not only used for early detection of AMD but also as a tool to monitor the progression of the AMD and the efficacy of the treatments rendered.
Supplements containing formulation based on the latest AREDS (AREDS 2) are available in the clinic. Moreover, Dr Cheryl Lee, the medical director of The EyeClinic, is a retinal doctor and she has been involved in research in retinal stem cells. She was also a clinical investigator for LUCENTIS® (ranibizumab injection) which has revolutionised the treatment of AMD.
Eye screening for AMD at The EyeClinic at $98
Our optometrists are qualified and trained to clinically diagnose eye conditions, including cataract, diabetic eye diseases and AMD. They are put in-charge of providing AMD screening in the centre that involves the following:
- Visual acuity test
- Measurement of eye pressure
- 3D image scan of macula
- Personalised educational video on your eye conditions
- Sufficient time allocation for onsite consultation for you
- Amsler grid for monitoring of central vision
- Personalised dietary and lifestyle advices
You will be referred to on-site ophthalmologist for further evaluation immediately if you are diagnosed with retinal changes otherwise a 6-monthly or an annual review appointment (depending on your eye condition) will be given to you on the same day in the clinic. A set of scans will be given to you along with your medical reports. You will also be reminded of your follow-up appointment via phone call or SMS.