Eye Health

Updated 15 February 2016

A focus on age-related macular degeneration (AMD)

AMD affects the macula, the part of the eye that allows you to see fine detail. It causes no pain and sometimes people hardly notice any change in their vision.

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Age-related macular degeneration (AMD) affects the macula, the part of the eye that allows you to see fine detail. It causes no pain and sometimes advances so slowly that people hardly notice any change in their vision. In others, it progresses faster and may lead to a loss of vision in both eyes.

Those over the age of 55 are at risk and – while certain factors like age and genetic predisposition are un-modifiable, other important risk factors are modifiable, such as diet, supplementation, smoking, body mass index (BMI), cholesterol levels and hypertension.

Now an anti-angiogenic treatment offers new hope for patients affected by severe Wet form of AMD: While limited treatment for AMD has existed, the first effective registered treatment for Wet AMD is currently available in South Africa. An injection stops the formation and growth of new blood vessels (choroidal Neo Vascularisation – CNV) and improves vision in 78% of cases.

Types of AMD

There are two types of AMD: Wet (neovascular) and dry (atrophic). It's possible to experience the wet type in one eye and the dry type in the other. In addition, the dry type can progress to wet in approximately 10-15% of cases.

The dry/atrophic type affects approximately 85-90% of individuals with AMD. Its cause is unknown, it tends to progress more slowly than the wet type, and there is not - as yet - an approved treatment or cure. In dry AMD, small white or yellowish deposits - called drusen - form on the retina, beneath the macula, causing it to deteriorate or degenerate over time.

The wet/neovascular type affects around 10-15% of individuals with AMD, but accounts for approximately 90% of all cases of severe vision loss from the disease. In wet AMD, abnormal blood vessels under the retina begin to grow toward the macula. Because these new blood vessels are abnormal, they tend to break, bleed, and leak fluid, damaging the macula and causing it to lift up and pull away from its base. This can result in a rapid and severe loss of central vision. While its cause is unknown, several new treatments are now available for wet AMD.

Note, though, that even with treatment, experts suggest that adding specific foods to your eating plan can help to slow down the progression of AMD.

These include:

·        Oily fish(like sardines and salmon) three times a week to ensure adequate Omega 3 fatty acid

·        A serving of spinach five to six times a week

·        Foods rich in vitamin D, E and C

·        Lots of green tea, which is high in anti oxidants

It’s also vital to know that if you are a smoker, you’re gambling with your vision: Retina South Africa says that those smoking 25 cigarettes a day increase their risk of developing AMD to 2,4 times more than non-smokers

Taking action, right now

Be sure to visit your optician or ophthalmologist and make sure your eyesight is all it should be. Then, pass on this article to anyone you know who may have Retinal Degenerative Diseases in their family - it could just be the most precious gift they ever receive. While some eye diseases remain untreatable at this point, medical science – and biologics in particular – offers great hope for those afflicted and their families.

 

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Optometrist

Megan Goodman qualified as an optometrist from the University of Johannesburg and is currently practising at Tygerberg Academic Hospital in Cape Town. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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