Age-related Macular Degeneration

1) What is the disease?
Age-related macular degeneration (AMD) is an eye condition which affects the centre portion of the retina (nerve fiber layer in the eye). It is a chronic disease which can be progressive and central blurring of vision. The condition usually affects both eyes and can be classified into "dry" and "wet" forms. The "dry" type can be asymptomatic in the
early stages and eventually leads to gradual blurring of vision. The "wet" type can cause acute and devastating loss of vision (Figure 1).

2) Who gets it?
The most important risk factor is older age especially over 50 years old. The other risk factors include family history of AMD, high blood pressure, smoking and sunlight exposure.

3) Why is it important?
AMD can cause irreversible blurring of vision and tends to affect both eyes. It is the most common cause of visual impairment amongst the older age group in developed countries worldwide -approximately affecting close to 300 million people by year 2040.

4) Why do we need screening?
AMD is asymptomatic in the early stages and can affect both eyes (Figure 2). A simple screening photograph of the retina can detect features of AMD including the presence of yellowish deposits (drusen), thinning of the retina (retinal pigment epithelium atrophy), scarring, bleeding and swelling of the retina. If there are features of early and
"dry" AMD, you will require routine follow up to monitor your condition. If you have advanced AMD in one eye, you may benefit from starting supplement tablets to prevent progression of AMD (Figure 3). In "wet" AMD, you need to see an ophthalmologist for further evaluation and early treatment can help prevent further visual loss.

5) Who should be encouraged to be screened?
Above 50 years old, one eye diagnosed with AMD or have a strong family history of AMD

Figure 1. “Wet” age-related macular degeneration showing bleeding spots at the macula (white arrows)

Figure 2. Early age-related macular degeneration showing yellow deposits called drusen (white arrows)

Figure 3. Advanced age-related macular degeneration showing extensive scarring (white arrow) of the macula