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Dry Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a long-term condition, which affects the central portion of the retina. Degeneration occurs in the central retina and this affects principally fine or reading vision.

Katy Taylor
Katy Taylor

In the monitoring phase

Definition

Age-related macular degeneration (AMD) is a long-term condition, which affects the central portion of the retina. Degeneration occurs in the central retina and this affects principally fine or reading vision.

Type

The dry form of AMD usually affects both eyes and is more common than the wet type. Tasks such as reading, writing and sewing, which require fine vision, become more difficult. Vision used for getting out and about, is not usually affected.
The dry form of AMD is less severe than the wet form of AMD. It progresses more slowly and causes less impairment of vision. It rarely progresses to severe loss of vision or blindness.

Dry AMD is characterised by thinning and drusen. There is thinning of the retina and / or the layer underneath the retina. The layer underneath the retina is vital for eye health, as it takes away waste products. Thinning of this vital layer causes waste products, such as drusen to accumulate. When thinning affects the very centre of the retina, fine vision is affected.

Figure 1. This shows drusen (arrow) in dry AMD. This patient has no symptoms and their vision is still normal.

Symptoms

The extent of visual difficulties that you have in dry AMD, depend on where the disease is located and the degree of thinning of the different retinal layers. If you have a few scattered drusen, you may have perfect vision and no symptoms. You may have mild difficulty with reading, if there is mild thinning at or near the centre of vision. You may have moderate visual loss, if there is significant thinning in the centre of the vision.

It is unusual to develop sudden symptoms in dry AMD. If you suddenly develop distortion of vison, or straight lines become kinked, this could herald the development of wet AMD. If this is the case, you need urgent assessment to look for the possible development of wet AMD.

Monitoring phase

Dry AMD can be monitored to look for the development of progressive changes. Regular review with scans and a consultation will show you whether the disease is progressing.

Wet AMD may develop in people, who already have dry AMD.  If this should happen, new symptoms will develop, as described above. Should you develop wet AMD, you need urgent assessment and treatment to prevent serious loss of vision.

Tests

You can monitor your vision directly by using an Amsler grid. If you develop new distortion or gaps in your vision, this could mean the development of wet AMD.
OCT of scanning of the retina is a highly sensitive test to analyse the retina. It shows, drusen, thinning and wet macular degeneration. Serial examinations over time will reveal any sequential changes.

Figure 2. This shows an OCT of the retina, in a patient who has extensive drusen. The colour picture shows a cut through the retina. The layer in red is the pigment layer, which lies underneath the retina. This layer is normally flat and smooth.  In this picture, there are multiple indentations of the pigment layer (arrow) and these are drusen.

Figure 3. OCT technology allows us to separate the retinal layers and examine them individually. This picture illustrates the pigment layer, underneath the retina, with multiple indentations (arrow) due to drusen.

A complete ocular examination, by your eye consultant will look for signs of dry and wet macular degeneration, in addition to any other eye problems such as cataract or glaucoma. Combining OCT of the retina, with a comprehensive eye examination is a very accurate indication as to the health of the eye.

Lifestyle

Many lifestyle factors affect the risk of developing AMD and the progression of the disease. Factors which increase the risk of developing AMD include increasing age, hypertension, obesity, smoking and family history. Factors which may decrease the risk of progression include vitamin supplements in a small subgroup of patients and controlling the above risk factors.

What should I do to help myself?

Lifestyle changes may help to reduce the risk of progression of AMD. Eat a diet rich in omega-3’s, fruit and vegetables, do not smoke, control your weight, take regular exercise and consider eye care supplements, if you are a non-smoker.

OcuPlan

OcuPlan provides you with eye monitoring at a frequency dictated by your needs. You can select appointments with tests and a visit with your eye consultant, one, two or three times per year. Should you notice new symptoms, you can arrange for additional tests and consultations. You will have the reassurance of knowing that if your symptoms change, you have access to tests and consultation. Treatment can then be arranged for you depending on your needs and wishes.

If you are interested to find out more about OcuPlan and our packages of private shared care then please contact our onboarding team, or see our website for further details.

Patients

Katy Taylor

Katy is OcuPlan's editor, content and a customer service manager. She enjoys helping patients, eye consultants and optometrists make the most of OcuPlan.