Age-related macular degeneration
What is it?
Age-related macular degeneration (AMD) is a common eye condition among people age 50 and older, which affects the macula – a small part of the light-sensitive layer at the back of the eye (the retina). We use the macula for the central, detailed vision needed for reading and driving. AMD causes blurred or reduced central vision, in one or both eyes.
AMD is the most common cause of permanent and irreversible sight loss in the UK as it affects approximately 475,000 people in the UK.
AMD can be diagnosed as either ‘dry’ or ‘wet’. Dry AMD is more common and generally results in a slower loss of vision.
Wet AMD progresses more quickly. About 1 in 10 people with AMD have the wet form. It happens when unhealthy new blood vessels grow under the macula. They leak blood and fluid, which damages the tissue. Whilst in dry AMD, layers of the macula, which include photoreceptors, get progressively thinner causing it to function less effectively.
We don’t yet know the exact cause of AMD but genetics and environment are both involved.
The risk of AMD increases with age. AMD is most likely to be diagnosed in people over 65. It affects more women than men (but this may be because women tend to live longer). Some, but not all, cases of AMD are thought to be inherited. People of African ancestry are less at risk.
Other known risk factors include smoking and obesity. Stopping smoking reduces the risk of developing all forms of AMD.
AMD affects the ability to see detail. Someone with AMD may have difficulty reading small print, even with their reading glasses on. The centre of vision may be slightly blurred or blank. Or, it may seem that there is a smudge across it. Straight lines may look wavy. If you notice changes like this, particularly if they come on suddenly you should urgently be seen by an ophthalmologist to minimise further damage to your eye.
It can start in one eye before progressing to both. It does not affect side vision (peripheral vision). This means that it does not cause complete blindness.
Typically vision worsens slowly over time in dry AMD whilst wet AMD is associated with severe vision loss, which can worsen rapidly.
TreatmentsThere is currently no treatment available for dry AMD but there is some evidence that diet or supplements can help slow it down in certain people. Vitamins A, C and E and the substances called lutein and zeaxanthin may also reduce the risk of getting wet AMD. Speak to an ophthalmologist to find out whether these might help you.
Age-related disease studies (AREDS1 and AREDS2) have shown that patients with early dry AMD may be able to reduce their risk of vision loss by taking a specific formulation of antioxidant vitamins.
Wet AMD can be treated if it is diagnosed early enough. Treatment is most often a series of injections to the eye but can also involve laser therapy. Treatment stops the blood vessels from growing before they cause damage to sight by forming a scar inside the eye.
AMD research has several strands. These include understanding the causes of AMD and what part genetics plays, preventing AMD from developing (especially important as the population ages), developing a treatment for dry AMD, detecting AMD early enough to prevent sight loss, monitoring its progress more easily and developing cell replacement therapies that might one day restore lost sight.
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Gathering the information we need to reduce the risk of severe sight loss.Find out more
Belinda was diagnosed with age-related macular degeneration (AMD) in 2010.
It’s more prevalent in women and can come in two forms, dry and wet. Belinda was initially diagnosed with dry macular degeneration after going for a routine eye test. She was shocked as she hardly had any problems with her sight beforehand.
After the diagnosis she didn't really notice any difference with her vision. However, as a keen sailor and being a lover of the sea, one day she noticed that the horizon was slightly wavy and this caused her some concern.
From then on her eye sight started to deteriorate slowly. She has now developed wet AMD and has cataracts in both eyes. Belinda’s central vision has been affected and she has had to make certain adjustments in her life, giving up her passions such as photography, having once taken the photo of Mikhal Gorbachev, and bookbinding.
Belinda has an incredibly strong and positive outlook. She didn't want to simply sit around and do nothing. Instead of donating to a charity, she wanted to have a hands on approach and was keen to get involved with fundraising. She wanted to fundraise for a charity that could help others like her who were affected by sight loss. Fight for Sight was the only choice.
Belinda has also had cataract operations on both eyes.
Belinda said: "So many people have a connection to sight loss, whether it's first-hand experience or through a loved one. I believe the only way forward is through eye research. I want to support Fight for Sight and their mission to prevent sight loss.
“If I have one message I would urge people to go and get their eyes tested regularly in order to help detect any sight problems. It’s very sad to see people accepting sight loss where there are treatments. There is some fantastic research happening and with more funding and more research many more conditions will become curable and sight loss may become a thing of the past.”
You could play an important part in eye research by being a participant in clinical research study that may benefit many people. You could even help shape clinical research by becoming more actively involved and having a say. Patients, carer, or anyone with an interest can help.
What are clinical trials
Clinical trials are research studies that find out if a medical strategy, treatment, or device is safe and effective for humans. They are a key research tool for improving medical knowledge and patient care. The people who carry out research are mostly the same doctors and healthcare professionals who treat people. Their aim is to find better ways of treating patients and keeping people healthy.
Here are some ways to find out about research projects and clinical trials that you can get involved in.
UK Clinical Trials Gateway
The UK Clinical Trials Gateway run by the National Institute for Health Research (NIHR) provides easy to understand information about clinical research trials running in the UK, and gives to a large range of information about these trials. It is designed to enable patients and clinicians to locate and contact trials of interest. Visit their website and select the eye condition that you are interested in.
NIHR Clinical Research Network Portfolio
The NIHR Clinical Research Network Portfolio is a database of high-quality clinical research studies in England, Northern Ireland, Scotland and Wales. Within this the Ophthalmology Specialty Group supports a national portfolio of research studies in ophthalmology and the vision sciences. See their website for details.
If you wish to join a trial it is always best to discuss this with your doctor or clinical team first.
Last updated November 2017
Approved by Professor Andrew Lotery, University of Southampton