Loss of vision in the elderly is often attributed to cataract, or after cataract surgery, to the inevitable process of aging. However, one of the most important reasons for decrease in vision, especially that is painless and progressive, is Age Related Macular degeneration or AMD. AMD can easily be detected by your ophthalmologist during a comprehensive eye evaluation.
What is Age Related Macular Degeneration?
The macula is the most light-sensitive, central part of yourretina, which helps in precise and sharp vision. With aging, there are certain lipid like deposits in the macular vision, called drusens which distort the macula. In addition, the retinal layers also begin to thin and atrophy. Sometimes new blood vessels for in the macula which tend to bleed and leak fluid. This group of changes constitute Age Related Macular Degeneration.
When do we suspect Age Related Macular Degeneration?
Age Related Macular Degeneration can easily be diagnosed by your eye doctor during your annual eye examination. AMD is one of the reasons why an annual dilated retinal check is mandatory in people above the age of 50.
The symptoms of AMD are non-specific and often confused with those of cataract. These include:
Blurring vision, difficulty in recognizing details in images and faces
Distortion of your central vision, broken lines, missing alphabets or words during reading
Dark spots or areas in the field of vision
Loss of vision, in the later stages.
What are the types of AMD?
Age Related Macular Degeneration is categorized into two broad types. These are:
Dry AMD: In this, the vision loss is more gradual. It is charatcerised by drusens, as described above, and by a gradual thinning and atrophy of the macula.
Wet AMD: Wet AMD is the more severe form of disease, which progresses rapidly and cause rapid loss of vision. It is characterizes by formation of abnormal blood vessels underneath the macula, and may leak fluid or blood.
About ten percent of patients have Wet AMD, while dry AMD patients is more common. Dry AMD may convert to the Wet form or time, and so a diagnosis of Dry AMD does not mean that you cannot have Wet AMD.
What is the best diagnostic test for Age Related Macular Degeneration?
The diagnosis of AMD requires some very sophisticated diagnostic equipment and procedures, all of which may support your doctor in coming to a final diagnosis. These tests are only indicated in case your doctor suspects AMD on evaluating your eyes. These include:
Fundus Flourescien Angiography, FFA:The FFAis asophisticated angiography procedure in why the surgeon injects a dye in your forearm, which travels through your body to reach the eye. Using a powerful camera, the surgeon can then image the blood vessels in your retina.
Indocyanin Green Angiography, ICG: This is also a method of imaging blood vessels at the back of the eye like FFA, but this dye helps in visualization of the choroidal blood vessels. The choroid is the layer underneath the retina.
Macular Optical Coherence Tomography, OCT: This is a high resolution imaging of the macula, which indicates its thickness, contour and other charateristics making diagnosis of AMD easier.
What is the best diagnostic test for Age Related Macular Degeneration?
Dry AMD:There is no specific treatment for dry AMD. There is some evidence that certain eye specific vitamins and micronutrients may decrease the risk of visual loss in patients of AMD. For this reason, your doctor may prescribe oral vitamin supplements with lutein, zeaxanthin, beta carotene, Vitamin A, C and E.
Wet AMD: Wet AMD can be treated effectively, if diagnosed early, with excellent recovery of vision. The principle of treatment for wet AMD is two pronged: One, arrest the growth of new vessels by intravitreal injections of anti-VEGF agents, and also decrease the leakage of blood and protein from the existing abnormal vessels by sealing them off using laser treatment.
The modalities used for AMD treatment include:
Trans pupillary thermotherapy(TTT)
Photodynamic therapy(PDT)
Vitrectomy
Intravitreal injections of anti- VEGF agents like Lucentis, Avastin, Accentrix
Is the best treatment for Age Related Macular Degeneration available in Delhi, India?
The best treatment for Age Related Macular Degeneration is definitely available in Delhi, India. In fact, the medical and surgical facilities in Delhi eye hospitals rival those of the best in the world. The world class treatment that is available in Delhi is far more affordable here, than most hospitals abroad.
In fact, all of the treatment modalities of AMD are available in most of the high end eye hospitals in Delhi, along with sophisticated diagnostic equipment, lasers, operation theaters and highly trained and acclaimed retina surgeons.