Wet AMD

Age-related Macular Degeneration (AMD) is the leading cause of blindness in the developed western world. Approximately 1 in 3 people over the age of 75 will suffer from mild AMD. AMD can be split into two main types: dry AMD and wet AMD.
Wet AMD develops when abnormal blood vessels grow under and into the macula - the most sensitive area of the retina at the back of your eye. The macula is responsible for detailed vision, the ability to read, recognise faces and colour vision. These abnormal blood vessel leak blood and fluid which leads to disruption in the macula, eventually leading to scarring of the macula and results in rapid loss of central vision. Damage to the macula will affect the central vision only, meaning someone with AMD may have perfect peripheral vision, seeing everything well except the very thing they are looking directly at.
We AMD can develop very suddenly and progress very quickly. Thankfully it can now be treated if diagnosed and treated quickly. Quick and accurate diagnosis are therefore crucial to enable fast referral to a hospital specialist.

What are the symptoms of wet AMD?

The symptoms of wet AMD vary with the severity of the condition and will affect different people in different ways. Common symptoms include:

1. Gaps or dark spots (like a smudge on glasses) may appear in your vision.
2. Objects in front of you might change shape, size or colour or seem to move or disappear.
3. Colours can fade.
4. You may find bright light glaring and uncomfortable or find it difficult to adapt when moving from dark to light environments.
5. Words might disappear when you are reading.
6. Straight lines such as door frames and lampposts may appear distorted or bent.

Diagnosing wet AMD

The best way of diagnosing wet AMD is to image your macula using our Zeiss Cirrus 5000 Optical Coherence Tomographer (OCT). OCT produces cross sectional images of the macula and allows our optometrist to differentiate between dry and wet AMD quickly and accurately. If we suspect you have wet AMD you will be referred to a medical retina specialist urgently with the aim of treatment within two weeks of diagnosis. Do not attend your GP as this will cause unnecessary delay.

We use our Zeiss Clarus 500 ultra-high-definition retinal camera to produce highly detailed true colour retinal images of the macula. Pictures can be compared year on year to look for subtle changes. We also use Optical Coherence Tomography (OCT) scans which create cross-sectional images of the retina and take highly detailed measurements of your macula. These measurements can be compared to what is normal for your age and also compared with previous measurements of your eye to detect even the most minute change in macular health. Fundus autofluorescence and macular pigment density analysis may also be used to complement the normal eye examination.

Treating wet AMD

Wet AMD can be treated effectively if diagnosed and treated early. In patients requiring treatment there are a number of potential Anti-VEGF drugs that can be used including Lucentis, Eylea and Avastin. These medicines are injected into the eye to stop the growth of the abnormal blood vessels within the macula. The injections are not as bad as they sound! The eye is anaesthetised so the patient feels nothing and the needle goes into the corner of the eye so the patient does not see it.

Following diagnosis patients with wet AMD will usually have a loading dose of three injections, once a month for three months. An assessment will then be conducted to decide whether further treatments are required. In the rare occasion that a patient does not respond to the anti-VEGF treatment a form of laser treatment may be offered instead. There are a range of treatment options a medical retina specialist may choose from. Most are available on the NHS.