Age-related Macular Degeneration (AMD)

Age-related Macular Degeneration (AMD)

Can I have AMD without knowing it?

AMD occurs from the age of 50 onwards. At the beginning of the disease, you may not feel any symptoms. It is sometimes possible to experience discomfort in the dark or a reduction in contrast perception.

In addition, when the first eye is affected, the use of the other eye may compensate for the defective vision of the affected eye.

AMD can only be diagnosed by an ophthalmological examination.

How do I know if I am at risk of developing AMD?

As the name suggests, AMD or age-related macular degeneration is caused by abnormal aging of the retina.

People with AMD are over the age of 50, so age is the primary risk factor for AMD.

Other risk factors are also involved, including smoking.

It also appears that AMD can run in some families and be rare in others, indicating a possible heredity.

Finally, other risk factors have been identified but with a lesser association and are not confirmed: arterial hypertension, dyslipidemia, obesity, cataract or a deficiency in antioxidant micronutrients.

If you have any questions, do not hesitate to consult your doctor or ophthalmologist.

Can I prevent AMD?

Recent studies have shown that smoking can promote the onset of AMD and may worsen it in the advanced stages. This is why smoking cessation should be considered; specialised consultations can help with smoking cessation.

Regarding the diet to adopt, several research studies suggest the importance of a varied diet rich in vegetables, fresh fruit and fish oils. These provide vitamins and antioxidants. Vitamins A (retinol, which is needed for the formation of pigments in the visual cells), C and E are particularly beneficial for the eyes and are present in many foods. They are found in citrus fruits, green leafy vegetables (salad, spinach, etc.), peppers, carrots, kiwis, but also in wheat germ and vegetable oils. The omega-3 fatty acids found in marine products and cold sea fish (salmon, sardines, anchovies, etc.) are also thought to have a protective role against AMD. These measures are not scientifically proven, but may be useful given the state of knowledge on retinal biology.

What are the first symptoms of AMD? How do I know if I have the disease?

AMD can lead to a loss of central vision, but usually leaves peripheral vision intact. The early signs of the disease are usually discrete before the characteristic symptoms appear, the most advanced of which is the appearance of a spot in the centre of the visual field.

Because they are discrete, early signs of the disease can be overlooked: a decline in vision in the aging person should not automatically be blamed on natural aging.

Signs potentially suggestive of AMD include the following:

• Decreased contrast sensitivity: First, you may feel as if you are not getting enough light to read or write. Images may appear duller or yellowed.
• Decreased visual acuity: You may also experience difficulty perceiving details. The decrease in visual acuity may occur rapidly.
• Distortion of straight lines: You may also perceive straight lines as distorted or wavy. For example, you may feel that straight lines are distorted or wavy in a crossword puzzle or on tile lines. These are called “metamorphopsias”.
• Appearance of a central dark spot: You may see a black or grey spot (called a scotoma) in front of your eye, which makes it difficult to see things.

Each of these symptoms should prompt you to see an ophthalmologist as only he or she can diagnose AMD or another eye disease.

For more information, talk to your ophthalmologist.

What should I do if I think I have AMD or if I start to experience symptoms of AMD?

AMD is an ophthalmic emergency. If a person experiences a sudden drop in vision, if they feel they are seeing distorted or wavy lines, or if they see one or more dark spots in the centre of the field of vision, they should call an ophthalmologist urgently.

If there is any doubt, it is important to specify the symptoms experienced when calling.

If I have AMD, how can it affect my daily life?

Only the centre of the retina is affected by AMD, so in most cases only central vision is affected. Patients often have difficulty reading, sewing, working on a craft or recognising faces in the street. However, because peripheral vision usually remains normal, they can move around on their own and get dressed, for example. This means that they retain a certain degree of independence.

What is the difference between “dry” and “wet” AMD?

There are 2 forms of AMD:

The “dry” or atrophic form is the most common, but it develops more slowly. It is characterised by a progressive disappearance of retinal cells with a thinning of the macula.
The “wet” or exudative form is rarer than the “dry” form but progresses more rapidly. Its progression can sometimes lead to a loss of central vision. In this form of AMD, abnormal vessels called neovessels develop. These vessels are very fragile and leak fluid, and sometimes blood, which accumulates in the retina and is responsible for the vision problems.

Whatever the stage and form of the disease, it must be checked regularly by an ophthalmologist to monitor its progress and detect any possible damage to the second eye.

If I have AMD in one eye, can I have AMD in the other eye?

AMD is considered a disease that can affect both eyes. Indeed, once the first eye is affected, there is an increased risk of the second eye being affected. However, many patients with very severe AMD in one eye retain good vision in the second eye throughout their lives. The severity of second eye damage is therefore highly variable from person to person: it can occur early or late.

It is recommended that patients already suffering from AMD carry out regular self-monitoring of their vision, eye by eye, with the Amsler grid (or other support: crossword grid for example) and they should reconsult their ophthalmologist in the event of a change in their vision (for example: drop in visual acuity, difficulty in reading, distortion of straight lines, appearance of dark spots in the centre of the vision)

Can I be cured of AMD?

AMD is a chronic condition. At present, there are no drugs that can permanently cure AMD, but there are solutions that can slow down its progression and reduce the discomfort associated with the symptoms. Your ophthalmologist will decide which approach is best for you.

In the ‘wet’ form of AMD, treatments are available that are prescribed and administered by eye specialists. These can be injected into the white of your eye, known as intravitreal injections or IVT.
In the ‘dry’ form of AMD, there is no treatment, but optical aids and visual rehabilitation can be of great help.

If I have AMD, will I be able to drive?

All drivers are primarily responsible for their actions and decisions. When your vision is significantly impaired, driving can be dangerous for you and those around you.

This is why it is very important to discuss this with an ophthalmologist. Dare to ask your family to accompany you to your appointments if you are unable to travel alone.

Are there any activities I am not allowed to do?

There are no “forbidden” activities when you have AMD as long as your safety or that of others is not at stake. If your eyesight allows it, you should continue to do your activities. Vision rehabilitation can also help. Advice can be given on how to get around better and carry out daily activities with small, simple tips: installing visual markers on the washing machine, enlarged labels on food packaging, etc.

Travel is allowed. There is no particular danger in taking a plane or other means of transport.

Does AMD require regular follow-up visits to the ophthalmologist?

AMD is a chronic and progressive disease. People with AMD should therefore be monitored throughout their lives and see their eye doctor regularly. As each AMD is different, it is the doctor who decides how often to check and treat it.

Between each appointment, it is recommended that the AMD patient performs regular self-monitoring of their vision, eye by eye, with the Amsler grid (or other support: crossword grid for example). If they feel that straight lines are becoming distorted or that a spot is darkening the centre of their vision, they should consult an ophthalmologist as soon as possible.

Even if the vision has stabilised, it is essential to keep appointments with the ophthalmologist to monitor the progress of AMD.