Age-related macular degeneration (AMD)

There are many risk factors that cannot be influenced, such as age and, in particular, genetic predisposition. For early detection, everyone should visit an ophthalmologist at least once by the age of 60.

Macular degeneration (AMD) is the most common cause of visual impairment in older age

The macula is located at the centre of the retina. It contains the “point of sharpest vision” and, with its 6–7 million colour-sensitive sensory cells (so-called cones), is responsible for the high resolution of our detailed colour vision. A wide range of diseases can impair this complex process of sharp daytime vision.

By far the most common form is age-related macular degeneration (AMD). In industrialised countries, AMD is the leading cause of blindness in people over 50. As macular degeneration is not yet curable, prevention is important.

Examples of macular degeneration

Macular degeneration

Causes of macular degeneration – AMD

AMD is a chronic disease. Metabolic deposits accumulate in the macula and damage the cells, potentially leading to cell death. We distinguish between two forms of AMD.

Dry AMD

Dry age-related macular degeneration accounts for at least 75% of cases. In the early stage, the deposits appear yellowish beneath the retina. Those affected may notice slight visual impairment, e.g. when reading. In the late stage, retinal cells die, which can significantly reduce central, sharp vision.

Wet AMD

Wet age-related macular degeneration is a more aggressive form and often progresses quickly. Metabolic deposits lead to an insufficient supply of oxygen and nutrients to the blood vessels, which ultimately results in excessive, abnormal blood vessel growth beneath the macula. Fluid leaks from the newly formed, diseased and leaky vessels and lifts the pigment layer. The retina swells, distorted, low-contrast images occur and, in the final stage, extensive cell death and scarring can lead to complete loss of central vision.

Early detection with a self-test

For early detection, everyone should visit an ophthalmologist at least once by the age of 60. Older people can use the Amsler grid test regularly. This provides an indication of whether straight lines suddenly appear curved.

Treatment of macular degeneration

There is currently no recognised effective treatment for dry AMD. However, studies show that a high-dose nutrient combination of antioxidant vitamins and lutein, taken as a dietary supplement, can slow the progression of the disease.

Even more important is avoiding nicotine and alcohol. In the wet form, prompt action is required because it progresses quickly. A medication is injected into the eye to inhibit the diseased, leaky vessels that grow into the macula. This is intended to prevent the disease from progressing.

These so-called VEGF inhibitors (Vascular Endothelial Growth Factor) are injected into the eye with a very fine needle. Thanks to local anaesthesia, you will hardly notice anything and can go home immediately after the injection. How often and at what intervals this procedure needs to be repeated is assessed individually.

Symptoms of macular degeneration

  • Reduced visual acuity and therefore reduced ability to read
  • Distorted vision – straight lines appear bent
  • Reduced contrast vision – colours appear pale and washed out
  • Reduced ability to adapt to changing light conditions (adaptation)
  • Central visual field loss – grey spot in the central visual field

Eye test with the Amsler grid

  • With the Amsler grid, you can carry out an initial self-test at home.
  • Cover one eye with your hand and view the grid with the other eye from a distance of approx. 40 cm.
  • If you see dark spots or bent lines, you should make an appointment with an ophthalmologist.

Prevention

There are many risk factors that cannot be influenced, such as age and, in particular, genetic predisposition.

If parents or grandparents have AMD, the risk of developing AMD yourself increases. In addition, there are a number of negative influences that should be avoided.

Smoking multiplies the risk of AMD and the disease occurs earlier in life. Ensure a balanced diet with plenty of vegetables and fish.

Protect yourself from UV rays and wear good sunglasses in bright light. Monitor blood pressure and blood sugar levels. All of this reduces the risk.

Eye test with the Amsler grid

Amsler grid test passed without symptoms.

Distorted image as an indication of age-related macular degeneration (AMD)

Instructions

You can easily perform the test on your computer screen. Please note the following instructions:

  • If you wear visual aids, keep them on for the test.
  • View the image with each eye separately from a distance of 35 to 40 centimetres. Cover one eye with your hand, but do not squeeze it shut.
  • Fixate on the dot in the centre. With a healthy eye, the grid lines appear straight, all squares are the same size, and all corners are visible.
  • If you notice one or more of the following changes in the grid, you should consult an ophthalmologist. It may be an early sign of macular degeneration.

Changes in the grid

  • Missing corners of the image
  • Squares of different sizes
  • A grey shadow over the image
  • Empty areas in the grid
  • Blurred or distorted lines