Articles

Age-Related Macular Degeneration

Age-related macular degeneration (AMD) occurs when there is damage to the macula, the centre part of the retina needed for sharp, central vision. This leads to central vision loss, which is particularly devastating, especially when both eyes are affected.

1. Types of AMD?

There are two types of AMD: Dry or wet AMD. In dry AMD, degeneration of the retina cells at the macula causes waste materials produced by the retina to accumulate under the macula, these deposits are known as drusen. As more drusen accumulate under the retina, this can result in the death of retina cells, which causes loss of central vision that is irreversible. As dry AMD progresses, usually slowly over years, areas of vision blockage within the central area of vision can become bigger and coalesce to cause a large central area of blocked vision in the advanced stage of dry AMD. Once these patches of blocked vision occurs, it is irreversible. Dry AMD usually occurs in both eyes but the severity of involvement can differ between both eyes. In wet AMD, there is bleeding and leakage of fluid from abnormal networks of blood vessel growth beneath the macula, causing sudden severe, painless central visual loss. If wet AMD is not treated promptly, there will eventually be a dense area of scarring that occupies the macula and leads to irreversible loss of vision.

2. What causes AMD?

There are many risk factors for developing dry or wet AMD. Ageing is one unmodifiable risk factor for developing AMD. Reported incidence for dry AMD is about 4.2% for those aged 60 years and below, and 32.5% for those aged 80 years and older. Genetic factors also play a part, so those with a family history of AMD run a higher risk of developing it once they reach the age of 50 years and above. Fortunately, there are many other modifiable risk factors such as smoking, excessive UV exposure during outdoor activities, a poor diet rich in fat and low in fish and vegetables, obesity and uncontrolled hypertension.

3. How does Lutein help with AMD?

Lutein and zeaxanthin are naturally present in the macula and they block blue light from reaching the underlying structures in the retina, thereby reducing the risk of light-induced oxidative damage that could lead to macular degeneration.

Studies have shown that 6 mg per day of lutein led to a 43% lower risk for macular degeneration. There are foods that contain a high level of lutein. Some of these foods are spinach, broccoli, kale, corn, Brussels sprouts, celery, carrots, peas, melons, tomatoes, oranges, papayas and grapefruits. Lutein supplements are available in various format like soft-gel capsules, tablets and also as liquid essence. They should be taken at mealtimes because lutein is absorbed better when ingested with a small amount of fat.

Lutein absorbed from our diet is transported to the macula and the lens of our eyes, where it increases the density of this macular pigment, providing a helpful, anti-oxidant effect. Thus, increasing the intake of lutein in our diet may reduce the risk of developing AMD and even cataract, and may prevent progression in patients with early AMD.

Doctor’s Profile: Dr Elaine Huang is a senior consultant ophthalmologist who specialises in managing general ophthalmology conditions, glaucoma, complicated and advanced cataract surgery. She also has subspecialised expertise in managing vitreo-retinal conditions, macular disorders, diabetic retinopathy, age-related macular degeneration, myopia and trauma-related conditions.

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