What is the full form of ARMD ?

What is ARMD?

Age-related Macular Degeneration- AMD is a very common eye disorder leading to vision loss in older persons. Age Related Macular Degeneration does not lead to complete blindness, but can deprive our central vision which might interfere in recognising faces, reading books, driving, cooking or performing daily household activities.

Symptoms

AMD is classified into teo types: Dry AMD and Wet AMD. The symptoms differ for both of these and are explained below.

Dry AMD

Dry AMD involves slow and painless loss of central vision over the years.People bear very few symptoms with this disease but when they develop symptoms,it happens for both the eyes.

Blurred images of the objects, less clarity of images,unable to recognise specific shapes like oval or spherical and difficulty in reading are some of the symptoms that are developed.With the gradual progression of the disease central blind spots or scotomas start developing leading to vision impairment. In some cases enough vision is maintained for reading or driving.

Wet AMD

Wet AMD involves rapid loss of vision with time, or it can be stated the loss of vision is very sudden if bleeding starts in one of the abnormal blood vessels.

The primary symptoms include blurriness, wavy vision, or distorted central vision. The peripheral vision or vision at the eye edges remains unaffected. In Wet AMD usually only one eye is affected at a time and raises difficulty in reading or watching television. Wet AMD can cause severe damage to the vision leading to permanent blindness.

Diagnosis

Following are the possible diagnosis for ARMD −

• Eye check by an ophthalmologist

• Undergoing colour photography, fluorescein angiography or optical coherence tomography

Medical personnels conduct the diagnosis of age-related macular degeneration by investigating the eyes with ophthalmoscopy, a type of eye microscopy.Retinal damage is one of the most significant symptoms before developing AMD.The diagnosis of wet AMD is confirmed by taking colour photographs of the retina or by undergoing fluorescein angiography. Another imaging study called Optical coherence tomography helps in identifying wet AMD and can predict about the treatment response by the patient.

Treatment

Following are the various treatment strategies taken for ARMD −

• Type of Dietary supplements

• Use of Drugs and laser techniques

• Using Low-vision aids

Dietary supplements

Nutritive dietary supplements are highly recommended for patients with basic or advanced AMD in one eye. Following supplements are mandatory for all persons diagnosed with AMD −

• Presence of Zinc in diet

• Copper rich food

• Ample amount of Vitamin C based diet

• Vitamin E based diet

• Lutein and zeaxanthin diet especially for smokers

• Vitamin A rich diet for non-smokers

Some of the other risk factors that must be controlled are atherosclerosis or high blood pressure. Hence a diet rich in omega-3 fatty acids, i.e, eating more dark green leafy vegetables can help downregulate the progression of age-related macular degeneration. Oral supplements of omega-3 fatty acids cannot slow down the degeneration process.

Drug treatments and laser procedures

• In the wet AMD, drugs like ranibizumab, bevacizumab, aflibercept or brolucizumab are injected intravitreally into the eye form preventing leakage from new blood vessels. These drugs are called anti vascular endothelial growth factors that work by lessening the growth of new blood vessels.The Intravitreal anti-VEGF injections, must be administered continuously for 3 months, because that will reduce the risk of vision loss and help rebuild the reading vision of most of the people.

• An engrafted port delivery system which is a recently discovered technique for ranibizumab was made available for the treatment of wet AMD. This surgical implant is permanent and can deliver ranibizumab systematically into the vitreous humour and the same can be refilled repeatedly.

• There is one more technique called photodynamic therapy- where the retinal blood vessels are sensitised by a substance in presence of a laser light and the same is injected into an arm vein followed by destroying the abnormal blood vessels by the laser light.A thermal laser is also used to destroy the new blood vessels which does not work under macula.Surgery is rarely done for wet AMD.

Adjusting to vision loss

Different types of software display like computer data in large print or data that can be processed as read aloud form with the help of Artificial intelligence are beneficial for the AMD patients.Electronic books or softwares like otter make reading easier and helps allow people to adjust with the font size and contrast level. Patients with permanent vision loss due to AMD, can use an engrafted miniature telescope.

Risk Factors

Cardiovascular factors, chain smoking, and alcohol consumption are the possible risk factors for AMD. Cytogenetic factors also plays a major role in AMD specifically in younger patients.The genes that predominantly affect ARMD are histocompatibility locus antigen or HLA and complement system genes. There are some controversies regarding the risk factors of AMD regarding exposure to sunlight, cardiovascular factors or diet pattern.Smoking is one of the most deadliest association of AMD. Moreover chain smokers are more prone to AMD than non-smokers and the possibility increases with smoking intensity of the concerned person.

Conclusion

Scientists till date are not sure about the causes of AMD and its possible treatment strategies.Recently a research team found a novel way to treat dry AMD in animals by the application of stem cells.This research could bring about a new dimension for treating dry AMD as well as wet AMD in the future.

FAQs

Q1. Can advanced AMD lead to total blindness?

Ans. In advanced AMD loss of central vision takes place but chances of complete blindness are rare.The eyes can function properly with the remaining peripheral vision seamlessly.Besides,certain low visual aids like hand and video magnifiers are superior supporting devices for AMD patients.

Q2.What is the risk of losing an eye if AMD has damaged one eye?

Ans. Yes,there is a high chance of having advanced AMD in the other eye if AMD has already damaged the other one in a patient.Intake of certain vitamin supplements can reduce this risk. The vision of the diseased person must be monitored everyday with an Amsler grid, a special device and report to the doctor regularly for the current updates. Even if there is no trace of symptoms a regular eye check up should be maintained.

Q3. What is Fluorescein Angiography?

Ans. A fluorescein angiography is a medical procedure in which a fluorescent dye is injected into the bloodstream. The dye highlights the blood vessels in the back of the eye so they can be photographed.