Macular Degeneration | Rupal Morjaria | Consultant Ophthalmic Surgeon

Summary
Macular degeneration is one of the top 5 causes for sight loss worldwide. The macular is the part of the retina responsible for central, reading vision.

Macular degeneration can be described as dry or wet. Both conditions can present with early distortion or loss of central vision.

It is common in those over the age 50, however can also be present in younger people with co-existing conditions such as very high short-sightedness, previous inflammatory conditions, or a strong family history.

Symptoms
There are many symptoms of Macular Degeneration, some of which are:

Visual distortion
Difficulty reading
Need for brighter light/magnifiers
Straightlines looking wavy
Difficulty recognising faces

Wet Macular Degeneration
Wet Macular Degeneration can present more quickly with a rapid reduction of vision. It is caused by leakage of fluid into the layers of the camera film.

This requires urgent treatment, normally with injections of drugs known as anti-VEGF drugs.

Currently common treatments approved and commonly used in the UK are Ranibizumab (Lucentis), Aflibercept (Eylea), Faricimab (Vabysmo), Brolucizumab (Beovu).

To find out more about the current or new treatments such as biosimilars, port delivery systems, Faricimab you can contact Dr Rupal Morjaria.

Figure 1. This picture shows a magnified cross section through the layers of the retina. This scan is called an OCT scan and shows the presence of a wet macular lesion and fluid. (Arrow to area)

Figure 2. This picture shows the unhealthy areas affected in the eye using a dye called fluorescein which is injected through the hand to look at the blood vessels in the eye

Figure 3. This is a picture of an eye that has had fluorescein dye where the macula is healthy and there is no macular degeneration.

Dry Macular Degeneration
Can remain stable for years and deteriorate slowly. There can be a varying speed of loss of central vision however the peripheral vision for navigation remains intact.

There are multiple trials looking for treatments to delay progress, however currently there are no approved treatments available.

Figure 4. OCT scan showing early dry macular degeneration

Advice
Follow the advice below to help with Macular Degeneration:

Monitor distortion regularly using a amsler grid covering one eye at a time when testing
A ‘Mediterranean’ diet rich in green leafy vegetables, oily fish
Wearing Sunglasses
Headwear such as caps
Vitamins containing Xanthine and Lutein have been found to delay worsening of the condition or delay the onset of wet macular degeneration in the second eye.

Predisposing Factors
The many predisposing factors regarding Macular Degeneration which can be seen below:

Genetic factors
Age
Smoking
UV light
Diet

Treatments for Dry Macular Degeneration
Previously there were shown to be no effective drug treatments for dry macular degeneration. This results in wear and tear to the back of the eye, inturn causing blindness. SYFOVRE (Pegcetacoplan) is an eye injection that has been used to treat geographic atrophy, the dry advanced form of age-related macular degeneration (AMD). The treatment was studied in 2 large clinical trials which both showed that people who received the treatment, had a decline in the progress of their dry macular degeneration compared to the untreated group. Now there is hope that even though geographic atrophy can not be cured, it may be possible to slow it down. For more information contact Dr Morjaria and click the source below

‍https://syfovre.com/about-syfovre/what-is-syfovre/

Amsler Grid
Follow the instructions below when using the Amsler Grid :

Tape this page at eye level where light is consistent and without glare covering one eye at a time when testing
Put on your reading glasses and cover one eye
While keeping your gaze fixed, try to see if the neighbouring lines are distorted
Mark the defect on the chart
Test each eye separately
If the distortion is new or has worsened, please see an Ophthalmologist urgently.
Always keep the Amsler’s Chart the same distance from your eyes each time you test.

Professional Memberships

Prizes/Awards

Contact Rupal Morjaria.