Early detection of age-related macular degeneration (AMD) is important in the differential diagnosis of other illnesses and to identify the point in time at which AMD (again) returns to an acute form, accompanied by permanent damage to the eye – i.e. transitions to “wet” AMD.
The clear recommendation and the gold standard in contemporary treatment of AMD is as follows: a check-up every 4 weeks, in which the visual acuity is precisely examined and measured with instruments to see whether a wet form of AMD is present, in onset or absent. If there are indications that the disorder is starting to transition to a wet stage, a repeat course of injections is recommended as soon as possible – whether or not the patient is actually complaining of worsening vision. This procedure has yielded evidence that the needs-based treatment settings applied in this way are able to achieve the best results for retaining a patient’s vision.
At our Centre, our outstanding technical facilities (Zeiss Reference Centre) and well-organised practice mean we can offer this AMD monitoring service precisely as required. Accordingly, we can treat this disorder in accordance with the guidelines and the gold standard in a way that is comfortable for our patients. If necessary, same-day injection treatments can be offered by our Centre if required.
AMD monitoring means security for you, since you can rely on our expertise and the very latest advances in technology. We are always improving our processes to ensure that attending these appointments involves a minimum investment of time on your part.
WHY MACULA MONITORING IS SO IMPORTANT
The wet form of AMD can and must be treated promptly in order to prevent permanent damage to visual acuity. The instruments available today permit us to identify the onset of the wet stage long before the patient experiences worsening vision due to his or her AMD. Research has also shown that the earlier treatment starts, the better our chances are of pushing back the progression of AMD.
The distinction between wet and dry AMD is a purely clinical categorisation of age-related macular degeneration based on experience in terms of the progression and diagnosis of the disorder. Wet and dry are simply different manifestations and stages of the same underlying disorder, which can alternate between them. That said, the dry form does not typically exhibit the dramatic progression with the potential to reduce visual parameters rapidly over a period of weeks or even days with scarring and permanent loss of vision after acute attacks, all of which characterises the wet form.
To date, while there is no recommended treatment option for the dry form, the form does not generally exhibit such a dramatic progression with rapid deterioration of vision. The wet form is sometimes associated with rapid deterioration within a very short period of time. Prompt action needs to be taken here to return the disorder back to the dry stage. Which means timely detection is required. And exactly what “timely” means has now been proven with studies (gold standard, introduction of VEGF inhibitors).
It is not simply the case that one person has the dry form and another person always has the wet form: they are manifestations of the same disease, which proceeds at an intensity and frequency that depends on individual propensities. The dry form can stay dry for an individual’s entire lifetime but also has the potential to transition to a wet stage at any time. While some people with AMD experience a wet stage only in once in their lifetimes (and it stays dry after treatment), others experience wet stages regularly – and yet others experience sporadic alternation between the two forms. That said, a wet form once properly treated can stay dry for a long time – or permanently. The disorder behaves differently from person to person. AMD is today the commonest cause of blindness in developed countries.
The introduction of injection therapy with VEGF inhibitors has vastly improved our potential to treat the disorder. Today, regular check-ups (macula monitoring) are the most important factor for a prognosis of how long good visual acuity can be maintained despite the presence of the disorder.The transition to a wet stage is a symptom of a progressive disease and can often be detected even well before patients actually notice any deterioration in their vision! Many studies and also our own experience have shown that the prognosis for the disease is much better if an immediate start to treatment is made at the onset of deterioration. This means that taking action immediately the disease starts to flare up again offers a better chance of stopping it in its tracks and retaining good visual acuity for longer than simply waiting for a really bad case of deterioration and only then moving to the next stage in the treatment.
Since this flare-up is often unclear and sometimes barely detectable by the patient although often plain to see with instrument-based diagnosis (OCT), regular monitoring is required. If visual deterioration is severe, there is less of a chance of restoring vision to its previous high quality.
This means that if a patient with a known case of AMD has to say to his or ophthalmologist, “My vision has been getting worse for the last 6 weeks”, then the gold standard for treatment has not been applied.
If you are not attending regular monitoring check-ups, a worsening of your vision is essentially a medical emergency and you should seek prompt medical advice. The urgency with which you need to take action depends on the severity: you should ensure you do not wait longer than 3 weeks for an appointment.
WE ARE HERE TO HELP
If age-related macular degeneration has resulted in impairments to your general vision and ability to read that cannot be reversed, you will find that magnifying visual aids, special glasses and certain types of lenses, etc. will prove very useful (->Optical solutions).