Age Related Macular Degeneration

(ARMD or AMD)

Age Related Macular Degeneration (ARMD or AMD) is the leading cause of vision loss in the over 50’s in North America.

By the year 2020 there will be an estimated 30Million patients with AMD in North America alone.

By far the most common type (80-90%) is DRY AMD that can progress to the WET form. The wet form is where fluid and blood may leak into retina. If this happens there is often catastrophic vision loss and although there are many treatments that are effective for wet AMD to stop the leaking and bleeding there can be significant side effects and visual recovery may not be as dramatic as its loss.

The dry form is generally slowly progressive with a loss of central vision that may interfere with daily activities requiring good vision. This can mean inability to drive and loss of independence as well as inability to read. Depression is far more common amongst AMD patients. Blindness is universally feared.

To date there have been no proven active treatments for dry AMD. Modification of life style – exercising, eating a healthy diet with plenty of leafy greens, not smoking and taking anti-oxidant vitamins may help to delay progress.

Below are some photographs of a healthy retina, a dry AMD retina and an advanced dry (atrophic or geographic atrophy) AMD retina.  (Click on each photo to enlarge).

This is a normal fundus photograph of the optic disc and vascular arcades surrounding the macular area. The darker pigmented area in the centre of the photograph shows a healthy looking macular area.
This photograph shows multiple drusen (the yellow and white spots) in the macular area. There are multiple small drusen peripherally and some larger more confluent drusen centrally. Drusen are the hallmark of dry AMD however visual function does not always correspond to the anatomical appearance. There is a much higher risk of progression to the wet form of AMD with this grade of dry AMD.
This is a photograph of geographic atrophy where the retinal pigment epithelial layer and photoreceptor layer have become atrophied and thinned (the paler disc shaped area centrally). Again, although the anatomical appearance does not correlate well with visual acuity this patient would have quite poor vision as there are very few functioning photoreceptors left.

Photobiomodulation as used in the TORPA study and Photospectra’s off label data has been shown to restore and preserve visual function and also may prevent conversion to wet AMD.