Providing expert management of age-related macular degeneration for the Melbourne community

The macula is an anatomical area of the retina at the back of the eyeball, responsible for the discernment of fine detail and colour in the centre of your field of view. Unfortunately, in the case of age-related macular degeneration, the cells and tissues forming the macula and supporting structures become diseased and lose their function, resulting in progressive deterioration and loss of central vision. The exact causes of macular degeneration are not yet fully understood, but oxidative damage and the accumulation of toxic metabolic waste material in the supportive tissues of the macula are thought to be contributing factors.

While some cases of age-related macular degeneration occur in the absence of any known risk factors, patients with a family history of macular disease, a history of smoking, and older patients are considered to be at higher risk. AMD is one of the leading causes of vision loss in Australia.

Signs of macular degeneration

Early AMD often has no signs. Many patients find out at a routine eye test before any vision is lost. As the disease progresses, you may notice blurred or dim central vision, straight lines that look wavy or bent, a grey or empty patch in the centre of your sight, or trouble reading and recognising faces. Side vision is not affected, and AMD is not painful. A sudden change in central vision, especially new distortion, can be a sign of wet AMD and should be checked straight away.

Types of age-related macular degeneration

Age-related macular degeneration takes two forms. Within both, your condition may be early or advanced.

Dry macular degeneration

Also known as the atrophic form, results from the formulation of drusen, which are microscopic yellowish granules of metabolic waste material accumulating in the retinal layers. The presence of drusen and subsequent atrophy of the surrounding sensory retinal tissues result in a slow loss of central vision. In advanced dry AMD, patches of the retinal pigment epithelium under the macula break down completely. This is called geographic atrophy.

Wet macular degeneration

Or the neovascular form, can cause a sudden and severe loss of central vision. The formation of abnormal, fragile blood vessels beneath the retina results in haemorrhaging and damage to the macular anatomy. Wet AMD occurs when these blood vessels leak fluid and blood into the macula. It is less common than dry AMD but causes most severe vision loss.

As vision loss from both the dry and wet forms of macular degeneration is typically irreversible, close monitoring and timely medical intervention where appropriate is crucial for our patients with macular degeneration in Melbourne.

Diagnosis of macular degeneration

Diagnosis starts with an examination. Drops widen the pupil so your ophthalmologist can see the retina. Our facilities are equipped with all necessary diagnostic equipment, including optical coherence tomography, fluorescein angiography, and retinal photography. Optical coherence tomography scans the macula in cross-section and picks up drusen, thinning and fluid. Fluorescein angiography shows where blood vessels are leaking. Retinal photography records a baseline for comparison over time. Many patients also check their vision at home with an Amsler grid.

Management of Macular Degeneration

Mornington Peninsula Eye Clinic provides care of accomplished macular degeneration specialists for our Melbourne patients and those travelling from rural Victoria. Our retinal ophthalmologists have undergone additional training in the retinal subspecialty, giving them the skill and expertise to manage age-related macular degeneration.

Managing dry AMD

There is currently no cure for age-related macular degeneration, though research continues in this area. At this time, patients with dry macular degeneration are counselled in making certain lifestyle and dietary modifications to reduce their risk of progression and further vision loss. While several risk factors are unmodifiable, such as age and family history, by quitting smoking, using UV protection for the eyes, and ensuring your diet is rich in certain nutrients such as vitamin C, vitamin E and zinc, you can reduce your risk. Research into new treatments for geographic atrophy continues.

Treatment options for wet AMD

Patients with neovascular disease are suitable for treatment with specific intravitreal injections for macular degeneration. The injection of a medication class known as anti-VEGF, or vascular endothelial growth factor inhibitors, aims to inhibit the growth of the abnormal blood vessels that characterise wet macular degeneration. Newer medications hold the macula steady and, for some patients, improve vision slightly. Wet AMD is best treated early, before scarring has occurred. Most patients will require repeat injections under the care of a retinal ophthalmologist who will tailor the frequency of treatments to your individual condition. This may mean injections as frequently as every four weeks, or for patients with more stable disease, up to every two months.

Our retinal specialist team will support you through each step of treatment and will explain the risks of any procedure beforehand.

Patients with age-related macular degeneration are welcome to come under the care of our retinal specialists. Call us now to organise your appointment.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.