Wet age-related macular degeneration (AMD)

Wet age-related macular degeneration (AMD) develops when abnormal blood vessels grow into the macula. These leak blood or fluid which leads to scarring of the macula and rapid loss of central vision. Wet AMD can develop very suddenly, but it can now be treated if caught quickly. Fast referral to a hospital specialist is essential.

What are the symptoms?

Macular disease affects people in different ways:

• Gaps or dark spots (like a smudge on glasses) may appear in your vision, especially first thing in the morning. Objects in front of you might change shape, size or colour, or seem to move or disappear.
• Colours can fade.
• You may find bright light glaring and uncomfortable or find it difficult to adapt when moving from dark to light environments.
• Words might disappear when you are reading.
• Straight lines, such as door frames and lampposts may appear distorted or bent.

Diagnosing wet AMD

The optometrist at your local optician’s practice can test sight, prescribe glasses and check for eye disease. Some optometrists use photography or other imaging to detect early signs of macular degeneration. These might include Optical Coherence Tomography (OCT) scans which create cross-sectional images of the retina. You may be charged for these tests.

If your optometrist suspects you have wet AMD, you should be referred to a retinal specialist at a hospital directly and seen within one to two weeks, and if applicable be treated within two weeks after initial detection. You should not be sent to your GP. This causes unnecessary delay.

At hospital, further tests will be carried out to confirm the diagnosis. The specialist may use:

• Eye drops to dilate the pupils to clearly see the back of the eye. These may make your vision blurred and sensitive to light for a short time, so consider taking someone with you to your appointment.
• OCT scans.
• Fluorescein dye angiography. A dye injected into a vein in the arm travels to the eye, highlighting the blood vessels in the retina so they can be photographed. The dye will temporarily change the colour of your urine, so be prepared.

Treating wet AMD

Wet AMD can be treated if caught early. Drugs are injected into the eye to stop the growth of the abnormal blood vessels. Following diagnosis people will usually have a loading dose of three injections, once a month for three months. A patient will then be assessed to see if more injections are required.

The injections are not as bad as they might sound. The patient’s eye is anaesthetised, and the needle goes into the corner of the eye so the patient does not see it.

A small number of people may respond better to a combination of injections and form of laser treatment. There are a range of treatments and options, although not all are available on the NHS.