2 Indications and current treatments
2.1 Age-related macular degeneration (AMD) is the commonest cause of irreversible blindness in industrialised countries. It usually occurs in older adults and is associated with degeneration of the macula – a small area at the centre of the retina responsible for central vision, and for appreciation of fine detail and colour. There are 2 main types of AMD, the most common of which is atrophic or 'dry' macular degeneration. This dry form is characterised by thinning of the macular retina. It develops slowly, causing a gradual loss in central vision. The other type is neovascular or 'wet' AMD, which is characterised by the growth of new blood vessels behind the retina, causing retinal bleeding and scarring. The new vessels are described according to whether they can be seen clearly ('classic') or poorly ('occult') on fluorescein angiography. The onset and disease progression of wet AMD is much faster than in the dry form. Both types of AMD typically affect both eyes, although 1 eye may be affected before the other.
2.2 Optical aids such as magnifying glasses may help patients with dry or wet AMD to read and do tasks needing fine-detail vision. For wet AMD, there are several treatment options but most patients have repeated intravitreal injections of anti-vascular endothelial growth factor agents, with ongoing regular clinic review. There is currently no standard treatment for dry AMD.