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What is ARMD?
It is degenerative condition due to continuous age related damage to the central and most important part of the retina i.e. macula. This damage occurs due to deposition of harmful materials below this area in old age.
What are the types of ARMD?
There are two types: dry and wet, early stage of dry ARMD has no swelling, no bleeding, no fluid inside the retina but the late stage causes damage to central retinal layers called geographical atrophy (GA). wet ARMD is the late stage of the disease with swelling due to fluid accumulation in retina and bleeding from abnormal vessels called CNVM (choroidal neovascular membrane).
Who is at risk for ARMD ?
You are more likely to get ARMD IF:
Eating high saturated fat containing food ( fried meat, butter, cheese etc)
Overweight
Smoke cigarettes
Over 50 years of age
Hypertension (high blood pressure)
Family history of AMD
What are the symptoms of ARMD?
Routine eye check-up and screening is very important as initial stage of dry ARMD has no symptom but as the disease progresses it causes more and more damage to retina.
Symptoms :
1. Blurred vision
2. Straight line appears wavy and broken (Metamorphopsia)
3. Black round spot in the centre (central scotoma)
4. Difficulty in reading letters from newspaper or mobile phone
What tests I need to do for diagnosis of my disease ?
Amsler grid :
The doctor will ask you to look at this grid as shown in the image and will ask you to follow the vertical and horizontal lines on this grid, you see this straight line as wavy or bluured in presence of the disease. This is generally a home based test so your doctor can give you this charts to self-examine in early dry ARMD stage as shown in the image below.
Optical coherence tomography (OCT):
Very important and best diagnostic tool to differential dry from wet ARMD which helps for early diagnosis and treatment so you can have better results.
Fluorescein angiography (FFA): It is special orange coloured dye injected in blood vessel of the the arm. This dye goes to the retinal vessels and with the help of special fundus camera the images of retina are taken. If you have the wet ARMD this dye will leak from the abnormal blood vessels showing presence of fluid and swelling in retina.
Optical coherence tomography angiography (OCTA): It is non-invasive recent and more advanced scanning technology and does not require injection of the dye for detection of the abnormal vessels.
How is ARMD treated ?
Your retina specialist can only tell which type of treatment will be needed to you because dry and wet types have totally different treatment.
Eye-friendly foods: green leafy vegetables, yellow fruits (beta-carotene) , balanced nutrition rich food are beneficial.
Dry ARMD :
At present there is no treatment for this however large study (AREDS and AREDS2) found the progression of the disease can be slow down with vitamins and mineral supplements. Your doctor only can tell which supplements to take as all vitamins and minerals are not beneficial in dry ARMD.
Wet ARMD:
Initially due to lack of awareness and treatment wet ARMD had very poor outcome leading to total blindness, now with recent development in treatment options this vision loss can be prevented. Therefore it is very important to screen your eyes by an ophthalmologist.
Previously wet ARMD was treated with laser to damage abnormal retinal vessels. Recently,due to development of antiVEGF injections there is no need to use lasers. Injections reduce number of these abnormal vessels and swelling by drying the fluid without burning the area of retina. Also vision improvement is more with antiVEGF injections than laser as laser can also damage normal retinal areas.
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