Types of AMD

There are 2 forms of Age-related macular degeneration – Dry and Wet form.

DRY or NON-Exudative AMD

is the more common form, these photoreceptors slowly fail to function properly. This results in any abnormal deposits or debris, called drusen to accumulate under the retina. Fortunately, these deposits rarely cause visual loss or blindness. However, in some patients, the photoreceptors slowly degenerate with time, resulting in an advanced form of dry AMD called Geographical Atrophy. In a small group of patients, patients with drusen can progress to develop wet AMD. Both advanced form of dry AMD and wet AMD can cause visual loss.

Treatment options for Dry AMD

There is currently no proven effective treatment for dry AMD.

amd-photo-signing

WET or Exudative AMD

Wet or Exudative AMD accounts for 10 to 15% of cases but is responsible for the majority of patients with vision loss. This is due to the growth of abnormal blood vessels under the retina called Choroidal Neovascularization (CNV). These new blood vessels are very fragile and may leak fluid or blood. This leads to scarring that causes rapid and severe visual loss. Another variant that is commonly seen in this part of the world is called Polypoidal Choroidal Vasculopathy (PCV). This condition frequently results in large amounts of bleeding and leakage under the retina.

Treatment options for Wet AMD

As for wet AMD, there are a few options but none of these are a cure.


Laser

This involves applying a focused beam of high energy laser to the leaky blood vessels. However, this will also destroy surrounding health tissues and cannot be used for blood vessels directly under the centre of the macula.

Photodynamic Therapy (PDT)

This is a 2 step procedure. The first step involves injection of a drug called verteprofin (Visudyne) into the blood stream. The drug accumulates in the abnormal leaky blood vessels but not in normal vessels. The second step involves applying a ‘cold’ laser to activate the drug on these abnormal blood vessels. This way, the abnormal vessels will be closed and the normal tissue will not be affected as they do not collect the drug.

Anti-VEGFs

This is a recently discovered new group of drugs, called anti-VEGF (anti-Vascular Endothelial Growth Factor). By injecting the drug directly into the eye using a small, fine needle, it has been shown to be effective in treating wet AMD by causing regression of the CNV. This is the only treatment that may result in improvement of vision but results vary between individuals. However, injections may have to be repeated on a monthly basis for optimal results. An example of this agent is Lucentis. Due to the high cost of Lucentis, a close chemical alternative of Lucentis, Avastin can be used. Avastin is a drug used for patients with colorectal cancer. It is used ‘off-label’ for patients who cannot afford Lucentis. Both of these drugs are injected directly into the eye known as an intravitreal injection.

As part of our comprehensive quality care we provide, we also offer counseling with regards to diet and lifestyle modifications to help reduce your risk of AMD.

Locate us

Mt Alvernia

820 Thomson Road,
Mount Alvernia Hospital,
Medical Centre D, #06-57/58/59/60/61/62
Singapore 574623

Fax: (65) 6456 1006
Mt Elizabeth Orchard

Mount Elizabeth Medical Centre,
3 Mount Elizabeth #08-08,
Singapore 228510

Fax: (65) 6836 0002
Parkway East

Parkway East Medical Centre,
319 Joo Chiat Place,
#05-03 Singapore 427989

Fax: (65) 6348-1001
Mt Elizabeth Novena

38 Irawaddy Road,
Mount Elizabeth Novena Specialist Centre,
#08-22/23/24 Singapore 329563

Fax: (65) 6570 1001
Westgate

Westgate Mall,
3 Gateway Drive,
#02-42A Singapore 608532

Fax: (65) 6250-6066
Royal Square at Novena

Royal Square Novena Medical Centre at Royal Square at Novena,
101 Irrawaddy Road,
#11-07 to 13 Singapore 329565

Fax: (65) 6456-1002
King Albert Park

KAP Residences Mall,
9 King Albert Park,
#01-42/43/44 Singapore 598332

Fax: (65) 6475-1880
HMI Medical Centre

12 Farrer Park Station Road,
#05-02/03/04,
StarMed Specialist Centre, Singapore 217565


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