Ophthalmology News South Africa

Age-related macular degeneration awareness during World Retina Week 2009

Because of the fact that Age-related Macular Degeneration (AMD) is the third leading cause of blindness and vision impairment, the focus of this year's Retina Week falls on this debilitating disease with the 2009 theme being: “Improving Vision, Restoring Hope”.

Retina South Africa and pharmaceutical company Novartis are supporting World Retina Week by way of raising awareness with an educational angle on how early detection of blindness may lead to better management thereof, specifically in the case of AMD.

“AMD is one of the most insidious eye conditions. It robs those affected of their precious central vision and the wet form is the most serious. Retina South Africa welcomes the new anti-angiogenic treatment for this devastating condition but we must warn people that early diagnosis is critical for the success of the treatment,” explains Claudette Medefindt, director for Science of Retina South Africa.

The World Health Organisation has classified Age-related Macular Degeneration (AMD) as a condition affecting people over the age of 50 and involves the loss of the person's central field of vision. It occurs when the macular (or central) retina develops degenerative lesions. It is thought that circulatory insufficiency, with reduction in the blood flow to the macular area, also plays a part.

Even today, there is no cure or prevention for AMD, and the disease is becoming more and more prevalent due to the fact that advances in the medical field lead to an increase of life expectancies.

A new anti-angiogenic treatment offers new hope for patients affected by severe Wet form of the disease. Until now, limited treatment for AMD existed but the first effective registered treatment for Wet AMD is available in South Africa. This injection stops the formation and growth of new blood vessels (choroidal Neo Vascularisation - CNV) and improves vision in 78% of cases.

Risk factors for contracting AMD are aging, tobacco use, genetic disposition, light coloured eyes, arterial hypertension, ultraviolet rays and an unbalanced diet. AMD is more common within Caucasian communities and industrialised countries.

Early detection of Macular Disease is entirely possible with regular eye tests at an optometrist. Tests include the standard eye chart tests, the Amsler grid test, colour testing to determine the status of cone cells, a dark adaptation test and a fluorescein angiogram.

Research has shown that 1 in 5 people may carry a gene for recessive retinal degeneration. AMD affects 5% to 20% of the South African population over the age of 65 with the disease being more prevalent in the South African Caucasian population.

The visually impaired person and his/her family face serious direct and indirect socio-economic challenges. Loss of income due to the person becoming unemployable can seriously impact on the person's financial status and usually goes along with a loss in social status and self-esteem, not to even mention the physical limitations that go hand in hand with this disease. The family of someone suffering from blindness essentially has to make enormous real-life sacrifices in order to accommodate their loved one. Not only does it affect the quality of life at home but it also has an effect on requirements in the workplace as the workforce continues to reach a more advanced age.

Visual requirements for a person to function well in a modern society has never been more important as it is today, therefore awareness of how this age-related disease can be managed by the individual affected, society around them, the medical profession and the workplace has never been more pertinent to ensure quality of life.

Medefindt concludes: “We encourage anyone experiencing central vision loss and particularly people over the age of 50 to regularly conduct self testing by using an Amsler Grid-test, that can be obtained from their eye care practitioner.”

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