Age related macular degeneration is the leading cause of visual loss in the over 65s in the developed world. As the elderly population increases the incidence of this disease consequently also increases. Various different treatments have been evolving to manage this condition over the years.

• Laser
• Photodynamic therapy
• Surgery
• Anti-VEGF therapies
• Possible nutrient prophylaxis (Age Related Eye Disease Study)

Risk Factors:

• Age
• Smoking
• Genetics
• Gender
• Nutrient status (possibly)

When are treatments for ARMD useful?

Laser, Photodynamic therapy, Surgery and anti-VEGF therapies are only useful when choroidal neovascularisation has occurred. The process of choroidal neovascularisation occurs when blood vessels accompanied by inflammatory cells grow under and through the retinal pigment epithelium to disrupt and damage the delicate overlying retinal cells.

The tissue invasion is as described above not only new blood vessels but also inflammatory cells. Specific treatments to target either or both of these components are being actively researched. Anti-VEGF treatments principally target the vascular components. Injectable steroids such as triamcinolone target principally the inflammatory cell component This has been termed a two component target therapeutic model for CNV

(Gasparini G, et al. (2005)J Clin Oncol 23:1295-1311)

Cathedral Eye Clinic are currently using both anti-VEGF, intraocular steroids and laser photocoagulation as part of the therapeutic modalities designed to manage these conditions.