AMD

Age-related Macular Degeneration (AMD) is the leading cause of blindness in French patients older than 50. It is estimated that more than a million French patients have AMD.


What is AMD ? How to detect it ? what is the treatment ? In this video, ophthalmogists of our department describe AMD care in Créteil. And patients speak about there desease experience, and talk about there clinical visits and treatments.

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Age-Related Maculopathy (ARM)

ARM represents an early stage of Age-related macular degeneration. It induces little or no visual symptoms. It is characterized by the presence of alterations in the pigment epithelium and / or deposits in the retina called drusen in the macula (central area of the retina). If ARM is present in one or both eyes of a patient, his or her risk of developing AMD within 5 years is approximately 50%. Depending upon the extent of ARM, preventive treatments can be prescribed including antioxidants.

Age-related Maculopathy (early stage macular degeneration): Significant drusen and alterations of the pigment epithelium (fundus photograph )
Age-related Maculopathy (early stage macular degeneration): Significant drusen and alterations of the pigment epithelium (fundus photograph)

Age-Related Macular Degeneration

  • The atrophic form (Dry AMD): it is the result of progressive atrophy of the pigment epithelium and photoreceptors. Impact on visual acuity is meaningful, but this process evolves in a relatively slow fashion.
    Dry Form of ARMD (fundus photograph)
    Dry Form of AMD (fundus photograph)
  • The exudative form (Wet AMD): Twice as frequent as the dry form of the disease, the wet form is characterized by the appearance of abnormal choroidal neovascularization in the macula. These vessels are responsible for the formation of edema, intra- and sub-retinal exudates, and retinal hemorrhage. Wet AMD typically evolves and progresses rapidly.
    Wet AMD : Advanced case with fibrosis present at the macula (fundus photograph )
    Wet AMD : Advanced case with fibrosis present at the macula (fundus photograph)

How is AMD diagnosed ?

Through a combination of fundoscopic examination and advanced retinal imaging:

These different tests are required to validate the diagnosis, initiate treatment, and ensure appropriate follow up care adapted to disease progression.

Wet AMD: Angiography sequence
Wet AMD: Angiography sequence
Wet AMD: Angiography imaging (left) correlated to OCT imaging (right)
Wet AMD: Angiography imaging (left) correlated to OCT imaging (right)

What therapies are currently available?

Currently treatment is only available for the wet form of the disease. Depending upon the location of the lesions relative to the center of the retina, different therapies are indicated: thermal laser photocoagulation, anti-angiogenic agents administered via intravitreal injections, and photodynamic therapy. Many treatments are currently being evaluated and the Department of Ophthalmology is involved in several clinical trials.

Last page modification: 9 Sep 2014