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.

In a show "Capital Santé" (broadcasted via social networks, on the internet and on TNT), Pr Souied explains in detail what "AMD" means. It explains the main visual symptoms as well as depicting the two forms: atrophic and exudative. The risk factors and research perspectives are also discussed in this interview.
You can watch this show on Youtube.

Le Pr Souied invité de l'émission Capital Santé

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 Macular Degeneration

By definition it is a disease of the macula that can appear from the age of 50 - 55 years. Two forms of Age-related Macular Degeneration exist: the atrophic form (or dry) and the exudative one (or wet).

Clinical signs

The clinical signs of AMD are metamorphopsia (the perception of wavy lines), and scotoma (the perception of a spot within the central visual field).

Urgent consultation

It is important to promptly seek medical attention in case of  metamorphopsia or scotoma.

Amsler grid : it allows to evaluate the metamorphopsia.

Central deformations called metamorphopsia.

Appearance of a spot in the center of the visual field: otherwise called central scotoma.

The atrophic form

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 AMD (fundus photograph)

The exsudative form

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)

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.

Exsudative AMD: Fluorescein Angiography (left: 1 minute after injection, right: 6 minutes after injection).

Exsudative AMD: Indocyanin Green Angiography (left: 1 minute after injection, right: 30 minutes after injection).

Exsudative AMD: OpticalCoherence Tomography. Left: Infra-Red imageing. Right: OCT section)

Which therapies are currently available?

Dry AMD

There is currently no treatment for atrophic AMD. However many therapeutic protocols do exist. If you are interested in these research protocols, the CHIC Ophthalmology team will be pleased to welcome you and answer to your questions. Many therapeutic research protocols are actually underway in our service.

Wet AMD

The standard treatment for exudative AMD is intravitreal injection therapy.

The injections are performed under local anaesthesia in aseptic conditions. One injection lasts a few seconds and is usually painless. A sand grain sensation may persist within 24 hours of injection. New and innovative treatments are currently under investigation. Our ophthalmology department is currently involved in many therapeutic protocols.

You can make an appointment with one of the Ophthalmologists of the department who provide specific care dedicated to this pathology:

Dr Olivia ZambrowskiStaff Physician

Department: Doctor
Specialty: AMD, Cataract surgery, Electrophysiology, General Ophthalmology, Hereditary macular dystrophies

Dr Alexandra MierePart-time Staff Physician

Department: Doctor
Specialty: AMD, Diabetic retinopathy, Myopic maculopathy, Retinal Lasers, Retinal venous occlusive disease

Dr Oudy SemounPart-time Staff Physician

Department: Doctor
Specialty: AMD, Cataract surgery, General Ophthalmology, Ophthalmic Echography, Vitreoretinal surgery

Dr Mayer SrourPart-time Staff Physician

Department: Doctor
Specialty: AMD
Department: Doctor
Specialty: AMD, Angioid streaks, Cataract surgery, Diabetic retinopathy, General Ophthalmology, Glaucoma, Retinal Lasers, Retinal venous occlusive disease

Dr Jean-Louis BacquetUniversity Fellow

Department: Doctor
Specialty: AMD, Cataract surgery, Electrophysiology, Hereditary macular dystrophies, Vitreoretinal surgery
Department: Doctor
Specialty: AMD, Cataract surgery, Children, Diabetic retinopathy, General Ophthalmology, Glaucoma, Glaucoma surgery, Retinal Lasers, Retinal venous occlusive disease, Strabismus, Strabismus surgery
Department: Doctor
Specialty: AMD, Cataract surgery, Diabetic retinopathy, Glaucoma, Retinal Lasers, Retinal venous occlusive disease
Department: Doctor
Specialty: AMD, Cataract surgery, Glaucoma, Lacrimal duct, Neuro-ophthalmology, Orbit and eyelid, Uveitis
Department: Doctor
Specialty: AMD, Cataract surgery, Diabetic retinopathy, Glaucoma, Neuro-ophthalmology, Retinal venous occlusive disease

Dr Sergio PiscitelloFellow

Department: Doctor
Specialty: AMD, Angioid streaks, Cataract surgery, Diabetic retinopathy, Glaucoma, Pachychoroid

Dr Daniel SeknaziFellow

Department: Doctor
Specialty: AMD, Cataract surgery, Children, Diabetic retinopathy, Myopic maculopathy, Retinal venous occlusive disease, Retinopathy of prematurity, Uveitis, Vitreoretinal surgery

Dr Setha Vo KimFellow

Department: Doctor
Specialty: AMD, Cataract surgery, Children, Diabetic retinopathy, Lacrimal duct, Orbit and eyelid, Retinal venous occlusive disease

The care pathway

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.

Video duration: 22 min 01 s (only in French).