Age-related macular degeneration – dry AMD vs wet AMD

Written by: Mr Praveen Patel
Published:
Edited by: Cal Murphy

Age-related macular degeneration is the UK’s leading cause of vision loss, affecting around 600,000 people across the country. Did you know there are two types of AMD? Top ophthalmologist Mr Praveen Patel explains the difference:

Dry AMD

The most common type of age-related macular degeneration. In people over 50 years old, it is common for waste material called “drusen” to accumulate beneath the retina. Build-up of drusen is associated with subtle problems with vision such as poor vision at dawn and dusk when lighting is poor. As dry AMD worsens, vision deteriorates over months or years.

 There is a severe or advanced form of dry AMD called “geographic atrophy” where light-detecting (photoreceptor) cells and the supporting layer of cells below the retina die away, leading to blind spots or gaps in vision. This makes it difficult to read or recognise faces.

New treatments for dry AMD are currently being assessed in research trials. These new treatments work in different ways, for example, by reducing inflammation in the retina or by reducing the build-up of waste material under the retina. Using different approaches, we hope to slow down or stop dry AMD worsening to sight-threatening forms.

Wet AMD

This is less common, but can lead to more sudden loss of vision. Wet AMD, or neovascular AMD has a more rapid onset than its dry counterpart. The photoreceptor cells in the macula are damaged by abnormal blood vessels which typically grow from underneath the macula into the photoreceptor layer. Vision can deteriorate within days.

Thankfully, we now have effective treatments for wet AMD, which are given as eye injections. There are different types of eye injection and these need to be given as a course of treatment as one injection is rarely enough to treat the condition. Moreover, stopping the injections too early can lead to new leakage from the abnormal blood vessels in wet AMD.

The key to successful treatment relies on the early detection of wet AMD and this can be difficult without retinal scans or other retinal imaging tests. Early symptoms include distorted or wavy vision where straight lines start to appear curved or distorted and faces or images can look squashed or stretched. Different types of retinal disease can cause this type of symptom but it is important to see an ophthalmologist specialising in the treatment of retinal disease within a few days of the start of symptoms of distorted vision to get to the bottom of the cause of the change in vision.

By Mr Praveen Patel
Ophthalmology

Mr Praveen Patel is an internationally-revered and award-winning consultant ophthalmologist based in central London, Bath, Sawbridgeworth, Hertfordshire and St Albans. He specialises in macular degeneration (AMD), retinas and retinal vein occlusion alongside diabetic retinopathy, macular oedema and intravitreal injection. He privately practices for Moorfields Private Outpatients Centre, The Rivers Hospital, London Medical and the Eyesight Clinic at the Redbourn Health Centre. He also works for the NHS at the world-renowned Moorfields Eye Hospital and Princess Alexandra Hospital in London.

Mr Patel is passionate about providing cutting-edge treatments for patients on the NHS and privately. He is the lead consultant for medical retina clinical trials and retinal imaging at Moorfields Eye Hospital and the age-related macular degeneration treatment service at the Princess Alexandra Hospital Trust, in partnership with Moorfields Eye Hospital. 

Mr Patel, who has a special interest in cataracts and retinal and macular disease, qualified from Cambridge University in 1997 with a first class degree. This was followed by postgraduate training in Ophthalmology at Moorfields Eye Hospital, London.   
 
Mr Patel has an esteemed reputation for excellence in patient care for macular disease, including the use of the injectable medications Lucentis, Eylea and Ozurdex as well as Avastin. Verteporfin photodynamic therapy and advanced macular laser treatments are also incorporated into his skilful practice. His clinical research reflects his expertise to the highest standard; Mr Patel won the Moorfields Research Medal for his work, as one of the lead investigators for the world's first randomised trial of Avastin for age-related macular degeneration, which was published in the British Medical Journal (BMJ).

His research work has also extended to validating new imaging modalities for the assessment of macular disease and he is a clinical research fellow at Moorfields and at the UCL Institute of Ophthalmology.

Mr Patel's work has been published in various peer-reviewed journals and he is an international member of the Association for Research in Vision & Ophthalmology (ARVO) and member of the American Academy of Ophthalmology (AAO) and the Royal Society of Medicine (RSM). He is also a fellow of the Royal College of Ophthalmologists.

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