Macular Degeneration (AMD) Care in Saskatoon

What is AMD?

AMD affects the macula, the small central part of the retina that gives you sharp, detailed vision. Side vision is usually not affected.

• Dry AMD is the most common form. Yellow deposits called drusen build up under the retina, and the macula thins slowly over time. It usually progresses over years. It is grouped into early, intermediate and late stages. The late stage of dry AMD is called geographic atrophy.
• Wet AMD is less common but more serious. Abnormal blood vessels grow under the macula and leak fluid or blood. Vision can worsen quickly, over days or weeks. Dry AMD can turn into wet AMD at any time.

Who is at risk?

• Age 50 and over (risk rises with age)
• A family history of AMD
• Smoking (one of the most important risks you can change)
• High blood pressure, heart disease or high cholesterol
• Lighter eye colour and fair skin
• A diet low in leafy greens and fish

How AMD is diagnosed

• Vision test and dilated eye exam – to look closely at the macula
• OCT scan – a quick, non-contact scan that shows the layers of the retina and any fluid
• Retinal photographs – to record drusen and track changes
• OCT angiography or fluorescein angiography – may be used to look for abnormal blood vessels in wet AMD
• Amsler grid – a simple grid you can use at home to watch for changes

Treatment options

Dry AMD

There is currently no treatment that reverses dry AMD. Steps that can help:

• AREDS2 eye vitamins – for people with intermediate AMD, or late AMD in one eye, a specific vitamin and mineral formula (vitamin C, vitamin E, zinc, copper, lutein and zeaxanthin) was shown in large studies to lower the risk of progressing to advanced AMD. It does not help early AMD, and it does not prevent AMD. Ask your eye doctor before starting, especially if you take other supplements. Older formulas with beta-carotene are not recommended for current or former smokers.
• Don’t smoke, and eat a diet rich in leafy greens, colourful vegetables and fish.
• Monitor at home with an Amsler grid and keep regular eye exams.

Treatments for geographic atrophy are an evolving area. Your eye doctor can tell you whether any are suitable and available in Saskatchewan.

Wet AMD

• Anti-VEGF injections are the main treatment, and they are offered at CEI. The medicine is injected into the eye after it is numbed, to stop abnormal vessels from leaking and growing. Treatment usually starts with injections about once a month, then the time between visits is adjusted based on how your eye responds. Most people need ongoing treatment. Injections aim to slow or stabilize vision loss. Some people see improvement, but injections do not cure AMD and vision does not always return to normal.
• Your ophthalmologist will explain the medicine, the schedule and the possible risks before you start.

Living with AMD and follow-up

• Keep all follow-up and injection appointments. Missing treatments for wet AMD can lead to vision loss.
• Check each eye with an Amsler grid as often as your doctor advises.
• Low-vision support – magnifiers, brighter lighting, large-print and talking devices can make daily tasks easier. Your doctor can refer you to low-vision services (for example, CNIB).
• Ask about driving if your central vision has changed.
• Stay socially active and ask for help if vision loss is affecting your mood.