EC Healthcare (HKEx: 2138.HK)

Macular Degeneration 
Age-related macular degeneration

Macular Degeneration 

Macular Degeneration is one of the top three blindness-causing eye diseases in the world. It is estimated that there are more than 190 million people with macular degeneration worldwide, and one in ten of them will lose their eyesight permanently as a result. With an ageing population, the number of people with the disease is expected to exceed 280 million by 2040.1.

Macular degeneration is usually seen in people over the age of 50. However, with the popularity of electronic products and excessive eye use in recent years, there is a trend towards a younger age group. It is common for people's eyes to deteriorate and age prematurely. Macular degeneration is an eye disease that happens with there is damage to the macula.

Symptoms of macular damage include decreased visual acuity, distortions in the appearance of lines, etc. The disease is usually caused by the ageing and deterioration of eye function. Delayed detection and treatment can lead to blindness.

1 Source: Ophthalmology and Visual Sciences, The Chinese University of Hong Kong

What is Macular Degeneration?

The macula is the central portion of the retina where 90% of photoreceptors are concentrated. It is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, write, recognize faces or colours, and see objects in fine detail. So it is important to keep your macula healthy in order to see clearly. Macular degeneration is an eye disease that happens when there is damage to the macula. Symptoms of macular damage are decreased visual acuity, distortions in the appearance of lines and darkening of the central vision. The disease is usually caused by the ageing and deterioration of eye function.

normal macula

Types of Macular Degeneration

Dry type

More serious complications such as macular degeneration can cause visual impairment and image distortion, and severe cases may even lead to blindness.

Dry macular degeneration
The cells in the macula begin to degenerate and accumulate metabolites that block the macula, which is responsible for clear vision, resulting in dry macular degeneration.

Wet type

More serious complications such as macular degeneration can cause visual impairment and image distortion, and severe cases may even lead to blindness.

Wet macular degeneration
Abnormal blood vessels grow under the retina, they are very fragile and may leak blood or other fluids, causing permanent damage to photoreceptor cells and rapid loss of vision, leading to blindness.

Causes of Macular Degeneration

The causes of macular degeneration may be increased risk due to aging, smoking, family inheritance, poor eating habits, lack of vitamins, retinal damage from ultraviolet light, etc. Therefore, if you have the above symptoms, please seek medical advice as soon as possible and receive appropriate treatment.

Causes of macular degeneration: family genetic disease

Family inheritance

Causes of macular disease: macular degeneration

Aging
Macular degeneration

Loss of vision due to long-term absorption of strong sunlight (ultraviolet rays)

長期吸收
猛烈陽光(紫外線)
Loss of vision due to long-term absorption of strong sunlight (ultraviolet rays)

Smoking can cause macular degeneration

Smoking

High cholesterol and high fat diet

Eating lots of high fat
or cholesterol food

High myopia can cause macular degeneration

High myopia

Symptoms of Macular Degeneration

Symptoms of macular degeneration include: central visual field changes: patients will find round, oval, oval, irregular dark spots, black circles, etc. in the center of the visual field; visual impairment: rapid or gradual loss of vision, with acute vision mostly in one eye. Significant decrease; abnormal color vision: abnormal perception of colors, and contrast color sensitivity may also be reduced.

Symptoms of macular degeneration  Darkness appears in the center of the vision

Darkness in the center
of the vision

Symptoms of macular degeneration blurred vision

Blurred vision

Distorted vision Macular degeneration

Distorted vision

Macular Degeneration Self-Examination and Test Diagnosis

Self-examination for macular degeneration

Macular Degeneration Self-Examination and Test Diagnosis

Amsler Grid

No matter what your age, you should always perform self-examination for macular degeneration. Use the "Amsler grid" on the left to perform the examination:

  • Hold the grid 30 cm from your eyes, looking at the centre with one eye
  • Repeat the same step again to test the other eye
  • During the test, if you find that the straight lines are blank or distorted, or that certain areas are blurry, this may be a sign of fundus trouble. You should see an ophthalmologist for a more detailed examination as soon as possible.
  • In addition to these common symptoms, patients may also experience night blindness

Be aware of the following symptoms

Amsler grid test

Distortion

Amsler Grid Dark spot

Dark spot

Amsler Grid Test Blurred vision

Blurred central vision

Macular degeneration treatment methods

Intravitreal Anti-VEGF Injection
Intravitreal injection(Intraocular Drug Injections)

The intravitreal injection stops the growth of new blood vessels, thus reducing neovascular leakage and bleeding. Not only can the intraocular condition be controlled, but the impaired vision can also be improved. Patients are required to receive the injection within a specified period of time and under sterile and surface anaesthetic conditions.

黃斑病變治療 眼內注射藥物

Laser photocoagulation

Laser photocoagulation uses high-energy laser light to destroy an abnormal growth of blood vessels in the retina to stop their proliferation and reduce leakage, bleeding and oedema, preventing vision loss. The treatment takes effect indiscriminately in the eye and has the potential to damage the surrounding healthy tissues, causing visual impairment. Therefore, it is only suitable for patients whose lesions are located far from the centre of the macula.

Macular degeneration laser treatment

Photodynamic therapy

The doctor will conduct an intravenous injection with a light-sensitive medicine which will be absorbed by the abnormally-grown blood vessels. The medicine will then be activated to block the abnormal blood vessels by special laser light, controlling the deterioration of this disease and improving the patient’s visual function. This treatment does not cause damage to peripheral tissues and is beneficial in improving vision degeneration.

Macular Degeneration Treatment Photodynamic Therapy
Anti-VEGF Medicine Subsidy Scheme

Dr. YEUNG Tak Yee is one of the designated doctors under the "Anti-VEGF Medicine Subsidy Scheme" jointly organised by Retina Hong Kong and the Hong Kong Health Care Alliance. The scheme provides financial assistance to designated eye clinic patients* currently waiting in public hospitals. Patients can save the time of waiting by visiting the designated doctor's clinic for anti-VEGF medicine. Patients in need of anti-VEGF medicine can come to our centre by appointment through the Hong Kong Health Care Alliance.

*They are Anti-VEGF therapy patients who are diagnosed with wet age-related macular degeneration, diabetic macular oedema, retinal vein occlusion or choroidal neovascularisation. Details of the scheme can be foundhere.

Macular Degeneration FAQ

The UVA from sunlight’s UV radiation have a lower energy level but is more penetrating. The energy can accelerate the ageing of photoreceptors in the retina, causing early damage to the posterior macula and its degeneration.

There is a chance of it. When new blood vessels or exudates take over the macula, they can damage the photoreceptors and eventually lead to loss of central vision.

- If straight lines appear to become wavy or the mild waviness have worsen and image become distorted
- If there is a central or near-central darkened area of vision
- If there is a sudden blockage or blackened area in or near the central vision

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