The macula is the part of the retina that gives us fine, detailed sight. It is basically the structure that we use for reading, watching TV, driving and working on computers. The fovea is the central small area of the macula which allows us to put a thread through a needle. Any disease affecting the macula, will lead to a blank spot in one’s central vision.

The macula has numerous layers. The inside layers contain our photo receptors. An interplay between several risk factors, can lead to damage of these layers leading to vision loss. ARMD can be divided into a dry-type and a wet-type.

The main risk factors are:

• age above 65 years
• smoking
• genetic predisposition

Other risk factors include

• Caucasian (white) race
• female sex
• blue eyes
• high blood pressure
• high cholesterol levels
• obesity

It is of utmost importance to manage modifiable risk factors such a smoking, hypertension, weight loss and high cholesterol levels. Unfortunately, we cannot control our demographics, age or genetic predisposition. Large studies have shown that antioxidant and mineral supplementation can reduce the risk of progression in people with established ARMD. These supplements are specifically formulated in precise dosages to slow down the evolution of the disease. OCUVITE is a fixed combination supplement taken twice a day. For dry ARMD where geographic atrophy has already been established, a newly approved injection called Pegcetacoplan has shown to decrease the size of the area affected. It’s not yet been approved in South Africa but does offer future hope for patients with dry ARMD. Wet AMD is treated with agents called anti-VEGFs that are injected into the eye. The earlier treatment is started, the better the final visual outcomes. This is an exciting field with extensive research taking place. Drugs available include Avastin, Eylea, Lucentis, Visqq and Vabismo. At Paarl Eye Centre we individualise treatment regimens and drugs depending on the patient’s response, severity of the disease and the status of the fellow eye.

The amount of injections vary for different patients. Everyone receives an initial loading period of three injections a month apart. The aim there after is to gradually increase the intervals between injections. Once someone reaches the three month mark without any new activity, they can usually be monitored going forward. Most people will need treatment for approximately 2 to 3 years.

The number of injections vary from person to person. The 1st three injections are given one month apart. Should the initial drug have a favourable effect, the aim is to gradually increase the intervals between injections. If the drug has a sub-optimal effect, a second line agent is introduced. Once the disease can be adequately supressed for a three-month interval between injections, treatment can usually be stopped. These patients will then be closely monitored for reactivation of their condition. The entire treatment duration ranges from two to three years, although some people might need longer term maintenance injections.

The short answer is no. Our doctors strive to make the experience as pleasant as possible and ensure that all our patients are properly anaesthetized over the area where the injection will be administered.

We administer all our injections in our practice. Stringent sterility measures are taken to prevent infection inside the eye after injections.