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Research - Age-related macular degeneration (AMD)

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Eye examination after macular relocation surgery.Age-related macular degeneration (AMD) is the most common reason for blind and partly sighted registration in the UK today.

The macula is a small and specialised region of the retina that is responsible for central vision which is necessary for reading, writing, driving and recognising peoples' faces.

In AMD there is slow degeneration of the pigment layer under the retina. This pigment layer, the retinal pigment epithelium (RPE), is essential for normal function of the retina. Amongst its many important functions it helps regenerate the visual pigments required for the retinal photoreceptors to function.

After several years of RPE degeneration, changes become visible within the macula. These early changes are termed atrophic or 'dry' AMD and cause a very slow deterioration in central vision. Dry AMD is the least severe type of AMD. There is no treatment for dry AMD.

A more severe form of AMD known as neovascular or 'wet' AMD arises when new blood vessels, known as choroidal neovascularisation (CNV), grow under the macula. These vessels can leak fluid, bleed and cause scar formation destroying vision in as little as three months.

Wet AMD represents approximately 15% of all cases of AMD but accounts for around 90% of the severe visual loss in the condition. It occurs in several types with differing severities and rapidity of visual loss.

Clinician using a stereo camera to analyse images of the retina in 3D.In order to accurately categorise neovascular AMD, ophthalmologists routinely perform fluorescein angiography. A dye is injected into a vein to show the nature of any vessels in the macula followed immediately by a series of pictures taken using a specifically designed camera. Assessment can also be helped in certain cases by angiography using a different dye, indocyanine green

Because it can cause profound, rapid loss of vision, wet AMD has been the subject of many years of research by teams of scientists and clinicians throughout the world. Unfortunately, for the vast majority of AMD patents there is still no effective treatment.

In Liverpool, research teams under the direction of Professor Ian Grierson, Professor Simon Harding and Professor David Wong are currently engaged in several studies investigating new treatments for AMD. These are listed below:

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