Age-related macular degeneration (AMD) is the leading cause of vision loss in Australians over 50, affecting approximately 1 in 7 people over the age of 50 to some degree. As Australia's population ages, AMD is becoming increasingly prevalent across Melbourne's northern suburbs — including Bundoora, Epping, Greensborough, South Morang, Eltham, Diamond Creek, and surrounding areas. Anti-VEGF injection treatment for wet AMD is available locally at Northpark Private Hospital — patients no longer need to travel to the CBD for this care.
What is macular degeneration?
AMD affects the macula — the small central area of the retina responsible for detailed central vision used for reading, recognising faces, and watching television. It does not affect peripheral vision, so patients rarely lose all their sight from AMD, but the central vision loss can be profound and severely affect independence.
Dry AMD is the more common form, accounting for approximately 85 to 90 percent of cases. It is characterised by the gradual accumulation of protein deposits called drusen beneath the retinal pigment epithelium, and progressive deterioration of the retinal pigment epithelium (RPE) and photoreceptors. It tends to progress slowly over years. Advanced dry AMD can result in geographic atrophy — areas of complete RPE and photoreceptor loss.
Wet (neovascular) AMD occurs when abnormal new blood vessels grow from the choroid beneath or into the retina — a process called choroidal neovascularisation (CNV). These vessels are fragile, prone to leaking fluid and blood, and can cause rapid, severe central vision loss if untreated. Wet AMD develops in approximately 10 to 15 percent of patients with dry AMD, often without warning.
Symptoms and monitoring at home
Early AMD often causes no noticeable symptoms. As the condition progresses, patients may notice blurred central vision, difficulty reading fine print, straight lines appearing wavy or distorted (metamorphopsia), a dark or blank spot in the centre of vision, or difficulty recognising faces.
Patients with intermediate dry AMD are advised to monitor their vision daily using an Amsler grid — a grid of straight lines with a central dot. Any new distortion, waviness, or missing areas on the grid should prompt urgent contact with their ophthalmologist, as this can indicate conversion to wet AMD requiring prompt treatment.
Risk factors
Age is the strongest risk factor — AMD is uncommon before 50 and becomes increasingly prevalent with each decade. Smoking is the most important modifiable risk factor; smokers have approximately twice the risk of AMD compared to non-smokers. Family history confers significant risk, and AMD has a strong hereditary component. Additional risk factors include fair skin and blue eyes, a diet low in leafy green vegetables, obesity, and cardiovascular disease.
Diagnosis
Optical coherence tomography (OCT) is the cornerstone of AMD diagnosis and monitoring. OCT provides cross-sectional imaging of the retinal layers with microscopic resolution, allowing direct visualisation of drusen, retinal pigment epithelium changes, and subretinal or intraretinal fluid. It is non-invasive, takes only a few minutes, and is repeated at each follow-up visit to track response to treatment.
Fluorescein angiography and OCT angiography provide detailed mapping of the choroidal neovascular membrane and are used when the diagnosis is uncertain or when the pattern of leakage needs to be characterised before commencing treatment. Fundus photography documents the extent of drusen and any areas of geographic atrophy.
Treatment for wet AMD — anti-VEGF injections
Intravitreal anti-VEGF injections are the standard of care for wet AMD and have transformed the prognosis of the condition since their introduction. By blocking vascular endothelial growth factor (VEGF), these agents suppress the growth and leakage of abnormal choroidal blood vessels. With regular treatment, many patients maintain or improve their vision; without treatment, wet AMD causes progressive and rapid vision loss.
Currently used anti-VEGF agents include aflibercept (Eylea), faricimab (Vabysmo), ranibizumab (Lucentis), and brolucizumab (Beovu). Each has a slightly different dosing schedule and mechanism of action; your specialist will advise on the most appropriate choice. Treatment typically begins with a loading phase of three monthly injections, followed by a monitoring and treat-as-needed phase adjusted based on OCT findings at each visit.
Anti-VEGF injections for wet AMD are performed at Northpark Private Hospital in Bundoora. Patients from Epping, Greensborough, Mill Park, South Morang, Diamond Creek, Eltham, and across the northern suburbs do not need to travel to the CBD or Eye and Ear Hospital for this treatment. A full overview of our macular degeneration service is available on our website.
Dry AMD — monitoring, supplements, and lifestyle
There is currently no approved treatment that reverses established dry AMD or geographic atrophy. Management focuses on slowing progression and monitoring for conversion to wet AMD, which requires prompt treatment.
The AREDS2 study demonstrated that a specific combination of antioxidant supplements — lutein, zeaxanthin, vitamin C, vitamin E, and zinc — reduces the risk of progression to advanced AMD by approximately 25 percent in patients with intermediate AMD. These supplements do not benefit patients with early-stage disease and are not a substitute for regular specialist review.
Stopping smoking, wearing UV-protective sunglasses outdoors, eating a diet rich in leafy green vegetables and oily fish, and managing blood pressure and cardiovascular risk factors all contribute to slowing AMD progression.
To arrange a macular assessment at Northern Eye Consultants, contact our rooms on (03) 9466 8822 or ask your GP or optometrist to refer via HealthLink EDI nthneyec.