Age-related macular degeneration (AMD) affects nearly 500,000 people in Hong Kong, with about 10% experiencing the more severe form that can lead to rapid vision loss . As one of the leading causes of central vision impairment in older adults, AMD is becoming increasingly common as the city's population continues to age. WhileAMD doesn’t lead to complete blindness, it can significantly impact quality of life if not managed early.

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What Is Age-Related Macular Degeneration?

Age-related macular degeneration (AMD) is an eye condition that causes damage to the macula, the central part of the retina responsible for sharp, detailed vision and most of our color vision. The retina is the light-sensitive tissue at the back of the eye that records images and transmits them to the brain via the optic nerve.

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AMD primarily affects the central vision, making it harder to read, drive, or recognize faces. Peripheral vision usually remains unaffected, so patients will rarely go completely blind from AMD. As the macula deteriorates, fine visual details become increasingly blurry. In advanced stages, patients may lose the ability to see and distinguish faces clearly, read small print, or navigate safely in low-light conditions. As the symptoms of AMD are not noticeable in the early stages, regular eye exams are crucial for detecting changes early and managing progression.

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Wet vs. Dry Macular Degeneration

There are two main types of macular degeneration: dry and wet, which are distinguished mainly by the different causes.

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Dry Macular Degeneration

Dry AMD, also called atrophic macular degeneration, is the most common form, affecting about 80% of AMD patients . Although its exact cause is unknown, genetic and environmental factors are thought to play a role. With age, the macula begins to thin and deteriorate, leading to a gradual and slow loss of vision. At present, there is no definitive cure or treatment for late-stage dry AMD.

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Dry AMD progresses through three stages:

1.Early stage: No symptoms, small yellow deposits (drusen) may be found during an eye exam

2.Intermediate stage: Some blurring, or difficulty seeing in light

3.Late stage: Noticeable central vision loss that may affect daily life

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Wet Macular Degeneration

Wet AMD is less common but more severe, accounting for about 10–20% of AMD cases . It causes rapid vision loss and is often considered the advanced stage of AMD. In wet AMD, abnormal blood vessels grow under the retina, leaking fluid or blood that damages the macula and distorts central vision.

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Dry AMD can progress into wet AMD, but wet AMD is typically considered a late-stage condition.

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Macular Degeneration Symptoms

The symptoms of macular degeneration differ depending on the type and stage of the disease. In the early stages of dry AMD, most individuals remain asymptomatic, and the condition is often detected only during routine eye examinations.

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As the disease progresses to the intermediate stage, some patients may begin to notice subtle changes, such as slight blurriness in their central vision or difficulty adapting to low-light environments, for example, when entering a dim room or driving at night.

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In late wet or dry stage AMD, symptoms are more pronounced and disruptive to the patient’s daily life. At this stage, patients may experience visual distortion, where straight lines appear warped, bent, or wavy. Patients may also experience a central dark or blurry spot within their vision, making it difficult to see objects in front of them.

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Who Is at Risk for Age-Related Macular Degeneration?

The likelihood of developing AMD increases with a combination of age, genetics, and lifestyle choices. Individuals over the age of 50 are at a notably higher risk, with the prevalence rising steadily in older age groups. A family history of AMD further amplifies this risk, as genetic predisposition plays a significant role in the disease’s onset.

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Smoking is a critical risk factor, where research shows that smokers are up to twice as likely to develop AMD compared to non-smokers . This is mainly because cigarette smoke reduces oxygen delivery to the retina, damages retinal blood vessels, and increases oxidative stress, all of which contribute to the progressive breakdown of macular cells. Those with uncontrolled high blood pressure or cardiovascular conditions may be more susceptible, as compromised blood flow can negatively impact retinal health. Diet also plays a part in AMD, where individuals who consume foods high in saturated fats and low in antioxidants may be at increased risk due to long-term oxidative damage to retinal cells.

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How is Age-Related Macular Degeneration Treated?

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Treatments for Early Stage AMD - Exercise and Diet

In the early stages of AMD, particularly when the disease is still asymptomatic, there are no approved medical treatments. Lifestyle modifications play a critical role at this stage. Stopping smoking, engaging in regular exercise, and a diet rich in leafy greens, fruits, and omega-3 fatty acids can help protect the retina from oxidative stress. Individuals diagnosed with early AMD should undergo annual dilated eye examinations to detect any changes in the retina and address them promptly.

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Treatments for Intermediate Stage AMD - AREDS 2 Vitamins

In intermediate AMD, particularly the dry form, clinical studies have shown that a specific formulation of eye vitamins, known as AREDS 2 (Age-Related Eye Disease Study 2) , may slow the progression of the disease. These supplements typically include antioxidants such

as vitamins C and E, zinc, copper, lutein, and zeaxanthin. They do not reverse vision loss but may reduce the risk of developing advanced AMD in high-risk individuals.

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Treatments for Late-Stage AMD - Anti-VEGF

For patients with late-stage AMD, particularly the wet type, medical treatment becomes more targeted. The primary treatment for wet AMD is anti-VEGF (vascular endothelial growth factor) therapy. These medications are injected directly into the eye and work by inhibiting the growth of abnormal blood vessels beneath the retina that cause leakage and scarring. When administered promptly and at regular intervals, anti-VEGF injections can stabilize and in some cases improve vision.

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AMD Isn’t the End - Preserve Your Sight with Proactive Care

Age-related macular degeneration is a leading cause of central vision loss in Hong Kong’s ageing population, but with early detection and proper management, its progression can often be slowed. While there is no definitive cure, lifestyle changes, nutritional support, and timely treatment can help preserve functional vision. As symptoms usually go unnoticed in the early stages, regular eye exams are essential. If you’re over 50 or have risk factors such as a family history, smoking, or high blood pressure, taking proactive steps now can make a meaningful difference to your long-term eye health.

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Source

1.Chinese University Medicine. (N.D). Pao So Kok Macular Disease Treatment and Research Centre. Retrieved from https://www.ovs.cuhk.edu.hk/en/research/psk/#1527651831539-3335b82b-3a96

2.Hong Kong Laser Eye Centre. (N.D). Macular Disease. Retrieved from https://www.hklasereye.com/en/treatments/macular-disease

3.NHS. (2025). What is AMD?. Retrieved from https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/

4.John Hopkins Medicine. (N.D). Age-Related Macular Degeneration (AMD). Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/agerelated-macular-degeneration-amd

5.National Eye Institute. (2021). Age-Related Macular Degeneration (AMD). Retrieved from

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration

6.British Journal of Ophthalmology. (2005). 28,000 Cases of age-related macular degeneration causing visual loss in people aged 75 years and above in the United Kingdom may be attributable to smoking. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC1772624/

7.National Eye Institute. (2021). AREDS 2 Supplements for Age-Related Macular Degeneration (AMD). Retrieved from https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration/nutritional-supplements-age-related-macular-degeneration