A Complete Guide to Treating Macular Degeneration (Hong Kong Edition)

Macular degeneration (MD), also known as macular degeneration , occurs when the macula, the center of the retina, develops, leading to impaired central vision. The macula is the finest part of our visual field, responsible for precise visual functions such as reading, recognizing faces, and distinguishing colors. Once damaged, although peripheral vision remains, central vision may appear blurry, distorted, or dark.

In Hong Kong, macular degeneration (AMD) is a common sight-threatening condition for people aged 50 and above . According to the Hong Kong Society of Ophthalmology, AMD is one of the leading causes of blindness among seniors in Hong Kong. Age-related macular degeneration (AMD) is the most common form, which can be categorized into dry and wet forms.

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1. Types of macular degeneration

1. Dry AMD

   • Accounting for about 80-90% of cases
   • The macular cells gradually degenerate, accumulating "glassy dots" (Drusen), and vision slowly deteriorates.
   • Progresses slowly but may become wet

2. Wet AMD

   • Accounts for about 10-20% of cases, but can cause blindness quickly
   • Abnormal blood vessels growing under the retina (choroidal neovascularization) that leak blood or fluid and damage the macula
   • Vision may deteriorate significantly over weeks to months

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2. Causes and Risk Factors

• Age (risk increases significantly over 50 years)
• Family history
• Smoking (2- to 4-fold increased risk)
• High blood pressure and high cholesterol
• Long-term exposure to strong light or ultraviolet rays
• Unbalanced diet (lack of lutein and zeaxanthin)

💡Editor ’s Tip :
Hong Kong's population is rapidly aging, and urban residents have little outdoor activity and a diet high in oil and salt, leading to a trend of younger people developing macular degeneration.

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3. Treatment Goals

There is no cure for macular degeneration. Treatment goals are to:

• Slow down the progression of the disease
• Stabilize or improve partial vision
• Prevent dryness from turning into wetness

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4. Treatment of Dry Macular Degeneration

There is currently no drug that can reverse dry macular degeneration, but progression can be slowed through nutritional supplements and lifestyle adjustments .

1. Antioxidant nutritional supplement (AREDS2 formula)

• Research from the National Eye Institute (NEI) in the United States shows that a combination of lutein, zeaxanthin, vitamin C, vitamin E, zinc, and copper can reduce the risk of progression to mid- to late-stage AMD.
• It is widely available in pharmacies and ophthalmology clinics in Hong Kong. Common brands include Ocuvite and PreserVision.
• Suitable for patients with mid- to late-stage dry AMD (early effects are not obvious)

2. Lifestyle adjustments

• Quit smoking
• Eat a balanced diet, including more dark green vegetables and fish
• Wear UV-blocking sunglasses
• Control blood pressure and cholesterol

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5. Wet macular degeneration treatment

Wet AMD worsens rapidly and must be treated promptly, otherwise central vision may be lost within a short period of time.

1. Anti-vascular endothelial growth factor (Anti-VEGF) injection

• Inhibit abnormal blood vessel growth and reduce leakage
• Commonly used drugs:
  • Lucentis (ranibizumab)
  • Eylea (Aflibercept)
  • Avastin (Bevacizumab, a cancer drug but available off-label for AMD)
• Treatment:
  • Initially, the injection is given once a month, and the interval can be extended after a few months.
• Hong Kong Fees:
  • Public hospitals: must meet funding conditions, some hospitals have drug funding programs
  • Private hospitals: approximately HK$7,000-$15,000 per injection (depending on the medication)

2. Photodynamic therapy (PDT)

• Injecting a photosensitizer and then irradiating the abnormal blood vessels with a low-energy laser to block them
• For certain types of wet AMD
• It is available in private eye centers in Hong Kong, and costs approximately HK$15,000-$25,000 per visit.

3. Laser Photocoagulation

• High-intensity laser ablation of abnormal blood vessels
• Suitable for patients with peripheral blood vessels (which can easily affect vision and are now rarely used)

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6. Comparison of Medical Resources and Costs in Hong Kong

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7. Vision Rehabilitation and Assistive Tools

• Magnifying glass, high-definition reading light
• Large font electronic devices
• Vision rehabilitation training (provided by the Hong Kong Blind Union and other organizations)

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8. Daily Self-Test

• Amsler Grid : Observe the grid daily with one eye to check for distorted or missing lines.
• If you find anything abnormal, seek medical attention immediately

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💬Let me tell you :
Many patients with wet macular degeneration in Hong Kong delay treatment because they initially perceive a slight visual distortion, mistaking it for presbyopia or a change in glasses. However, macular degeneration is a time-sensitive disease , and the earlier treatment is received, the greater the chance of preserving vision. Annual fundus examinations are recommended, especially for those with a family history of the disease or for older smokers.

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⚠️ Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.

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