Dr. Jennifer Lim highlights important patient education and communication during AMD awareness month
Jennifer Lim, MD, of the University of Illinois, talks about the importance of recognizing Age-Related Macular Degeneration (AMD) Awareness Month in February and how ophthalmologists can speak to and educate their patients.
Question:
How can ophthalmologists contribute to the education and conversation around AMD and general eye health?
Jennifer Lim, MD:
Many patients see an ophthalmologist concerned about cataracts or just for glasses, and it’s really important to educate them about other diseases that can of course affect the eye and result in visual loss if not diagnosed and treated promptly. One of these diseases is age-related macular degeneration. Now, AMD affects patients of course over the age of 50 to 55 predominantly, and as the name suggests, it increases with increasing age. For those particular patients, it’s very important that the ophthalmologist bring up the topic of age-related macular degeneration.
Moreover, it’s very important that the ophthalmologist inform the patient of the importance of early diagnosis because early diagnosis can lead to preventive therapies such as the age-related eye disease vitamins for patients, or if they have early geographic atrophy recommendation of early geographic atrophy medications. Or of course, if they have neovascular or wet macular degeneration, they can get prompt treatment. We know from research studies that earlier treatment is associated with better outcomes for age-related macular degeneration. It’s also important when talking to younger patients to perhaps inform them about AMD as well because they have older parents or relatives that can also benefit from this information. In general, I think an ophthalmologist when they talk to their patients can really help raise the awareness of age-related macular degeneration and get patients to comply with screening and get them in for early treatment and management.
Question:
What are some risks associated with the development of AMD and how do you recommend educating patients about any risk modifications? How important is early diagnosis and treatment
Jennifer Lim, MD:
Age-related macular degeneration, as you know, is divided into the non-neovascular, or dry form, and the neovascular, or wet form. By that we mean the development of abnormal blood vessels underneath the retina where they shouldn’t be. When we first take the non-neovascular or the dry form of age-related macular degeneration, we have great research data that shows us that progression of the macular degeneration can be slowed down by the use of the age-related eye disease vitamins. Essentially the progression of the dry macular degeneration to the wet or to the most severe form of dry known as geographic atrophy can be slowed down by the use of the age-related eye disease vitamins. This was shown in the AREDS-I as well as the AREDS-II studies. More recently, we’ve also found the progression is slowed down by the use of the Mediterranean diet and the AREDS vitamins essentially almost the same as the use of the medications that are in use for the most severe form of dry macular degeneration.
Of course, that’s looking at specific groups of patients and comparing those numbers. However, it’s really important that patients understand that they can have a really big role in slowing down their disease simply by taking their vitamins and by eating a Mediterranean or heart-healthy diet. Fish, fruits, legumes, lower red meat, lower baked goods, and of course, exercise is important. Moreover, we’ve also known that a lot of research has shown us that smoking, even secondhand smoke, is associated with progression of age-related macular degeneration. Again, this is a huge public health problem with smoking as it causes other diseases such as cardiovascular diseases and is linked with stroke as well. This also helps patients in general with their lifestyle changes and modifications. Another one that’s really easy is to wear sunglasses because that can cut down on sunlight exposure that can not only lead to oxidative stress in the retina, but can also be associated with progression of cataracts. That’s a win-win preventive treatment there as well.
Now, when we talk about wet macular degeneration, we know that that also is associated with the above mentioned factors, poor diet, sun exposure, smoking, and so those same preventive measures are helpful for that as well. Moreover, the AREDS-II vitamins also slows down the rate of progression to the wet macular degeneration. It’s really important to do that. Now, once a patient has that, it’s very important to let them know that in 2025, we have great treatments available for them, and in fact, we can actually regain vision and improve vision by as much on average, maybe 3 lines, sometimes more, sometimes less, but of course it depends where you start. If you start closer to 20/20, you’re more likely to end up closer to 20/20. If you start out with really poor vision because your disease is late, we may not be able to help you if you’re already scarred down. Again, early diagnosis and early treatment is really of major importance.
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