Macular Degeneration: What You Need to Know

How does AMD happen?

As we age, the cells that support the macula become less efficient at clearing waste and coping with everyday cellular stress.

In eyes with AMD, small yellow deposits called drusen can build up beneath the retina. Over time, these changes may damage the supporting retinal cells and the light-sensitive cells responsible for central vision.

AMD develops gradually through a combination of ageing, genetics, and lifestyle factors like diet, exercise and smoking. It is a disease, not a normal part of ageing.

1. Have regular eye examinations

Your eye care professional may monitor your macula with a dilated retinal examination, retinal photography, optical coherence tomography (OCT) scans and visual acuity testing. OCT provides a detailed cross-sectional view of the retina and can detect very small changes over time.

2. Eat well and stay active

A healthy diet rich in green leafy vegetables, colourful fruit and vegetables, fish, nuts and whole foods is recommended. Regular physical activity may also help reduce the risk of AMD progression.

Avoid smoking: smoking is one of the most important modifiable risk factors for AMD.

3. AREDS2 supplements

For people with intermediate AMD, or advanced AMD in one eye, an Age-Related Eye Disease Study 2 (AREDS2) supplement may help reduce the risk of further progression. These supplements do not reverse existing damage or improve vision, and they are not recommended for people with no AMD or only very early changes. Ask us whether AREDS2 supplements are suitable for you.

A personalised approach

Our approach is personalised according to:

• Your stage of AMD
• OCT and retinal findings
• Your vision and symptoms
• Risk factors for progression
• Other eye conditions

Photobiomodulation therapy (PBM) — supporting retinal cells with light

PBM uses low-level light in selected wavelengths. It is thought to support mitochondrial function, helping retinal cells manage energy production, oxidative stress and inflammation better. A light-emitting facial mask is positioned over the eyes. Treatment is non-invasive and painless, taking 12 minutes per session, with no downtime afterwards.

Subthreshold laser — stimulating the retinal pigment epithelium

Subthreshold laser uses precisely controlled, low-energy laser pulses to stimulate the retinal pigment epithelium (RPE) without creating a visible burn, aiming to support retinal function. It is an in-clinic procedure, with same-day treatment available for suitable patients. Treatment takes 5–10 minutes per eye. Dilated pupils may cause blurred vision and light sensitivity for several hours, so you cannot drive immediately afterward.

Microcurrent therapy — gentle electrical stimulation

Microcurrent therapy uses very low-level electrical stimulation around the closed eyes to support retinal cell activity and energy production. Small electrodes are positioned around the closed eyes while controlled microcurrent is delivered for 32 minutes, with no downtime afterwards.

PBM

• Evidence: randomised sham-controlled clinical studies have reported improvements in visual function and retinal outcomes.
• Treatment plan: initial course of 8 sessions over 4 weeks; maintenance of 6 sessions over 3 weeks, every 4–6 months.
• Cost: $2,800 for the initial course; $2,100 for a maintenance course.

Subthreshold laser

• Evidence: early non-controlled studies report improvements in some measures of retinal function and slowing of progression.
• Treatment plan: initial course of 1 session; maintenance of 1 session every 6 months.
• Cost: $1,186 for one eye; $1,907 for both eyes.

Microcurrent therapy

• Evidence: a randomised sham-controlled study in Canada reported improvements in visual acuity and contrast sensitivity.
• Treatment plan: initial course of 4 sessions over 10 days; maintenance of 1 session every 3 months.
• Cost: $3,500 for the initial course; $875 per maintenance session.

About pricing

All prices are GST inclusive. Consultation and diagnostic testing fees are charged separately.

How do anti-VEGF injections work?

Vascular endothelial growth factor (VEGF) is a natural protein that promotes blood vessel growth. In wet AMD, excessive VEGF drives the growth of fragile, leaky blood vessels. Anti-VEGF medicines block this signal, helping to reduce leakage and control abnormal vessel growth.

What does treatment involve?

Treatment is performed in the clinic using sterile technique. Anaesthetic drops are used to numb the eye, and a very small amount of medication is injected into the vitreous jelly inside the eye. The injection itself takes only a few moments and is usually well tolerated.

Will I need more than one injection?

Usually, yes. Wet AMD is often a long-term condition requiring life-long regular monitoring and repeated injections. OCT scans are used to assess and guide the timing of future treatment. Injection intervals may be extended if the macula remains stable.

What can treatment achieve?

Anti-VEGF treatment can often stabilise vision and prevent permanent central vision loss. Many patients will experience an initial improvement in vision. Early diagnosis and prompt treatment give the best chance of preserving central vision.

Changing the narrative on dry AMD

For many years, dry AMD lacked treatment options beyond monitoring. Today, newer therapies such as photobiomodulation (PBM) allow us to take a more proactive approach in selected patients. Our clinical experience, as the first in NZ to offer PBM, has been encouraging. Our PBM data shows 60% of eyes gain 1 line or more on eye chart tests.

Lightening your load

AMD requires life-long care. Where appropriate, I use longer-acting medicines and targeted laser therapies to safely extend treatment intervals, so you can spend less time in the clinic and more time getting on with life.

Managing dry and wet AMD together

Dry and wet AMD can occur in the same eye. Anti-VEGF injections can control leakage from wet AMD, but for many patients, underlying dry AMD may still limit vision. For this reason, we assess and manage the whole macula, addressing both wet and dry components to give you the best opportunity to improve retinal function and vision.

My philosophy

“Here, at The Eye Clinic, we combine advanced diagnostics and specialist treatments with care tailored to you. My aim is to control disease effectively while avoiding unnecessary treatment and reducing the burden of frequent clinic visits.”

Let’s talk. I’m committed to delivering the best possible advanced specialist care. My team and I will always do our best and we will look after you every step of the way. — Dr James Leong, Ophthalmologist & Retinal Specialist

Using the Amsler grid (page 9 of the booklet)

• Hold the page at your normal reading distance (about 30–33 cm). Wear your reading glasses if needed.
• Cover one eye at a time and look directly at the centre dot.
• Check whether the lines look straight and complete.

When to seek help

If you notice a sudden change in central vision, new distortion, a dark or blank patch, or a rapid drop in vision, contact us promptly.

Need extra support?

• Macular Degeneration New Zealand — AMD information, education and patient support. 0800 622 852 · mdnz.org.nz
• Blind Low Vision NZ — low-vision aids, adaptive technology and practical support. 0800 24 33 33 · blindlowvision.org.nz