Eye SchoolUrgent

This site provides general eye-health education. It cannot replace individual assessment by a registered doctor, and does not offer personal diagnosis, prescriptions, bookings, sales or referrals.

If translations differ or are incomplete, the Traditional Chinese (zh-Hant) text on this site prevails.

Retina and macula · 05

Age-related macular degeneration

Bent lines or a central dark patch: same-day ophthalmic assessment

Last reviewed: 2026-10-03 · 潘家健醫生

Key points

  • Age-related macular degeneration affects central vision; dry and wet forms are distinguished after examination.
  • An Amsler grid can help self-monitor; a normal screen result does not rule out disease.
  • New distortion or a central dark patch: same-day dilated fundus exam when possible.
  • Sudden blindness or a clear curtain: go to A&E now.

What it is

The macula serves fine central vision. Dry AMD is more common (drusen, geographic atrophy). Wet AMD is driven by choroidal neovascular leakage and can steal vision quickly. Polypoidal choroidal vasculopathy (PCV) is not rare among Chinese patients with wet disease. Wet macular neovascularisation / leakage involves several signals: vascular endothelial growth factor A (VEGF-A) drives endothelial proliferation, new vessels and higher permeability and is one main clinical anti-VEGF target; angiopoietin-2 (Ang-2) can weaken vessel stability via Tie-2 and make vessels more VEGF-sensitive (literature reviews; dual-pathway drug labelling also describes this mechanism, but the independent contribution of Ang-2 inhibition to clinical efficacy is still being established). Related family factors such as PlGF and PDGF are also discussed in vessel maturation and fibrosis-related processes — no single molecule explains every patient. Whether to inject, and which registered class, is decided only by an ophthalmologist against the indication; this page does not compare products.

Symptoms

  • Straight lines look bent (metamorphopsia), a central dark patch, washed-out colour
  • Trouble recognising faces, reading, or traffic lights

Care a doctor may discuss

  • Stop smoking; blood pressure and lipids. AREDS2-type nutrient formulas are mainly discussed for people who already have intermediate AMD — not as prevention for every healthy eye, and not a substitute for stopping smoking. Whether to use them is a doctor’s decision, not an advert.
  • Amsler grid for self-checks. New distortion, a central dark patch or a sudden vision drop: dilated fundus exam the same day if possible. Sudden blindness or a clear curtain: go to A&E now.
  • Wet AMD: an ophthalmologist may consider intravitreal anti-VEGF injections according to Hong Kong-registered indications. Recovery of lost vision is not guaranteed.
  • Injection number and interval vary; OCT follow-up is usual.
  • PCV is more common in Chinese wet disease; education figures on dosing strategy are on the intravitreal anti-VEGF topic — not a product comparison.
  • The order of the day, and which symptoms afterwards mean A&E, are on The day of an intravitreal anti-VEGF injection.

Nutrition reference: AREDS2 Research Group, JAMA 2013. No product names on this page.

Related public education video (HKOS)

Video thumbnail: 長者視力下降切勿當正常 | 濕性、乾性黃斑病變治療大不同長者視力下降切勿當正常 | 濕性、乾性黃斑病變治療大不同Open on YouTube (external link)

Video source: Hong Kong Ophthalmological Society (HKOS) “Eyes Decoded” YouTube (public education)

This site is not affiliated with, and is not the same organisation as, the Hong Kong Ophthalmological Society (HKOS).

Selected public references (not a full bibliography)

These are the public studies this page draws on. PMID links go to PubMed (US National Library of Medicine) so you can check them. Figures are from those studies — not your prognosis and not a clinic success rate. Links are not a shop.

  1. Age-Related Eye Disease Study 2 Research Group Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the AREDS2 randomized clinical trial. JAMA. 2013;309(19):2005-2015. PMID 23644932主要討論已有中等度年齡相關性黃斑改變的人。不是人人預防配方，本頁不列商品名。
  2. CATT Research Group, Martin DF, Maguire MG, et al. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011;364(20):1897-1908. PMID 21526923比較兩種抗血管內皮生長因子注射的大型試驗（bevacizumab 僅作試驗對照，不是本港選藥表）。本頁不列商品名、不保證視力。
  3. Dervenis N, Dervenis P, Agorogiannis E Neovascular age-related macular degeneration: disease pathogenesis and current state of molecular biomarkers predicting treatment response—a scoping review. BMJ Open Ophthalmol. 2024;9(1):e001516. https://doi.org/10.1136/bmjophth-2023-001516. PMID 38341189濕性 AMD 發病機制與生物標誌綜述。多路徑訊號屬教育；不作雙路徑藥物優劣比較。
  4. U.S. Food and Drug Administration Faricimab-svoa injection — Prescribing Information (label). https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/761235s000lbl.pdf. 美國 FDA 公開標籤描述 VEGF-A 與 Ang-2 機制。不作商品比較、療效保證或本港適應症推介；本地註冊以香港為準。

This is general medical information, not a diagnosis, and cannot replace an in-person consultation with a registered ophthalmologist, refraction, or a dilated fundus exam. It is not advice to use any medicine or undergo any procedure. Medicines (including off-label use), laser or surgery must be decided by a registered doctor after examination, according to indications and Hong Kong registration. Figures from the literature are published averages, not any clinic’s results. This site does not book, prescribe or refer. Do not change treatment on your own.