Wet Macular Degeneration (Wet AMD):
Recognise It. Treat It. Protect Your Vision .
What Is Wet AMD?
Wet age-related macular degeneration (wet AMD) is an advanced form of AMD affecting the macula—the specialised central area of the retina responsible for detailed vision. Abnormal, fragile blood vessels can develop beneath the retina and leak fluid or blood. This can cause swelling, distortion and damage to the macula, leading to blurred or missing central vision. Without timely treatment, these changes can become permanent.
About the author:
This information has been written by Mr Praveen Kumar, Consultant Ophthalmologist and Medical Retinal Specialist who is the Lead Consultant for Macular Degeneration in NHS .
Why timely diagnosis matters
Wet AMD can progress relatively quickly. Leakage, bleeding and retinal damage may lead to distortion, blurred central vision or a permanent loss of visual function.
Importantly, delaying assessment or treatment can allow active disease to cause damage that may not be fully reversible. Treatment is therefore aimed not only at improving vision where possible, but also at controlling disease activity and preserving useful vision over the longer term. The Royal College of Ophthalmologists describes wet AMD as requiring urgent and ongoing treatment.Not every patient responds in exactly the same way, and treatment needs to be individualised. However, when active wet AMD is confirmed, timely anti-VEGF treatment is the established first-line approach for appropriate patients.
How is wet AMD diagnosed?
A comprehensive retinal assessment usually combines clinical examination with sophisticated imaging. Depending on the individual circumstances, this may include:
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Detailed visual acuity assessment
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Dilated retinal examination
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Fundus photography
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OCT (optical coherence tomography) to examine the structure of the retina and detect fluid or other signs of activity
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OCT-A (OCT angiography) to assess abnormal retinal and choroidal blood vessels
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Fundus autofluorescence imaging where appropriate
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Comparative analysis of current and previous scans
This combination of clinical examination and imaging enables the ophthalmologist to determine whether AMD is active, assess its extent and establish an appropriate treatment strategy.
Wet macular degeneration treatment
The principal treatment for active wet AMD is an intravitreal anti-VEGF injection.
VEGF—vascular endothelial growth factor—is one of the signals involved in the development and leakage of abnormal blood vessels. Anti-VEGF medicines reduce this activity, helping to control leakage and retinal swelling.
Treatment is delivered directly into the eye using a very fine needle following appropriate preparation and anaesthesia. The procedure is generally brief. Many patients require a series of injections and ongoing monitoring because wet AMD is a chronic condition that may reactivate
How often is wet macular degeneration injections given?
There is no single treatment schedule that is appropriate for every patient.
PRN — treatment when required
With a PRN (pro re nata) approach, the eye is reviewed regularly using vision testing and retinal imaging. An injection is given when there are clinical or imaging signs that the AMD is active.
This approach can reduce unnecessary injections, but it requires reliable attendance for monitoring because treatment decisions depend on detecting disease activity promptly. NICE describes PRN treatment as requiring routine monitoring appointments to determine whether treatment is needed
Treat-and-Extend
With a treat-and-extend approach, treatment is initially given at relatively short intervals. If the macula becomes stable, the interval between treatments can gradually be extended. If disease activity returns, the interval can be shortened again.
Current Royal College commissioning guidance recommends a treat-and-extend approach based on visual acuity and OCT, with treatment intervals individualised according to disease activity.
For many patients, this approach can provide a structured balance between maintaining disease control and reducing the frequency of visits and injections where clinically appropriate.
What happens if wet AMD is not treated?
Untreated active wet AMD can result in continuing leakage, haemorrhage and progressive damage to the macula. This may lead to increasingly blurred or distorted central vision and, in some cases, substantial and lasting visual impairment.
Treatment cannot always restore vision that has already been lost.
This is why early diagnosis, appropriate treatment and continued monitoring are so important.
What happens if I delay wet AMD injections:
With wet AMD, time matters. Active abnormal blood vessels can continue to leak fluid or bleed within the macula, causing damage to the delicate retinal tissue responsible for detailed central vision. Delaying anti-VEGF treatment may allow this damage to progress, with some vision loss becoming permanent. Prompt diagnosis and treatment are therefore crucial to control disease activity, protect the macula and give you the best opportunity to preserve your vision.
How Mr Praveen Kumar can help
Wet AMD can look very different from one patient to another. The decision is therefore not simply whether to treat, but how best to treat and monitor your individual condition.
Mr Praveen Kumar, Lead Consultant for Macular Degeneration, provides specialist assessment of patients with wet AMD, combining detailed clinical examination with high-resolution retinal imaging and longitudinal comparison of scans.
He will consider the activity and characteristics of your AMD, your visual function, previous treatment response and practical circumstances when discussing the available options.
Together, you can determine whether a PRN or treat-and-extend approach, a particular anti-VEGF strategy, or—where appropriate—another treatment pathway is most suitable.
The objective is straightforward: to control the disease, protect your remaining central vision and provide a treatment plan that is carefully tailored to you.
Specialist AMD Assessment and Monitoring
A diagnosis of Wet Age-related macular degeneration (AMD) does not necessarily mean your vision will deteriorate. However, regular specialist assessment is important because AMD can change gradually, sometimes before you notice any symptoms.
Specialist monitoring allows detailed examination of the macula and tracking of changes over time. This may include vision testing, Amsler grid assessment and retinal imaging such as OCT and, when appropriate, OCT angiography (OCTA). Follow-up can then be tailored to your individual retinal findings and risk factors.
You should also seek prompt assessment if you develop new distortion, waviness, blurred central vision, a dark or missing area, or any sudden change in vision.
Mr Praveen Kumar is Senior Consultant Ophthalmologist is Lead Consultant for AMD services in NHS, provides specialist assessment and monitoring of AMD, with a focus on detailed retinal evaluation and modern imaging. His approach can help provide a clear understanding of your condition, monitor changes over time and identify concerning developments promptly.
Early AMD deserves careful monitoring, not simply reassurance. Regular assessment with a macular specialist provides the surveillance needed to respond appropriately if your condition changes.
