Macular Degeneration

What is Age-Related Macular Degeneration?

AMD is a disease of the retina. It is largely caused by damage to the macula, a small spot near the center of the retina, which can affect the patient’s ability to see fine details if damaged. In early, less advanced AMD, visual symptoms are generally mild and may or may not impact vision‑related activities. However, advanced stages of AMD can result in severe loss of sight in the central part of the vision. End‑Stage AMD is the most advanced form of the disease and the leading cause of irreversible loss of vision and legal blindness in individuals over the age of 65. This blind spot is different than the visual disturbances experienced with cataracts (clouding of the eye’s lens) and cannot be corrected with cataract surgery or eyeglasses.

Age-Related Macular Degeneration causes

AMD is a multifactorial degenerative disease involving the retinal pigment epithelium, Bruch membrane, choriocapillaris, photoreceptors, genetics, complement/inflammation, and, in wet AMD, abnormal neovascularization. Patients may experience blurriness, grey or distorted areas, and possibly a blind spot in the center of their vision. Macular degeneration does not cause total blindness because it doesn’t affect the peripheral vision. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent loss of vision.

Forms of Macular Degeneration

There are two forms of macular degeneration: dry (non‑neovascular) and wet (neovascular).

• Dry AMD is an early stage of the disease which can result from aging and thinning of macular tissue. Eye doctors often see pigment changes and yellow spots in the macula (called drusen). Gradual loss of best corrected central vision may occur with the dry form of AMD, but it is typically not as severe as the vision loss caused by wet AMD. However, early forms of dry AMD can eventually lead to late‑stage geographic atrophy, which may cause severe vision loss.
• Wet AMD (in about ten percent of individuals with AMD) is the more damaging form of the disease. In wet AMD, new blood vessel growth under the macula leads to leakage of fluid and blood, which causes permanent damage to the retina. Once the retina becomes damaged and dies off, this can lead to blind spots in the central vision.

Age-Related Macular Degeneration symptoms and risk factors

In the early stages of the disease process, the patient may not have any visual changes or symptoms of vision loss. The macula is the central most portion of the retina. It is the area of the retina that we use to see 20/20 vision. As the disease process progresses, some of the more common signs and symptoms of dry AMD include:

• Difficulty with night vision and with changing light conditions.
• Difficulty with reading and making out faces (specifically, changes in Amsler grid self‑evaluation and trouble with reading)
• Slow, painless loss of central vision, but in some cases, vision loss can be sudden.
• Shadowy areas in central vision or fuzzy/blurry/distorted vision.

Other risk factors may include:

• Age
• Genetics (family member/blood relative with AMD)
• Smoking
• Light Skin (Caucasians) and light eye color
• Uncontrolled blood pressure and cholesterol
• Obesity and inactivity

Age-related Macular Degeneration Treatment Options

At this time, there is no cure for end‑stage AMD and no way to reverse its effects. The type of treatment for the disease depends on what stage the degeneration is in (early dry form or advanced wet form).

Treatment for Dry Macular Degeneration

For appropriate patients with intermediate AMD or advanced AMD in one eye, AREDS/AREDS2 supplementation has established evidence of reducing progression to advanced AMD by about 25 percent.

Treatment for Wet Macular Degeneration

For the wet and more serious form of macular degeneration, treatments aimed at stopping abnormal blood vessel growth include FDA‑approved drugs that are administered by Retina Specialists. We are happy to refer you if the need arises.