What is age-related macular degeneration?
Age-related macular degeneration (AMD) is a disease that can lead to progressive vision loss and blindness. It causes a deterioration of the macula, which is at the center of the retina. It’s the part of the eye responsible for capturing light and allowing us to see.
There are two forms of AMD: Dry AMD is much more common. Wet AMD is more damaging.
Treatments can slow the progression of the disease, but AMD is still the leading cause of blindness for those over 50 years old.
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Most common symptoms
The vast majority who have the disease are over 70 years old. They may describe a blind spot or wavy vision in one or both eyes. They would describe a gradual decline in vision but can have an acute worsening if they converted to the “wet” form of AMD. There is no pain or other symptoms. —Dr. Daniel Choi
There may be no early signs of AMD. As it progresses, you will experience a gradual loss of central vision, which often begins with a waviness or blurred vision in the center part of your vision.
- Vision loss in the central part of your vision
- Blurred vision or waviness in the center part of your vision
- Difficulty seeing at night
- Difficulty reading
These symptoms are more common in wet AMD.
- Dark spots in your vision, called scotoma
- Straight lines that appear distorted or curved (called metamorphopsia)
The most common risk factors for AMD are tobacco use, family history, European ancestry (lighter skin complexion), obesity, cardiovascular disease, poor diet, and excessive sun exposure.
AMD is not an urgent or life-threatening condition. But it should be evaluated and treated promptly by an optometrist (vision doctor) or an ophthalmologist (a medical doctor who treats eye conditions). Ideally, you should see someone who specializes in retinas.
What causes age-related macular degeneration?
The retina is the "film" in the back of the eye that senses light to produce vision. At the center of the retina is the macula, the part of the retina that becomes progressively damaged. The macula is damaged in two ways:
- Dry AMD: Abnormal deposits (called drusen) gradually develop in the retina. It affects the macula by making it drier and thinner. Eventually, the macula dies off and loses its function. How bad your vision becomes depends on how thin the macula gets. Over time, dry AMD can develop into wet AMD.
- Wet AMD: New, abnormal blood vessels grow into the retina, causing bleeding, leakage, and severe vision loss. (The “dry" in dry AMD refers to the fact that there is no leakage from blood vessels.). The blood vessel growth is stimulated by vascular endothelial growth factor (VEGF).
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Can age-related macular degeneration be cured?
Macular degeneration is the most common cause of blindness in older patients in the United States. You are not alone. And there is continuing research to improve treatments as more and more targeted treatments are being developed. —Dr. Choi
AMD cannot be completely cured, though treatments can slow the progression of the disease and sometimes stabilize it or reverse vision loss. Treatment for AMD is different depending on whether it is dry form or wet form. Quitting smoking and maintaining a healthy diet help both types.
Dry AMD Treatments
- There are specific antioxidants that reduce the risk of progressing from dry AMD to wet AMD. The combinations of antioxidants are known as "AREDS" and "AREDS2." These contain a combination of vitamin C, vitamin E, and zinc, as well as either beta-carotene or lutein and zeaxanthin.
Wet AMD Treatments
- The antioxidant combinations AREDS and AREDS2 are also helpful for wet AMD.
- You will likely be given injections into the retina with medications called VEGF-inhibitors. These target VEGF to decrease the growth of abnormal blood vessels.
- Another option is laser therapy. It damages the abnormal blood vessels to stop them from leaking. Though temporarily helpful, new blood vessels return.
Follow-up should be determined by your eye care professional. If you have wet AMD, you’ll need to see a retina specialist regularly throughout the year for evaluation and treatment.
Reducing the risk factors at a younger age can help prevent age-related macular degeneration as you get older.
- Do not smoke, vape, or chew tobacco
- Protect your eyes from sun exposure
- Eat a diet high in dark green leafy vegetables
- Reduce risks for cardiovascular disease by maintaining a healthy weight, exercising, and eating a diet high in fruits, vegetables, and whole grains.