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Macular Degeneration

Age-Related Macular Degeneration (AMD)

Macular degeneration, also called age-related macular degeneration (AMD), is a condition that occurs when the macula — the small central portion of your retina, wears down.

Overview

What is macular degeneration (AMD)?

Macular degeneration is the leading cause of vision loss, affecting more than 10 million Americans—more than cataracts and glaucoma combined. Although macular degeneration doesn’t usually cause full blindness, it can make it nearly impossible to read, recognize faces, drive, watch television, or perform other detailed visual tasks. With AMD, the health of the peripheral (side) vision remains unaffected.

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What are the different types of macular degeneration?

There are two different types of macular degeneration—dry (or non-exudative) AMD and wet (or exudative) AMD.

Dry (Non-Exudative) AMD

    Dry AMD is the most common form, affecting roughly 80–90% of people diagnosed.

  • Dry AMD occurs when a buildup of proteins (tiny yellow spots called drusen) occurs in the macula. As the condition worsens, the light-sensitive cells in the macula begin to get thinner, and eventually, the cells die. In most cases of dry AMD, people notice a gradual, painless loss of vision that progresses with time. Dry AMD can progress into wet AMD if left untreated.

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Wet (Exudative) AMD

    Wet AMD is rarer but more serious, affecting roughly 10–20% of people with AMD.

  • Wet AMD causes vision loss due to abnormal blood vessel growth, ultimately leading to blood and protein leakage, causing scarring of the macula. Vision loss from wet AMD is often faster than with dry AMD.

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When to call the doctor

Early signs of vision loss from AMD include shadowy areas in your central vision or unusually fuzzy or distorted vision. Some patients may notice wavy or warped words when reading. If you experience these or any other changes in your vision, make an appointment with your provider. Yearly comprehensive eye examinations are also recommended as preventative care, especially for those 65 and older.

Causes

What causes macular degeneration (AMD)?

Though macular degeneration is most commonly associated with aging, research suggests that genetics can also play a role. While the exact cause of AMD is not known, it has been linked to a number of risk factors, including:

Aging

While approximately 10% of patients age 66 to 74 will have experienced AMD, the prevalence increases to 30% for patients 75 to 85 years of age.

Family History

AMD is a highly heritable condition. If you have a family history of AMD, you are at an increased risk for developing it yourself.

Smoking

Smokers are up to 4x more likely than non-smokers to develop AMD.

High Blood Pressure

High blood pressure restricts the amount of oxygen getting to your eyes, which can raise your odds of developing AMD.

Cardiovascular Disease

If you've had a stroke, angina, or a heart attack, your risk for AMD may be 1.5 times as high as someone without cardiovascular problems.

Obesity

Abdominal obesity is a risk factor, especially among men.

Symptoms

What are the symptoms of macular degeneration (AMD)?

Early signs of vision loss caused by AMD can include worse or less clear vision, dark and blurry areas in the center of your vision, and different color perception.

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Other symptoms of macular degeneration include:

  • A reduction in central vision
  • The need for brighter lighting/difficulty adapting to low lights
  • Blurriness
  • Trouble recognizing faces
  • Straight lines starting to appear wavy, blurry or missing
  • Fading and/or changes in the appearance of colors

Diagnosis

How is macular degeneration (AMD) diagnosed?

In most cases, macular degeneration can be diagnosed following an eye exam. One of the most common early signs is the appearance of drusen, tiny yellow spots under your retina, that your doctor can see when they examine your eyes. You may also be asked to look at an Amsler grid, which helps you to notice any blurry, distorted, or blind spots in your field of vision.

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A doctor setting up eye exam equipment in front of a patient.

Treatment & Prevention

How is macular degeneration (AMD) treated?

Currently, there is no known cure for macular degeneration, but there are things you can do to reduce your risk and slow the progression once you’ve been diagnosed. The treatment approach your doctor takes depends on whether the AMD is dry or wet.

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Some options are:

Vitamins (Dry AMD)

For patients with early to intermediate dry AMD, a regimen of antioxidant vitamins(called the AREDS2 formula) has been found to help reduce vision loss. For patients with late stage AMD there is no treatment although there are some promising clinical trials.

Anti-Angiogenesis Drugs (Wet AMD)

Anti-angiogenesis medications block the creation of new leaky blood vessels in your eye that cause wet AMD. Patients who have been treated with these eye injections regained some vision that was lost, but this treatment may need to continue to be performed over time to work.

Laser Therapy (Wet AMD)

While most wet AMD patients are treated with anti-angiogenesis injections, laser therapy may still be used for certain patients. Laser light can be used to destroy abnormal blood vessels that may be growing in your eye. Photodynamic laser therapy is another laser option in which a doctor first injects a light-sensitive drug into your bloodstream, then shines a laser into the eye to trigger the medication to damage those blood vessels that absorbed the drug.

Low Vision Aids

There are also devices like magnifying tools, large print newspapers and books, high-intensity lamps, handheld computers, and more, that aid in helping people make the most of their remaining vision.

How can macular degeneration (AMD) be prevented?

Since some of the risk factors like obesity and smoking can be controlled, it’s important to exercise regularly and not to smoke. Regular eye exams are also an excellent tool in combating macular degeneration, since doctors can often diagnose AMD before the onset of symptoms. As always, be sure to contact your doctor if you experience any vision changes.

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Think you may have macular degeneration?