What is Age-Related Macular Degeneration?
Age-related macular degeneration (AMD) is an ocular disease that affects central vision, which is the ability to see finer details. Over time, the condition can cause vision loss.
Macular degeneration results from damage to the macula, the part of the retina responsible for central vision. It helps send information from the eye’s optic nerve to the brain.
If your macula is damaged, your brain cannot comprehend or read the images that your eyes see. AMD is common among people over 50.1
There are two types of AMD:
- Dry AMD. Dry macular degeneration is the most common and accounts for about 80% of all AMD cases.
- Wet (neovascular) AMD. Wet macular degeneration is rare but much more severe.
Age-Related Macular Degeneration Symptoms
Age-related macular degeneration is a progressive disease. In other words, it worsens over time.2
The early stages of macular degeneration may present no symptoms. As a result, most people don’t realize they have it until it progresses.
However, as the disease progresses, you may notice a change in visual acuity. These changes will be more significant if the condition affects both eyes.
Symptoms of Dry Macular Degeneration
Dry macular degeneration is characterized by the gradual thinning of the macula and the formation of tiny yellow protein clumps (drusen).3 The presence of large drusen signifies more advanced macular degeneration.
Dry macular degeneration progresses more slowly and is less likely to result in significant vision loss or other problems. Changes in blood vessels are also less severe in dry macular degeneration.
Symptoms include:
- Retinal damage
- Blurry vision
- Difficulty recognizing faces
- Straight lines that now appear wavy or bent
- Blindspot near the central vision
- Change in color perception (rare)
- Light sensitivity
- Loss of central vision
- Vision loss
Symptoms of Wet Macular Degeneration
Wet macular degeneration occurs when abnormal and new blood vessels form beneath the retina.4 As a result, blood or other fluids may leak from these vessels and cause macular damage. In some cases, advanced dry AMD may become wet AMD.
Wet macular degeneration symptoms are similar to dry macular degeneration symptoms. People with wet AMD lose their central vision more quickly than those with dry AMD.
Other symptoms include:
- A dark spot in the central vision due to leaking vessels
- Hazy vision
- Rapidly worsening symptoms
- Vision loss
Stages of Macular Degeneration
You develop macular degeneration in three stages:
Early Stage
In the early stage of macular generation, the disease affects your macula but not your vision. You may not notice any changes in your sight right away. However, objects may look blurry or straight lines may appear wavy.
Intermediate Stage
During the intermediate stage of macular degeneration, you may experience reduced central vision. It can be difficult to see faces from far away, and colors may appear duller.
Late (Advanced) Stage
Loss of central vision occurs during late or advanced macular degeneration. You aren't able to drive, read, or recognize faces anymore. You may also experience severe visual hallucinations during this stage.
What Causes Macular Degeneration?
Generally, macular degeneration affects older people. Its exact cause is unknown.
Some eye experts believe macular degeneration has something to do with genetics. In this case, if someone in your family has macular degeneration, your risk might be higher.
Other age-related macular degeneration risk factors include:
- Smoking
- Cardiovascular diseases such as high blood pressure (hypertension)
- High cholesterol
- Obesity
- Skin tone (common among light-skinned people)
- Sex (females are at higher risk)5
- Light eye color
When to See a Medical Professional
AMD is not detectable during its early stage, so don’t wait for your vision to change. Schedule regular eye exams for early detection if you’re at risk for macular degeneration due to family history, age, or sex.
If you have age-related macular degeneration, observe your eyes daily and tell your doctor if you notice any vision changes.
How Is Macular Degeneration Diagnosed?
Here are some ways your doctor may diagnose macular degeneration:
Eye Exams
Age-related macular degeneration is detectable during a routine eye exam. Drusen, or little yellow patches under your retina, is one of the most common early indicators of AMD.
Amsler Grid
Your ophthalmologist may also ask you to look at an Amsler grid.7 This is a checkerboard-like pattern of straight lines.
You may notice that some of the straight lines are wavy or missing. These are signs of macular degeneration.
Optical Coherence Tomography (OCT)
Your ophthalmologist might also recommend optical coherence tomography (OCT). During an OCT exam, your eye doctor will use a particular machine to capture ultrasound images of the inside of your eye.
How is Macular Degeneration Treated?
Treatment for macular degeneration varies depending on its type and stage.
Dry Macular Degeneration Treatment
There’s no standard treatment for dry age-related macular degeneration. Available options aim to slow down its progression and prevent further vision loss. Your doctor will recommend a treatment based on the stage of the disease.
Currently, early-stage macular degeneration isn’t treatable. An eye doctor will likely observe the disease’s progression and counsel you on how to slow it down. You may benefit from eating healthy foods, quitting smoking, and regular exercise.
If you have intermediate macular degeneration, your doctor may recommend special dietary supplements, such as vitamins and minerals, to slow its progression. If one of your eyes is in late-stage AMD, these supplements can slow advancement in the opposite eye.
Wet Macular Degeneration Treatment
Your doctor will recommend the most suitable treatment for wet AMD based on available options. Treatment options include:
Anti-Vascular Endothelial Growth Factor (anti-VEGF)
Anti-VEGFs are injected into the eye to block the creation of abnormal blood vessels. Examples include:
- Aflibercept (Eylea)
- Bevacizumab (Avastin)
- Ranibizumab (Lucentis)
Laser Therapy
Laser therapy or laser surgery can reduce the symptoms of macular degeneration. This treatment uses high-energy laser beams to destroy abnormal blood vessels.
Photodynamic Laser Therapy (PDT)
PDT combines injections and laser treatment to reduce macular degeneration symptoms. The injection contains a photosensitizing drug, which is activated by the laser. It helps destroy abnormal blood vessels and slow down vision loss.
Low Vision Aids
Low vision aids are devices used to improve your eyesight. Examples include magnifiers and low-vision optical lenses. They can help you make the most of what remains of your vision.
Submacular Surgery and Retinal Translocation
These techniques have been evaluated in studies but are not standard treatments for AMD. Newer methods are under investigation.6
How to Prevent Macular Degeneration
Studies show that non-smokers and those who maintain a proper diet have a lower risk of developing AMD.8 You can also prevent macular degeneration by:
- Managing your other medical conditions, if applicable
- Taking supplements rich in vitamins, Omega-3, zinc, copper, lutein, and zeaxanthin
- Quitting smoking
- Exercising regularly
- Maintaining healthy cholesterol levels and blood pressure
- Eating healthy foods such as whole grains, fruits, leafy green vegetables, and fish
Age-Related Macular Degeneration Research and Outlook
If you’re diagnosed with macular degeneration, don’t lose all hope. The National Eye Institute has been researching age-related macular degeneration (AMD).
For instance, the NEI hopes they can use pharmacologic, stem cell-, and gene therapy-based strategies for macular degeneration treatment in the future. They hope their research will lead to a greater understanding of how the disease works and how it can be treated.
Summary
Age-related macular degeneration (AMD) is an eye disease that affects central vision (the ability to see finer details). It damages the macula, which is responsible for central vision.
There are two types of macular AMD: dry and wet. Dry AMD is more common and involves gradual macula thinning and the formation of tiny yellow protein clumps (drusen).
Wet AMD is rare and involves the formation of new, abnormal blood vessels beneath the retina. It is more severe than dry AMD.
Both conditions result in retinal damage, blurry vision, blind spot, light sensitivity, and central vision loss.
AMD is not symptomatic during its early stage. If you’re at risk for AMD, scheduling regular eye exams is essential for early detection. AMD treatments aim to slow its progression.
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