Age-related Macular Degeneration

What is Age-related Macular Degeneration?

Age-related macular degeneration (AMD) is a retinal disease that causes vision loss in patients as young as age 50 but most commonly over 65 years of age. AMD is primarily caused by damage to a spot in the retina called the macula. This spot is important for visual acuity because it has plenty of visual receptors.

Because AMD damages this visually sensitive part of the eye, patients experience progressive loss of sight in the central area of the visual field and may advance to irreversible vision loss and blindness if not treated quickly.

Causes of Age-related Macular Degeneration

The main cause of AMD is degeneration of the retinal arteries. As the body ages, these arteries harden and reduce the proportion of nutrients and oxygen delivered to the retinal cells, causing the cells to ultimately become weak and die.

Risk factors for Age-Related Macular Degeneration include:

  • Genetic predisposition
  • Fair skin and light eye color
  • Smoking
  • Excessive sunlight exposure
  • Older age
  • Inadequate diet
  • Obesity and sedentary lifestyle
  • Uncontrolled hypertension and blood cholesterol levels
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Forms of Macular Degeneration

There are two types of AMD:

1). Dry AMD  
2). Wet/neovascular AMD
Dry AMD is more common, and wet AMD also called neovascular AMD is less common but causes more severe visual impairments.

Dry AMD develops in an earlier stage of the disease. During this stage, the macula thins and your eye doctor may note pigment changes during an eye examination due to the accumulation of waste material. Dry AMD is associated with mild or moderate visual impairment, but may ultimately lead to atrophy of the tissue, which causes severe vision loss.

Dry AMD progresses into wet AMD in 10% of patients. In this phase of the disease, new blood vessels are formed under the macula tissue as a form of abnormal growth. Fluid and blood begin leaking into the tissue, causing irreversible damage to the retina and loss of central vision.

Symptoms of Age-related Macular Degeneration

Early in the initial phase of dry AMD, you might not experience significant visual changes, but as the disease progresses, the following signs and symptoms may occur at any point:

  • Reduced night vision
  • Difficulty seeing under changing light conditions
  • Increasing difficulty reading
  • Increasing difficulty distinguishing faces and facial expressions
  • Blurry, fuzzy, or distorted vision
  • Shadows in the center of the visual field
  • Progressive or sudden central vision loss

Age-related Macular Degeneration Treatment Options

There is no available cure for end-stage AMD and there is currently no way to reverse the effects of the disease. Treatment widely depends on the stage of the disease and is most commonly available in cases of dry AMD. However, moderate forms of wet AMD can also be treated.

Treatment for Dry AMD

High doses of antioxidants have shown promising results in clinical trials to prevent the progression of dry AMD. Other nutrients may also play a role, especially zinc, but also lutein, copper, vitamin E, vitamin C, and zeaxanthin.

Treatment for Wet AMD

In wet AMD, the primary goal is preventing further growth of the blood vessels. This is done using drugs such as Eyelea, Avastin, Lucentis, or Visudyne. Photodynamic Therapy can also be used in some cases.

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