Age-Related Macular Degeneration
What Is Macular Degeneration?
Age-related macular degeneration (AMD) is a problem with your retina. It happens when a part of the retina called the macula is damaged. With AMD you lose your central vision. You cannot see fine details, whether you are looking at something close or far. But your peripheral (side) vision will still be normal. For instance, imagine you are looking at a clock with hands. With AMD, you might see the clock’s numbers but not the hands.
Two types of AMD
This form is quite common. About 80% (8 out of 10) of people who have AMD have the dry form. Dry AMD is an early stage of the disease which can result from aging and from thinning of macular tissue with formation of tiny clumps of protein called drusen. Gradual loss of 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. There is no treatment for dry AMD yet.
This form is less common but much more serious. In about ten percent of individuals with AMD, dry AMD progresses to the wet form, the more damaging form of the disease. 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. You lose vision faster with wet AMD than with dry AMD.
Many people don’t realize they have AMD until their vision is very blurry. This is why it is important to have regular visits to an ophthalmologist. He or she can look for early signs of AMD before you have any vision problems.
Who is at Risk for Macular Degeneration?
You are more likely to develop AMD if you have the following risk factors:
Diagnosis
During an eye exam, your ophthalmologist may ask you to look at an Amsler grid. This grid helps you notice any blurry or blank spots in your field of vision. Your ophthalmologist will also look inside your eye through a special lens. He or she can see if there are changes in the retina and macula.
Your ophthalmologist will put drops in your eye to dilate (widen) your pupil. This allows him or her to look through a special lens at the inside of your eye.
Your doctor may do fluorescein angiography to see what is happening with your retina. Yellow dye (called fluorescein) is injected into a vein, usually in your arm. The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if abnormal new blood vessels are growing under the retina.
Optical coherence tomography (OCT) is another way to look closely at the retina. A machine scans the retina and provides very detailed images of the retina and macula.
Macular Degeneration Treatment: How is AMD Treated?
Dry AMD
There is no treatment for the dry form of AMD at this time. However people with lots of drusen or serious vision loss might benefit from taking a certain combination of nutritional supplements. A large study found those people may slow their progression of dry AMD by taking these vitamins and minerals daily:
- Vitamin C
- Vitamin E
- Lutein
- Zeaxanthin
- Zinc
- Copper
Your ophthalmologist can tell you if vitamins and minerals are recommended for your dry AMD.
Wet AMD
To help treat wet AMD, there are medications called anti-VEGF drugs. Anti-VEGF treatment helps reduce the number of abnormal blood vessels in your retina. It also slows any leaking from blood vessels. This medicine is delivered to your eye through a very slender needle.
Laser surgery may also be used to treat some types of wet AMD. Your eye surgeon shines a laser light beam on the abnormal blood vessels. This reduces the number of vessels and slows their leaking.
Talk with your ophthalmologist about ways to treat your AMD.