Age-Related Macular Degeneration

Age-Related Macular Degeneration Overview

Age-related macular degeneration (AMD) affects the macula, a small area in the retina where there is light-sensitive tissue in the back of the eye. The macula is where fine vision (central) is located, allowing you to read, see street signs, and see small details. The rest of the retina is for peripheral or side vision. As one ages, there may be damage to the retina as part of the normal aging process. This is associated with deposits of tiny pieces of fatty protein called drusen or other changes.

The exact cause of AMD is not fully understood, but it is strongly associated with aging. Age-related macular degeneration prevalence is about 2% for patients in their 50s and about 30% in patients over the age of 75. AMD affects your central vision, but your side vision is usually not affected. There are two types of age related macular degeneration, dry age related macular degeneration and wet age related macular degeneration. There are several risk factors for age-related macular degeneration as detailed further in this article.

Macular Degeneration Overview Legarreta Eye

Age-related macular degeneration (AMD) affects the macula, a small area in the retina where there is light-sensitive tissue in the back of the eye. The macula is where fine vision (central) is located, allowing you to read, see street signs, and see small details. The rest of the retina is for peripheral or side vision. As one ages, there may be damage to the retina as part of the normal aging process. This is associated with deposits of tiny pieces of fatty protein called drusen or other changes.

  • Age
  • Smoking
  • Family history of AMD
  • Female
  • Fatty diet
  • Elevated Cholesterol
  • Hypertension
  • Cardiovascular disease
  • Obesity

Symptoms

Symptoms of Age-Related Macular Degeneration

The symptoms of age-related macular degeneration (AMD) can vary greatly from early stages to late stages of the condition. Blurred or distorted central vision is one of the hallmark signs of macular disruption in age-related macular degeneration. AMD can lead to blurred or darkened vision in the central area of the eye (called the macula) over time and can cause vision problems. 

AMD can also make colors less vivid. A blurred or distorted central view can lead to inability to do tasks that require precision such as driving a car and reading books and newspapers. AMD typically does not cause total blindness as the side vision is not affected. The symptoms of macular degeneration may not be apparent in one eye. This is because the good eye compensates for what the poor eye does.

AMD Symptoms

  • A gradual loss of ability to see objects clearly
  • A gradual loss of color vision
  • Distorted or blurry vision; straight lines appear bent, crooked, or irregular
  • A dark or empty area appearing in the center of vision
  • The size of objects may appear different for each eye

Diagnosis

Diagnosis of Age-Related Macular Degeneration

When you visit your doctor for a routine eye examination, they can diagnose you with age-related macular damage. You may also have your eyes dilated by them. Early diagnosis can help you to start treatment. This may delay or make symptoms less severe.

During the exam, the doctor will examine the retina for tiny yellow deposits known as drusen. This is a sign that you may have the disease early. A checkerboard-like pattern of straight lines, the Amsler grid may be requested by your doctor. It could indicate macular degeneration if some lines look wavy or are missing.

If AMD is suspected, your doctor will perform a series of tests, including optical coherence tomography, fundus photography or fluorescein angiography to detect this serious condition as early as possible.

Dry Age-Related Macular Degeneration

This is the most common form. It occurs when tiny deposits of fatty protein collect under the retina. These deposits are known as drusen. This may be associated with thinning of the macula, leading to gradual damage to your vision. This type of AMD is not associated with leakage of fluid or blood and is also known as non-neovascular AMD. Dry AMD can progress to wet AMD and is usually monitored with an Amsler grid test that can be done at home.

Wet Age-Related Macular Degeneration

This occurs in about 10% of patients with AMD and is associated with abnormal blood vessels growing underneath the retina. These blood vessels can leak fluid or blood, causing distortion of the central vision. Damage to your vision occurs faster with wet AMD than with dry AMD. If you have wet AMD in one eye, then you are at greater risk for developing a similar problem in the other eye.

Treatment

Treatment of Age-Related Macular Degeneration

While there is no cure for macular degeneration, there are several treatment options available to help patients manage this condition and preserve their vision. The best treatment option for each patient depends on the severity and type of the condition, as well as how much, if any, permanent vision loss has occurred. Treatment options include different forms of anti-VEGF therapies. Some of these therapies include Avastin, Lucentis and Eylea.

Living a healthy lifestyle is one way you can help. Stop smoking, reduce your blood pressure, exercise, and control your weight. Research has shown that diet and nutrition are important. A prescribed combination of natural supplements can help slow down the progression of this condition. Nutritional supplements are not always effective and may not work in all cases. 

Your eye doctor may recommend a new prescription to your eyeglasses in the initial stages of treatment. They also ask that you schedule regular eye examinations. To monitor changes in your vision, you may be asked to perform an Amsler grid at-home test. Dry AMD is more common than wet AMD. However, it’s important to be diagnosed promptly and treated aggressively. 

Intravitreal injections are an option for some patients. Intravitreal injections can be used to improve vision and maintain visual acuity for most patients. However, intravitreal injections should only be administered once a month. A laser beam can be focused on the retina to treat wet AMD. This can either seal or eliminate any leaking blood vessels. If permanent vision loss is a possibility, special glasses or low vision equipment like magnifiers and bright light may be helpful. Talk to your doctor about the best treatment options for you.

Age-Related Macular Degeneration (AMD)

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