Age-Related Macular Degeneration

Age-related macular degeneration (AMD) is a very common condition that affects the very center of the retina, an area called the macula. This tiny area is responsible for our central vision and allows us to read, perform most everyday tasks and recognize faces. Any problem with the macula results in a significant change of vision. AMD is the leading cause of visual impairment in people over the age of 65.

AMD is classified into two broad categories: dry and wet. Dry AMD is a very slow degenerative process resulting from the accumulation of metabolic waste products in the retina over the course of a lifetime. For reasons that mostly genetic, these waste products cause damage to the retina in some individuals and not in others. In most patients, significant vision loss does not occur, but in a small percentage vision loss can be severe. Wet AMD is not a separate disease, but rather a complication of AMD which develops in a small percentage of patients. In wet AMD, abnormal blood vessels develop under the retina which can cause retinal swelling and bleeding in some cases. Wet AMD is generally considered to be more concerning because it can cause rapid vision loss, as opposed to the slowly progressive changes of dry AMD.

Treatment of AMD

Unfortunately, no known treatment exists to reverse the slowly progressive degenerative changes of dry AMD. Treatment is aimed at slowing down the disease process and preventing the complication known as wet AMD from developing, or catching it early if it develops. The following recommendations apply to individuals with significant evidence of dry AMD:

· Vitamin supplementation using a combination of vitamins based on a study called AREDS has been shown to slow progression of disease to a small extent

· Research is underway into other vitamins and medications which show promise as well

· Smoking is known to be the single most detrimental factor and should be absolutely avoided

· Use of an at-home test called the Amsler grid is extremely effective in picking up the early signs of development of the complication known as wet AMD and should be employed on a daily or weekly basis by all AMD patients

· Regular dilated eye examinations with retinal imaging as recommended by your physician

If a patient develops wet AMD, several excellent and highly effective medications have recently been introduced which can stop progression of vision loss in the majority of cases, and improve vision in many cases as well. These treatments involve injections of medication into the eye, which may sound unpleasant but is extremely well tolerated and has minimal associated risks. Unfortunately, the medication effect is of limited duration and it is common for a patient to need to continue to undergo treatments at regular intervals in order to prevent recurrence and maintain the best possible vision. In some more atypical cases, several types of laser treatments can also be effective at stabilizing some forms of wet AMD.

What are the warning signs?

You should see your ophthalmologist, optometrist, or retinal specialist if you experience any of these symptoms: decreased visual sharpness, blind spots, turning away from an object to see better, distorted vision, decreased color perception.