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  • Writer's pictureCarina Lee

What is Macular Degeneration?

Dr. Carina Lee, May 28, 2022

Have you received a macular degeneration diagnosis?

Age-related macular degeneration (AMD), often known as macular degeneration, is an eye condition brought on by degradation of the macula, the portion of the retina that regulates visual acuity.

Macular degeneration accounts for 8.7% of blindness worldwide

  • Macular degeneration is the #1 cause of low vision

What are the symptoms of AMD?

With a progressive loss of central vision, macular degeneration causes dark "blind" spots to appear in the middle of anything you are looking, including images. Reading, driving, recognizing faces, using a computer, watching TV, and other visual occupations that require attention to minute details are all affected by the condition.

Early detection and treatment of AMD are essential to preventing significant vision loss and occasionally even blindness.

Early signs of AMD include:

  • Blurry vision

  • Cloudy vision

  • Dark ‘blind’ spots

Signs of AMD in its advanced stages:

  • Sudden, severe vision loss

  • Larger blind spots

  • Loss of central vision

Types of Macular Degeneration (AMD)

The most prevalent type, dry macular degeneration, can be found during a routine eye exam. Given that it develops gradually over many years or decades and gradually reduces vision quality, it is regarded as the less aggressive form of AMD. It can be brought on by pigment in the macula, aging and macula thinning, or a combination of the two.

80–90% of AMD cases are dry AMD instances.

The most severe form of AMD is wet macular degeneration. It typically progresses quickly and results in blind spots and a sudden loss of central vision as a result of aberrant blood vessel growth beneath the retina and fluid and blood leakage.

Treatments for AMD

Although macular degeneration cannot be cured, there are treatments that can reduce the disease's progression, protect remaining eyesight, and occasionally even improve visual loss.

How is dry AMD treated?

Dry AMD is treated by employing high zinc and antioxidant concentrations to stop the disease's progression.

According to the Age-Related Eye Disease Study (AREDS), persons with intermediate AMD and those who have advanced AMD in only one eye may be able to slow down the progression of their condition by taking a specific combination of nutritional supplements containing high levels of antioxidants and zinc.

A crucial follow-up study called AREDS2 found that lutein and zeaxanthin should take the place of beta-carotene. The maintenance of retinal health can also be achieved using lutein and zeaxanthin, although beta-carotene has been linked to an increased risk of lung cancer in smokers.

According to the findings of AREDS2, lutein and zeaxanthin decreased the risk of AMD development by 19% and vision loss by 25%.

At this time, the only cures for moderate-to-severe dry AMD are the AREDS and AREDS2 formulations.

Numerous "eye vitamins" and "ocular supplements" with the unique nutrient combination are now widely accessible.

AREDS2 Formula

  • 500 mg vitamin C

  • 400 IU vitamin E

  • 10 mg lutein

  • 2 mg zeaxanthin

  • 80 mg zinc

  • 2 mg copper

How is wet AMD treated?

In order to treat wet AMD, blood vessel growth must be stopped, blood cells must be destroyed, and leaking into the macula must be avoided.

Treatment options for wet AMD include:

  • Anti-VEGF treatment

  • Laser surgery

  • Photodynamic therapy

What is anti-VEGF treatment?

A molecule in your body called vascular endothelial growth factor (VEGF) helps your body produce new blood vessels when it does. Your eye may develop aberrant blood vessels if your body produces too much VEGF. Your eye health and vision are at danger from these aberrant blood vessels, which can result in blindness or vision loss.

In order to prevent further damage from the aberrant blood vessels or to prevent vision loss, anti-VEGF medicines prevent the VEGF from producing new blood vessels.

Your eye doctor will deliver the anti-VEGF medicine. To minimize discomfort during administration, your eye doctor will administer an eye numbing medication. The drug will next be injected with a tiny needle into the sclera, the white portion of your eye.

How effective is the treatment?

  • 9 in 10 people report stabilized vision

  • 1 in 3 people report improved vision

Types of anti-VEGF medications

All of the drugs have been shown to be secure and successful in treating AMD. Each treatment inhibits the development of aberrant blood vessels in the rear of the eye, although they differ in the type of medication they utilize and in price.

  • Beovu uses a drug called aflibercep.

  • Avastin uses a drug called bevacizumab.

  • Lucentis uses a drug called ranibizumab.

  • Eylea uses a drug called aflibercept.

  • Mucugen uses a drug called pegaptanib sodium.

Laser photocoagulation

While conserving healthy blood vessels, this laser surgery closes down the aberrant blood vessels that are leaking. Although the procedure won't be able to restore any lost eyesight, it can halt additional vision loss from occurring.

Photodynamic therapy (PDT)

This procedure uses a laser as well as Visudyne dye, a medication that is injected into an arm vein and becomes active when exposed to light.

Typically, PDT is carried out at an eye doctor's office. Your eye will be dilated and anesthetized with eye drops prior to the treatment. The aberrant blood vessels under the retina are reached by the Visudyne dye when it is injected into the body. Your eye doctor will flash a laser into your eye through a special contact lens to activate the light-sensitive dye and cause it to close off the aberrant blood vessels.

Your eye may be painful after the surgery and your vision may be cloudy; your eye doctor may choose to temporarily cover your eye.

Additionally, because the effects of the laser are frequently transient, you might be forced to repeat this process.

Low vision devices

There are several low vision tools (such as magnifiers, telescopes, and other aids) that can help you preserve your independence even if there is no cure for AMD-related vision loss.

If AMD has been identified in you, it is essential that your eye doctor keep a careful eye on you.

Who is at risk for developing AMD?

Early on in macular degeneration, symptoms may go unreported. Therefore, it's critical to get frequent eye exams that can spot AMD's early warning signs, especially if you're at risk.

Many risk factors include:

  • Age (over age 60)

  • Family history

  • Race

  • Gender (female)

  • Obesity

  • High cholesterol

  • Hypertension

  • Smoking

  • Exposure to ultraviolet (UV) rays

  • Certain medications

How can you lower your risk of developing AMD?

There are strategies to reduce your risk of developing AMD, despite the fact that some risk factors are beyond your control.

Make an appointment for yearly eye exams and tell your doctor if any eye issues run in your family.

  • Avoid smoking

  • Consume a healthy diet

  • Get regular exercise

  • Control cholesterol and blood pressure

  • Wear 100% UV-blocking sunglasses

Consider taking preventative measures to lessen your risk of developing AMD; doing so will help to maintain both the health of your eyes and your entire wellbeing.

If you think that you or a loved one may be experiencing AMD symptoms, schedule an appointment for an eye exam for a complete assessment.

If AMD signs are discovered, there are several effective treatments available to stop or slow down vision loss, and there are many devices available to help the current vision.

Your ophthalmologist will talk to you about the best management and treatment options for your condition.

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