Age-related Macular Degeneration
Age-related macular degeneration (AMD) is the leading cause of central visual loss in patients over the age of 60 years-old in the United States. This condition is caused by dysfunction in the center of the retina as we age. One component of the disease is related to genetics meaning that a patient born with certain genes can place him or her at higher risk. But the largest component is aging – and we know that the risk increases as a patient ages. In addition, there are other modifiable risk factors, including smoking and sunlight exposure.
AMD has a “dry” and a “wet” form. Most patients have the “dry” form. In dry macular degeneration, the center of the retina has difficulty eliminating waste products thereby allowing accumulation of deposits called drusen. These drusen can lead to atrophy of the retina and subsequent vision loss. Dry macular degeneration has a wide range of severity – some patients maintain excellent vision for a long period of time while other patients have a dramatic reduction in central vision. The retina doctor will be able to tell you about the severity of your disease. Treatment for dry macular degeneration involves eating a diet rich in green leafy vegetables, wearing sunglasses when outdoors, and for some patients, taking a special vitamin pill daily called the AREDS supplement. This pill was shown in a large trial to reduce the risk of disease progression in some patients by 25%. Your retina doctor will tell you whether you should be taking this supplement as the supplement is not indicated for everyone.
The “wet” form of macular degeneration is less common. With wet AMD, abnormal blood vessels grow underneath the retina. These blood vessels leak fluid and sometimes blood into and under the retina which causes central vision loss. A patient typically complains of acute decrease in vision or distortion of the central vision when the dry form turns to the wet form. Treatment of wet AMD involves periodic injections of medication, called anti-VEGF medicine, into the eye.