Macular Degeneration
What is Macular Degeneration?
Age-related macular degeneration (AMD) is one of the most common causes of poor vision after people reach the age of 60. It is generally considered to be age-related and part of the body’s natural aging process, but there are some risk factors that can be taken into consideration as well. Heredity and family history, high blood pressure, cardiovascular disease, smoking, and even blue eyes are generally regarded to help increase the risk level for macular degeneration.
AMD is, in its most simple description, the breakdown of the eye’s macula, which is the light-sensitive tissue that lines the back of the eye. The macula is important, as it is responsible for your central vision, which helps you see fine details easily. Things like threading a needle, reading fine print , seeing street signs, or even recognizing faces rely heavily on the macula.
AMD is caused when deposits called drusen develop under the retina. Drusen are yellow deposits, and are made up of lipids, which are a fatty protein. There are two types of drusen – “hard,” and “soft.” Hard drusen may not ever cause vision problems, and they’re located far away from each other. Soft drusen, on the other hand, are larger and often form clusters. It’s generally acknowledged that drusen don’t cause age-related macular degeneration, but soft drusen especially can add to the risk factors for AMD if they’re present.
AMD is, in its most simple description, the breakdown of the eye’s macula, which is the light-sensitive tissue that lines the back of the eye. The macula is important, as it is responsible for your central vision, which helps you see fine details easily. Things like threading a needle, reading fine print , seeing street signs, or even recognizing faces rely heavily on the macula.
AMD is caused when deposits called drusen develop under the retina. Drusen are yellow deposits, and are made up of lipids, which are a fatty protein. There are two types of drusen – “hard,” and “soft.” Hard drusen may not ever cause vision problems, and they’re located far away from each other. Soft drusen, on the other hand, are larger and often form clusters. It’s generally acknowledged that drusen don’t cause age-related macular degeneration, but soft drusen especially can add to the risk factors for AMD if they’re present.
Symptoms of Macular Degeneration
Age-related macular degeneration doesn’t affect side or peripheral vision, and only affects the person’s central vision. Symptoms of AMD often include blurriness in vision, or dark areas and distortion in the central vision. There is the possibility of permanent loss of central vision, but that’s extremely rare, and doesn’t happen very often.
There is a tool that is often used to detect early changes of AMD, and are used by ophthalmologists, but can even be used at home. The tool is called an Amsler grid, and it’s actually very simple. An Amsler grid is a simple grid of horizontal and vertical lines with a dot in the middle. For the test, the person looks at the dot with each eye separately. Those with AMD will notice that the lines in the Amsler grid appear to be wavy or missing.
There is a tool that is often used to detect early changes of AMD, and are used by ophthalmologists, but can even be used at home. The tool is called an Amsler grid, and it’s actually very simple. An Amsler grid is a simple grid of horizontal and vertical lines with a dot in the middle. For the test, the person looks at the dot with each eye separately. Those with AMD will notice that the lines in the Amsler grid appear to be wavy or missing.
Stages of Macular Degeneration
There are three main stages of age-related macular degeneration, and they are defined in large part by the size and number of drusen in the eye. The first stage is called Early AMD, and diagnosis of this stage will take place with the presence of medium-sized drusen. Medium-sized drusen are typically about the width of a normal human hair. When someone is diagnosed with early AMD, there is typically no vision loss at this point.
Intermediate AMD, on the other hand, may cause some vision loss, but many people with this stage won’t have any symptoms as described above. Typically with intermediate AMD, people have large drusen present, as well as pigment in the retina, or potentially both.
Late AMD, finally, is the stage where real vision loss is noticeable from damage to the macula. It is within the late AMD stage that the two subtypes of dry and wet AMD emerge, which will be discussed in the following section.
Interestingly, not everyone with early-stage AMD will develop later-stage AMD. For those with early AMD in both eyes, about 15 percent will develop late AMD in at least one eye after 10 years. For those with early AMD in just one eye, that number shrinks to about five percent. As with anything else, the key to success is early detection.
Intermediate AMD, on the other hand, may cause some vision loss, but many people with this stage won’t have any symptoms as described above. Typically with intermediate AMD, people have large drusen present, as well as pigment in the retina, or potentially both.
Late AMD, finally, is the stage where real vision loss is noticeable from damage to the macula. It is within the late AMD stage that the two subtypes of dry and wet AMD emerge, which will be discussed in the following section.
Interestingly, not everyone with early-stage AMD will develop later-stage AMD. For those with early AMD in both eyes, about 15 percent will develop late AMD in at least one eye after 10 years. For those with early AMD in just one eye, that number shrinks to about five percent. As with anything else, the key to success is early detection.
Types of Macular Degeneration
There are two types of age-related macular degeneration: dry, and wet. The first type, dry, or atrophic, is the most common type, which affects 90 percent of people with AMD. It’s caused by the aging and thinning of the tissues of the macula, and takes many years to develop. With this type, vision loss is typically fairly gradual and happens over a longer term. It can, however, transform into the more damaging wet macular degeneration, which will be explained in more detail below.
Wet macular degeneration is also known as exudative, and it makes up only about 10 percent of cases of AMD. However, it can lead to much more damage, and can also progress much more quickly than the dry or atrophic type. Wet macular degeneration happens when abnormal blood vessels begin to grow under the retina. This is called “chloroidal neovascularization,” commonly known by the abbreviation of CNV. This name is because the vessels grow from the layer around the retina called the choroid.
With either dry or wet macular degeneration, catching the problems early on is key to preventing more significant damage. There is no medication or cure for dry macular degeneration, but there are some vitamin regimens incorporating a number of different vitamins which can be therapeutic for the condition and slow the progression and future vision loss of dry AMD. Vitamins C, E, zinc oxide, culpric oxide and beta-carotene are among the components of these vitamin cocktails.
Wet AMD, on the other hand, is more serious, so requires more serious treatment. The most common treatment for Wet Macular Degeneration is anti-vascular endothelial growth factor (anti-VEGF) injections. Laser surgery is also an option for the treatment of wet (blood vessels that are growing directly beneath the macula) macular degeneration.
Treatments of either dry, atrophic AMD or wet, exudative AMD typically don’t improve vision, but they do work to slow down and prevent further loss of vision, which is, of course, a huge benefit to the patient.
Call for an Appointment
Age-related macular degeneration is a significant problem, and yet it is extremely common. In large part because symptoms can be managed and slowed with certain treatments, it is important to undergo proper eye examinations on a regular basis. Your ophthalmologist is an expert in this field and can guide you in the appropriate direction.
Wet macular degeneration is also known as exudative, and it makes up only about 10 percent of cases of AMD. However, it can lead to much more damage, and can also progress much more quickly than the dry or atrophic type. Wet macular degeneration happens when abnormal blood vessels begin to grow under the retina. This is called “chloroidal neovascularization,” commonly known by the abbreviation of CNV. This name is because the vessels grow from the layer around the retina called the choroid.
With either dry or wet macular degeneration, catching the problems early on is key to preventing more significant damage. There is no medication or cure for dry macular degeneration, but there are some vitamin regimens incorporating a number of different vitamins which can be therapeutic for the condition and slow the progression and future vision loss of dry AMD. Vitamins C, E, zinc oxide, culpric oxide and beta-carotene are among the components of these vitamin cocktails.
Wet AMD, on the other hand, is more serious, so requires more serious treatment. The most common treatment for Wet Macular Degeneration is anti-vascular endothelial growth factor (anti-VEGF) injections. Laser surgery is also an option for the treatment of wet (blood vessels that are growing directly beneath the macula) macular degeneration.
Treatments of either dry, atrophic AMD or wet, exudative AMD typically don’t improve vision, but they do work to slow down and prevent further loss of vision, which is, of course, a huge benefit to the patient.
Call for an Appointment
Age-related macular degeneration is a significant problem, and yet it is extremely common. In large part because symptoms can be managed and slowed with certain treatments, it is important to undergo proper eye examinations on a regular basis. Your ophthalmologist is an expert in this field and can guide you in the appropriate direction.