Age-related macular degeneration (AMD) is an eye disease that causes a person’s central vision to become blurry. It usually affects people over the age of 60 years. It can worsen over time but does not usually lead to total vision loss.
Macular degeneration affects the retina, a layer at the back of the eyeball. This layer contains light-sensitive cells that enable a person to see.
Age-related macular degeneration (AMD) affects a person’s central vision. It becomes more common after the age of
Reading, writing, recognizing faces, and driving can become more difficult. However, there is usually enough peripheral vision to allow other daily activities. Total vision loss is unlikely.
This article looks at the types, symptoms, and treatment for AMD.
AMD can be wet or dry.
Dry AMD, also known as atrophic AMD, develops gradually. There is no treatment, but a person can learn strategies to cope with it. This type accounts for 85–90% of cases.
Wet or exudative AMD, also known as advanced neovascular AMD, happens when new blood vessels develop under the macula. These can cause blood and fluid to leak. This type tends to progress more quickly and results in more severe vision loss.
In 10–15% of people with AMD, the dry form progresses to the wet form. This can happen at any stage of dry AMD.
Juvenile macular degeneration
Doctors do not consider wet AMD to have an early or intermediate stage. They regard wet AMD as advanced stage AMD. In the advanced stage, symptoms are the same for wet and dry AMD.
The table below shows how symptoms
| Dry AMD | Wet AMD | |
| Early stage | no symptoms | not applicable |
| Intermediate stage | no symptoms / mild symptoms, including blurriness and difficulty seeing in low light | not applicable |
| Advanced stage | blurring or blank spots in the central vision straight lines starting to look wavy or crooked colors appearing faded difficulty seeing in low light | as for dry AMD |
Doctors do not know exactly why AMD occurs, but genetic and environmental factors may play a role, including oxidative stress.
Features of AMD
- changes in pigmentation
- drusen, which are fat deposits that appear as pale yellow spots on the retina
- a thickening of Bruch’s membrane, a layer between the retina and the choroid
- basal laminar deposits on the retina consisting of collagen fibers and other substances
- in dry AMD, a thinning of the retina around the macula
- in wet AMD, new blood vessels form rapidly and incorrectly, leading to lesions, scarring, exuding of fluid, and internal bleeding
Factors that may increase AMD risk include:
- being aged over
60 years - smoking
- having a family history of AMD, as around 15–20% of those with AMD have a close relative who also has it
- high blood pressure
- obesity
- a diet that is high in fat and processed foods
- a low intake of certain nutrients, such as antioxidants and zinc
- exposure to UV rays, for example, from sunlight
There is
If vision problems start to occur, a person should contact an eye doctor, an optometrist, or an ophthalmologist.
The doctor will give the person some eye drops to dilate the pupil and then examine the eye.
They may also
- Optical coherence tomography: Special light rays scan the retina and take an image. The image can show if the macula has any unusual features.
- Amsler grid: The person looks at a grid with vertical and horizontal lines. If AMD is present, some of the lines on the grid may seem distorted, broken, or faded.
- Fluorescein angiography: The doctor may recommend this if they suspect wet AMD. The doctor injects a dye into the person’s arm and examines their eyes with a special magnifying device. They can take pictures of the eye that show whether the blood vessels behind the macula are leaking.
Treatment for AMD cannot restore vision, but it can slow vision loss.
Dry AMD
There is no treatment for dry AMD, but tips that can help a person manage it include:
- choosing larger print books or increasing the font size on screens
- using magnifying devices
- changing the lighting
Wet AMD
Some treatments can help slow the progression of wet AMD.
Anti-vascular endothelial growth factor medication
Vascular endothelial growth factor (VEGF) is a chemical that contributes to the formation of new blood vessels in the eyes. In people with wet AMD, anti-VEGF drugs block this chemical and prevent the overproduction of blood vessels.
Examples
To deliver the drugs, a doctor will:
- apply an anesthetic
- clean the eye, usually with Betadine, to reduce the risk of infection
- inject the drug into the eye with a very fine needle
The person may need this injection once a month, at least to start with. After this, the intervals may be longer.
Possible side effects include bleeding under the conjunctiva.
In very rare cases, complications can occur, such as:
- retinal detachment
- damage to the lens of the eye
- infection
Photodynamic therapy
Doctors sometimes
A doctor will:
- inject the drug verteporfin into the arm
- numb the eye
- place a special contact lens on the eye
- apply a laser light with a specific wavelength to the blood vessels in the back of the eye
This breaks down the blood vessels that are causing wet AMD.
How useful is laser treatment for AMD?
Home and natural remedies
For a person with AMD in one eye, dietary supplements may help prevent or slow the development of AMD in the other eye.
AREDS 2 supplements consist of a special formulation for people who have or are at risk of AMD.
They
- vitamin C
- vitamin E
- beta carotene
- zinc
- cuprid oxide (copper)
- lutein
- zeaxanthin
A person cannot obtain the right combination of these nutrients from diet alone. Combined in this way, they may help slow the progression of AMD.
A
It concludes that some medicinal plants may help, for example:
The following antioxidants may also have benefits:
- carotenoids, which give rise to vitamin A
- polyphenol, such as resveratrol
- flavonoids, such as quercetin
- anthocyanidins, which give red, blue, and purple plants their coloring
- vitamin C and E
These antioxidants are present in plant-based foods, such as fruits and vegetables.
Anyone who wishes to try supplements or significantly increase their intake of certain foods should first speak with a doctor. Some herbs, spices, and even foods can interact with certain drugs.
Can supplements help with AMD?
Other options
In the future, the following may be options for people with AMD:
Stem cell therapy
Studies have suggested that human stem cells might enable the retina to repair itself one day.
In 2018,
Implantable telescope
A 2016
Vision loss due to AMD can affect a person’s quality of life and lead to various complications, such as:
- a
higher risk of falls - an inability to carry out daily activities, including driving
- anxiety and depression
However, rehabilitation and support
It is not always possible to prevent AMD, but these
- following a diet that contains plenty of fruits and vegetables
- exercising regularly
- avoiding risk factors for CVD, as there may be a link
- quitting or avoiding smoking
- having regular eye tests
- wearing sunglasses that block UV rays to protect the eyes from damage
The authors of a
People often ask the following questions about AMD.
Is there any treatment for AMD?
There is no treatment for dry AMD, the most common type. However, anti-VEGF medication
What are the early warning signs of AMD?
The
What causes AMD?
AMD happens as the macula, a part of the retina, degenerates over time. Smoking may
Age-related macular degeneration (AMD) is an eye disease that
Dry AMD is the most common type. It progresses slowly and happens as the macula gets thinner. There is no cure, but some lifestyle remedies can help people manage with reduced vision.
Wet AMD can progress quickly. It happens when blood vessels in the back of the eye start to develop incorrectly.
Anyone who notices changes in their vision should see an opthalmologist. If wet AMD is present, early treatment can help manage it.