Macular degeneration, also called age-related macular degeneration (AMD), refers to a gradual loss of central vision. There are two main types — dry and wet.
AMD causes blurry central vision. An estimated
There are two types of AMD: dry and wet. Dry is the more common type, while wet is an advanced form of AMD that leads to more rapid vision loss.
Both types are progressive conditions. Treatment can slow progression to preserve more of a person’s vision.
This article reviews the two types of AMD, their stages, and more.
Dry AMD accounts for about 80% of all people with AMD. It occurs when age causes parts of the macula to thin and deposits of drusen to grow. Drusen are small clumps of protein.
The macula is located in the center of the retina. People living with dry AMD will notice blurry vision starting to affect their central vision. This can cause other symptoms, such as difficulty seeing in low light.
Once it advances, a person may notice changes in how colors look, as well as blind spots in their central vision.
Early stages of dry AMD have no treatment options. An eye doctor will monitor a person’s vision with regular examinations. They may also recommend:
- getting plenty of exercise
- quitting smoking, if applicable, or avoiding cigarette smoke
As the condition progresses, a doctor
Geographic atrophy
Geographic atrophy is an advanced stage of dry AMD. It affects an estimated 1 million people in the United States.
When it occurs, retina cells die off, causing further vision loss. It can cause symptoms such as:
- dark spots in the central vision
- numbers or letters disappearing when reading
- dull, washed-out colors
- difficulty reading in low light
- trouble seeing in dimly lit rooms
- blurry vision
Not everyone with dry AMD will develop geographic atrophy. Certain risk factors can increase a person’s chances of developing it, such as:
- a family history of the condition
- being over the age of 60 years
- poor diet
- genetics
- high blood pressure or cholesterol
- obesity
- prolonged, lifetime sun exposure
- smoking
- diabetes or heart disease
In 2023, the Food and Drug Administration (FDA) approved the first medications for geographic atrophy called pegcetacoplan (Empaveli, Syfovre) and avacincaptad pegol (Izervay). These medications can help slow the progression of the condition but cannot restore lost vision or improve eyesight.
Wet AMD is less common than dry, accounting for about 20% of all AMD cases. Experts consider it an advanced stage of AMD, and it can lead to more rapid vision loss.
It occurs when abnormal blood vessels grow under the retina. The abnormal vessels may then leak or bleed, leading to vision loss.
Doctors
There are four stages of AMD.
Subclinical
Subclinical AMD means a person shows very early signs that AMD may occur. A person will not typically have any symptoms, but they may benefit from monitoring.
A
Early
In the early stage of AMD, a person will not generally show any signs of symptoms. A doctor
- getting regular exercise
- quitting smoking
- eating a nutritious diet
Intermediate
Some people will start to notice mild symptoms at this stage, but others will not notice anything different with their vision. Some symptoms a person may notice include mild blurriness in their central vision and trouble seeing in low light.
Advanced
There is an association between advanced dry or wet AMD with significant central vision loss. A person may notice straight lines becoming wavy, large blurry areas or dark spots, and diminished colors.
The following sections provide answers to frequently asked questions about AMD.
Is wet or dry macular degeneration treatable?
There is
Intermediate dry AMD may benefit from AREDS 2, a supplement regimen that helps slow its progression.
Advanced dry macular degeneration with geographic atrophy may benefit from the injectable medications pegcetacoplan and avacincaptad pegol. Ophthalmologists inject these medications directly into the eye once per month or every 2 months.
Wet AMD often responds to anti-VEGF drug injections or photodynamic therapy (PDT).
What type of macular degeneration is the most serious?
Wet AMD is an advanced form of the condition, and experts generally consider it the most severe form. Treatments can help preserve vision and prevent vision loss.
How do people cope with macular degeneration?
Learning to live with vision loss due to AMD is possible. Many people benefit from assistive devices, such as magnifying glasses or specialized computers and screens. A person may also find that working with a vision rehabilitation specialist helps them better utilize their side vision.
Macular degeneration is an age-related vision condition in which a person loses clarity in their central vision. The most common type is dry, which is divided into stages based on severity. Wet macular degeneration is an advanced form of the condition.
A person can take steps to decrease their chances of developing macular degeneration. Diet, exercise, regular eye exams, and not smoking can help a person care for their eyes.
Intermediate dry macular degeneration can benefit from a vitamin and mineral supplement called AREDS 2. Wet macular degeneration has two main treatment options that a doctor may recommend.
A person should discuss their outlook and treatment plan with an eye doctor. They can recommend a schedule for eye exams, provide necessary treatments, and recommend other specialists, as needed.