Macular Degeneration

As a disease usually associated with aging, macular degeneration is also called age-related macular degeneration (ARMD), though there are other, less common types of macular degeneration.

Macular degeneration symptoms include a gradual loss of central vision needed to perform everyday tasks like driving or reading, and a reduced ability to see small visual details like fine print or patterns.

Age-related macular degeneration is the leading cause of vision loss in Americans over age 60, and presents itself in two forms: dry macular degeneration and wet macular degeneration. Of the two, the “dry” form is far more common. Both affect the center region of the retina, the light-sensitive area in the back of the eye responsible for processing images we see.

Macular Degeneration Statistics

Currently, macular degeneration is the leading cause of vision loss in persons over age 60. Caucasians are far more likely to lose vision from ARMD than African Americans, and studies show that obesity, smoking, and exposure to UV rays may also be risk factors for developing the disease. Macular degeneration tends to affect women more than men, and has also been linked to heredity. Nearly 90% of all diagnosed ARMD is the dry form.

Overview

Macular degeneration (also called AMD, ARMD, or age-related macular degeneration) is an age-related condition in which the most sensitive part of the retina, called the macula, starts to break down and lose its ability to create clear visual images. The macula is responsible for central vision – the part of our sight we use to read, drive and recognize faces. So although a person’s peripheral vision is left unaffected by AMD, the most important aspect of vision is lost.

AMD is the leading cause of vision loss and blindness in Americans of ages 65 and older. And because older people represent an increasingly larger percentage of the general population, vision loss associated with macular degeneration is a growing problem.

It’s estimated that more than 1.75 million U.S. residents currently have significant vision loss from AMD, and that number is expected to grow to almost 3 million by 2020.

Forms Of Macular Degeneration

Macular degeneration can be classified as either dry (non-neovascular) or wet (neovascular). Neovascular refers to growth of new blood vessels in an area, such as the macula, where they are not supposed to be.

The dry form of AMD is more common – about 85% to 90% of all cases of macular degeneration are the dry variety.

Dry Macular Degeneration

Dry AMD is an early stage of the disease, and may result from the aging and thinning of macular tissues, depositing of pigment in the macula, or a combination of the two processes.

Dry macular degeneration is diagnosed when yellowish spots called drusen begin to accumulate in the macula. Drusen are believed to be deposits or debris from deteriorating macular tissue. Gradual central vision loss may occur with dry AMD. Vision loss from this form of the disease is usually not as severe as that caused by wet AMD.

A major study conducted by the National Eye Institute (NEI) looked into the risk factors for developing macular degeneration and cataracts. The study, called the Age-Related Eye Disease Study (AREDS), showed that high levels of antioxidants and zinc significantly reduce the risk of advanced dry AMD and its associated vision loss. The AREDS study also indicated that taking high dose formulas containing beta carotene, vitamins C and E and zinc can reduce the risk of early stage AMD progression by 25%.

Early detection of dry macular degeneration is critical to long-term treatment.

Wet Macular Degeneration

Wet AMD is the more advanced and damaging stage of the disease. In about 10% of cases, dry AMD progresses to wet macular degeneration.

With wet AMD, new blood vessels grow beneath the retina and leak blood and fluid. This leakage causes permanent damage to light-sensitive cells in the retina, causing blind spots or a total loss of central vision.

The abnormal blood vessel growth in wet AMD is the body’s misguided attempt to create a new network of blood vessels to supply more nutrients and oxygen to the macula. But the process instead creates scarring and central vision loss.

Macular Degeneration Signs And Symptoms

Macular degeneration usually produces a slow, painless loss of vision. Early signs of vision loss associated with macular degeneration can include seeing shadowy areas in your central vision or experiencing unusually fuzzy or distorted vision. In rare cases, it may cause a sudden loss of central vision.

An eyecare practitioner usually can detect early signs of macular degeneration before symptoms occur. Usually this is accomplished through a retinal examination.

What Causes Macular Degeneration?

Many forms of macular degeneration appear be linked to aging and related deterioration of eye tissue crucial for good vision. Research also suggests a gene deficiency may be associated with almost half of all potentially blinding cases of macular degeneration.

Who Gets Macular Degeneration?

Besides affecting older individuals, macular degeneration appears to occur in whites and females in particular. The disease also can result as a side effect of some drugs, and it appears to run in families.

New evidence strongly suggests that smoking is high on the list of risk factors for macular degeneration. Other risk factors for macular degeneration include having a family member with it, high blood pressure, lighter eye color and obesity. Some researchers believe that over-exposure to sunlight also may be a contributing factor in development of macular degeneration, and a high-fat diet also may be a risk factor.

Macular Degeneration Treatment

There is currently no cure for macular degeneration. Macular degeneration treatment options exist that can slow the progress of the disease or improve vision based on the type of macular degeneration you are experiencing. To understand the risks and the limitations of all macular degeneration treatments, speak frankly with your eye doctor.

Dry macular degeneration treatment actually begins with routine eye exams, especially after age 60. The goal here is to catch the development of ARMD early. If detected, you may be prescribed a specific mix of high-dose zinc and antioxidants that have shown an ability to slow the progression of the disease.
Wet macular degeneration treatment can include a number of options; including laser surgery, light-activated dyes that are injected into the circulatory system, or drugs injected directly into the eye that inhibit the growth of abnormal blood vessels that cause the wet form of the disease.

​​​​​​​With any macular degeneration treatment, there are no guarantees that the disease can be stopped, no promises that a treatment won’t need to be repeated, and a sobering reminder that vision, once lost, is rarely restored.