Age-Related Macular Degeneration (AMD)
Have you noticed issues with your sharp, straight-ahead central vision? You may have a condition called age-related macular degeneration (AMD). Among people over the age of 50, AMD is the nation’s leading cause of irreversible vision impairment, with cases expected to grow to almost 22 million by 2050. At Retina Associates of Utah, AMD is one of the most common conditions we treat.
What is Age-Related Macular Degeneration (AMD)?
AMD is a degenerative disease that affects the retina – the thin, photosensitive tissue layer in the back of the eye. As light signals enter the eye, the retina converts them into electrical signals that are sent to the brain via the optic nerve. AMD targets the retina’s central portion, the macula, which contains cells enabling your eye to perform multiple advanced central vision tasks. As you age, your macular tissue weakens and loses its functionality.
Age-Related Macular Degeneration Symptoms
AMD can develop quickly or slowly, and early on, there are likely no apparent symptoms. Generally, AMD doesn’t result in complete blindness, and peripheral vision isn't affected. But there may be central vision loss, such as issues with close-up tasks, like seeing faces or reading. You may experience such symptoms as blurriness, darkened areas within your central field of vision, and visual distortions, like straight lines appearing wavy.
Types of Age-Related Macular Degeneration
1.) Dry Age-Related Macular Degeneration (AMD) – Also known as atrophic AMD, this is the more common type, affecting about 90 percent of all patients. Part of normal aging, dry AMD is usually not harmful or painful. Vision loss generally develops slowly and gradually, affecting one or both eyes. But dry AMD may not impact vision at all, and you may not even be aware until a routine eye exam.
Dry AMD can make it difficult to see in the dark and make out contrasts. During your regular dilated eye exams, your ophthalmologist may detect deposits of drusen, small, yellow, cholesterol-like deposits that accumulate under the retina. Drusen are a normal part of aging, but should they grow in size and number, retinal specialists can use this to determine AMD progression. Drusen can cause visual distortions, as the macula becomes thinner and ceases to function properly. Once diagnosed, dry AMD patients must monitor their vision regularly. Typically, patients do well with no treatment, but alert your ophthalmologist immediately if you notice any vision changes. The reason is that over time, dry AMD can turn into wet AMD.
2.) Wet Age-Related Macular Degeneration (AMD) – The much more serious type (also called exudative AMD), wet AMD only affects about 10 percent of patients. Its main sign is the development of irregular, weed-like blood vessels under the retina. Known as choroidal neovascularization (CNV), these new blood vessels can break, causing blood and other fluids to leak into the macular area. This can result in swelling, bleeding, central vision blurriness and distortions, and worsening vision loss. Wet AMD vision loss is much quicker and more noticeable than dry AMD.
Age-Related Macular Degeneration Risk Factors
When it comes to dry AMD, the main risk factor is being over the age of 50. But other conditions and lifestyle factors may raise your chances, including:
- Having a family history of AMD
- Having underlying conditions, such as diabetes, high blood pressure, or cholesterol
- Having light-colored irises
- Having a poor diet, such as consuming high quantities of saturated fats
- Long-term exposure to sunlight without protection
Preventive Steps for AMD
There is not yet a dry AMD cure or treatment. But for wet AMD, you can take certain preventive measures to prevent its development, including:
- Ensuring that any underlying conditions that worsen AMD are under control
- Engaging in physical activity on a daily basis
- Avoiding smoking
- Achieving and maintaining a healthy body mass index (BMI)
- Protecting your eyes from harmful UV ray exposure with sunglasses and hats
Eating a diet with foods rich in certain nutrients may promote eye and vision health, such as dark leafy greens, oily fish, citrus fruits, and nuts. Research also suggests that multiple supplements benefit vision, including vitamins C and E, lutein, zeaxanthin, zinc, and copper. But you may want to first discuss any nutritional changes with your doctor.
For dry AMD, it’s important to monitor your vision daily to quickly detect any changes. You can do this with an Amsler grid, which is a simple chart consisting of horizontal and vertical lines that form a grid pattern, with a dot in the center. If used regularly, it can help you detect any visual distortions. Here’s how to use it:
- Wear your normal reading glasses.
- Make sure the grid’s in an area with good lighting.
- Hold the grid about 12-15 inches away from your face.
- Cover one eye and focus your uncovered eye on the center dot.
- Look to see if the grid’s lines look straight or appear distorted, such as wavy lines, blurred areas, darkened areas, or blank spots.
- Repeat these steps with the other eye.
If you notice any changes or distortions, contact your ophthalmologist immediately.
To preserve your vision, schedule regular eye exams to detect the earliest signs of AMD. If you’re between 40 and 54, we advise you to visit our ophthalmologists at least every 2-4 years, depending on your health needs. If over 55, schedule an eye exam at least every 1-2 years.
Treatment of Wet Age-Related Macular Degeneration
For wet AMD, when diagnosed in the earliest stages, patients have a better chance of delaying and preserving vision loss. Treatment options are determined by the symptoms’ severity.
- One of the most common treatments is anti-vascular endothelial growth factor (anti-VEGF) medications. It’s regularly injected into the affected eye(s) to inhibit abnormal blood vessel growth. Your eye is numbed first, making it a relatively painless procedure. Patients usually do well, and if diagnosed early, your central vision may be preserved.
- Focal laser surgery, or photocoagulation, involves a high-energy laser that seals off abnormal blood vessels. This prevents further macular leaking and bleeding.
- Photodynamic therapy involves a light-activated drug injected into the bloodstream. The drug then travels to the ocular blood vessels. A laser is used on the eye to activate the drug, which then seals the abnormal blood vessels.
Schedule a Consultation With Our AMD Specialists in Utah
At Retinal Associates of Utah, our physicians have extensive experience in the diagnosis and treatment of dry and wet age-related macular degeneration. Contact us with any questions or schedule an appointment today.