Macular Degeneration Overview

• Wet or Dry AMD
• Treatments
• Vitamins & Nutrition

Advancements In Treating Macular Degeneration

Age-related macular degeneration. also referred to as AMD, is a common eye disease associated with aging that gradually impairs sharp, central vision. It affects approximately 13 million people in the U.S. and is the leading cause of vision loss. Because of the aging baby boomer population in this country, some experts say AMD will be "the epidemic of the 21st century."

AMD is a disease of the macula, the part of the eye that allows you to see fine detail.  AMD causes no pain.

In some cases, AMD advances so slowly that people notice little change in their vision.  In others, the disease progresses faster and may lead to a loss of vision in both eyes.  It typically affects both eyes at different rates.  AMD is a leading cause of vision loss in Americans 60 years of age and older.

Even a small amount of vision loss can impair function and increase the risk of falls and injuries. The disease not only takes a physical toll on its patients, but also can have a devastating emotional impact on them, their families and caregivers.

Where is the Macula?

The macula is located in the center of the retina, the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses.  The retina then sends these impulses, or nerve signals, to the brain.

The Two Common Forms of AMD: Dry and Wet

"Dry" AMD  

Eight-five percent of all people with AMD have the dry form of the disease. Researchers believe that dry AMD is caused by the aging and thinning of the tissues of the macula, a region in the center of the retina that controls central vision and allows us to make out fine details. Some people have dry AMD for many years without vision loss. But because the dry form can progress quickly to the potentially damaging wet form, early detection and careful monitoring is crucial.

Although there is no proven treatment for dry macular degeneration, studies have been conducted to evaluate the possible benefit of nutritional supplements for the condition. The Eye Centers of Florida participated in one such study that assessed the relationship between nutrition and macular degeneration in almost 500 women across the U.S.  

"Wet" AMD

Although a small percentage of people with macular degeneration have this type, it is a much greater threat to vision. With the wet form of the disease abnormal blood vessels grow rapidly, developing beneath the macula, leaking fluid and blood that can cause severe loss of central vision. Laser treatment has been the traditional and most widely used method of treating wet macular degeneration, but while it can slow or prevent further vision loss, it rarely improves vision.

Frequently Asked Questions about Dry and Wet AMD

Which is more common-the dry form or the wet form?

Can the dry form turn into the wet form?

Yes. All people who have the wet form had the dry form first.
The dry form can advance and cause vision loss without turning into the wet form. The dry form also can suddenly turn into the wet form, even during early stage AMD. There is no way to tell if or when the dry form will turn into the wet form.The dry form has early and intermediate stages.

Does the wet form have similar stages?

No. The wet form is considered advanced AMD.

Can advanced AMD be either the dry form or the wet form?

Yes. Both the wet form and the advanced dry form are considered advanced AMD. Vision loss occurs with either form. In most cases, only advanced AMD can cause vision loss.
People who have advanced AMD in one eye are at especially high risk of developing advanced AMD in the other eye.

Causes and Risk Factors

Who is at risk for AMD?

The greatest risk factor is age. Although AMD may occur during middle age, studies show that people over age 60 are clearly at greater risk than other age groups. For instance, a large study found that people in middle-age have about a 2 percent risk of getting AMD, but this risk increased to nearly 30 percent in those over age 75.

Other risk factors include:

• Smoking. Smoking may increase the risk of AMD.
• Obesity. Research studies suggest a link between obesity and the progression of early and intermediate stage AMD to advanced AMD.
• Race. Whites are much more likely to lose vision from AMD than African Americans.
• Family history. Those with immediate family members who have AMD are at a higher risk of developing the disease.
• Gender. Women appear to be at greater risk than men.

Can my lifestyle make a difference?

Your lifestyle can play a role in reducing your risk of developing AMD.

• Eat a healthy diet high in green leafy vegetables and fish.
• Don't smoke.
• Maintain normal blood pressure.
• Watch your weight.
• Exercise.

Symptoms and Detection

What are the symptoms?

Both dry and wet AMD cause no pain.

For dry AMD: the most common early sign is blurred vision. As fewer cells in the macula are able to function, people will see details less clearly in front of them, such as faces or words in a book. Often this blurred vision will go away in brighter light. If the loss of these light-sensing cells becomes great, people may see a small--but growing--blind spot in the middle of their field of vision.

For wet AMD: the classic early symptom is that straight lines appear crooked. This results when fluid from the leaking blood vessels gathers and lifts the macula, distorting vision. A small blind spot may also appear in wet AMD, resulting in loss of one's central vision.

How is AMD detected?

Your eye care professional may suspect AMD if you are over age 60 and have had recent changes in your central vision. To look for signs of the disease, he or she will use eye drops to dilate, or enlarge, your pupils. Dilating the pupils allows your eye care professional to view the back of the eye better.
AMD is detected during a comprehensive eye exam that includes:

1. Visual acuity test. This eye chart test measures how well you see at various distances.
2. Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
3. Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional also may do other tests to learn more about the structure and health of your eye.
During an eye exam, you may be asked to look at an Amsler grid. The pattern of the grid resembles a checkerboard. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD.
Do NOT depend on the grid displayed below for any diagnoses-check with your eye care professional.

Amsler Grid (click above image for larger display)
If your eye care professional believes you need treatment for wet AMD, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

*THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT WHICH IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.