Age Related Macular Degeneration

AMD has two forms - wet and dry. Below is an overview of wet and dry AMD

macula

The macula is a small, oval-shaped area near the center of the retina in the eye. It is responsible for central vision, which allows us to see fine details clearly. The macula contains a high concentration of photoreceptor cells called cones, which are responsible for color vision and visual acuity.

There are two main parts of the macula: the fovea and the parafovea. The fovea is at the center of the macula and is the most critical region for sharp vision. It has a high density of cones and is responsible for the perception of fine details. The parafovea surrounds the fovea and also plays a role in visual acuity but to a lesser extent.

Age-related macular degeneration (AMD) is a common eye condition that affects the macula and can result in vision loss, particularly in the central field of vision. It is one of the leading causes of vision impairment in older adults. There are two types of AMD: dry AMD, which involves the gradual breakdown of cells in the macula, and wet AMD, which involves abnormal blood vessel growth that can lead to leakage and damage.

Regular eye exams are important for detecting conditions like AMD early, as early intervention can sometimes help slow the progression of the disease and preserve vision.

amddrusen

Dry macular degeneration, also known as atrophic or non-neovascular AMD (age-related macular degeneration), is a common eye disorder that affects the macula, the central part of the retina responsible for sharp, central vision. This condition is more prevalent among older adults and is a leading cause of vision loss in people over the age of 50.

In dry macular degeneration, there is a gradual breakdown or atrophy of the light-sensitive cells in the macula, particularly the retinal pigment epithelium (RPE) cells. The RPE cells play a crucial role in supporting the health and function of the photoreceptor cells, such as cones, in the macula.

As the RPE cells deteriorate, the photoreceptor cells can also be affected, leading to a loss of central vision. Dry AMD typically progresses slowly over time. It may cause symptoms such as:

  1. Blurred central vision: The gradual loss of sharpness in the central vision can make it challenging to read, recognize faces, or see fine details.
  2. Distorted vision: Straight lines may appear wavy or distorted, a phenomenon known as metamorphopsia.
  3. Difficulty seeing in low light: Reduced ability to see clearly in dimly lit environments.

Unlike wet macular degeneration, which involves the growth of abnormal blood vessels beneath the macula, dry AMD does not typically involve leaking blood vessels. However, in some cases, dry AMD can progress to the wet form.

Currently, there is no cure for dry macular degeneration, but certain lifestyle changes, nutritional supplements, and regular eye exams are recommended to manage the condition and monitor its progression. It’s crucial for individuals with AMD to work closely with their eye care professionals to determine the best course of action for their specific situation.

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amdwet_fp_cnvm

Wet macular degeneration, also known as neovascular or exudative AMD (age-related macular degeneration), is a more advanced and severe form of AMD compared to the dry form. It represents a relatively smaller proportion of AMD cases but is responsible for a significant majority of severe vision loss associated with the condition.

In wet macular degeneration, abnormal blood vessels (choroidal neovascularization) grow beneath the macula, the central part of the retina responsible for sharp, central vision. These abnormal blood vessels are fragile and prone to leaking blood and fluid into the surrounding retinal tissues. This leakage can cause damage to the macula and lead to rapid and severe loss of central vision.

The symptoms of wet AMD can include:

  1. Distorted vision: Straight lines may appear wavy or distorted.
  2. Blind spots: Dark or blurry areas in the central field of vision.
  3. Rapid loss of central vision: Vision loss can occur relatively quickly, sometimes over a matter of days or weeks.

Wet AMD can develop independently or as a progression from dry AMD. It is essential for individuals with AMD to monitor their vision regularly and seek prompt medical attention if they notice any changes.

Treatment options for wet macular degeneration have improved over the years. Anti-vascular endothelial growth factor (anti-VEGF) drugs are commonly used to inhibit the growth of abnormal blood vessels and reduce leakage. These medications are often administered through injections into the eye. Photodynamic therapy and laser therapy are additional treatment approaches that may be used in certain cases.

Early detection and timely intervention are crucial in managing wet AMD and preventing further vision loss. Regular eye exams and monitoring of symptoms are essential for individuals at risk of AMD or those who have already been diagnosed with the condition.

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DR. PAUTLER'S BLOG

American Academy of Ophthalmology

What Is ARMD?

The basics about AMD

MedlinePlus

Macular Degeneration

Extensive list of links from excellent sources

National Institutes of Health

ARMD

NIH’s SeniorHealth website covers the topic of Age-Related Macular Degeneration

National Eye Institute

ARMD Resource Guide

Answers questions about causes and symptoms, and discusses diagnosis and types of treatment.

ARMD What You Should Know

Booklet covering the same topic as provided in the NEI website, in printable PDF format.

AREDS Information

Age-Related Eye Disease Study

American Foundation for the Blind - Senior Site

Macular Degeneration

Basic information about AMD and low vision; includes a self-test using an Amsler Grid

WebMD

Macular Degeneration

Detailed article covering all aspects of AMD.

LightHouse International

Macular Degeneration

Provides a general overview of the basics of AMD, and a simulation showing a scene as it might be viewed by a person with AMD

Prevent Blindness America

AMD Learning Center

AMD basics and links to relevant news stories