Age-Related Macular Degeneration (AMD)
AMD is a common eye disease
associated with aging that
gradually destroys sharp, central
vision. Central vision is needed for
seeing objects clearly and for
common daily tasks such as
reading and driving. In some
people, AMD advances so slowly
that it will have little effect on
their vision as they age. But in
others, the disease progresses
faster and may lead to a loss of
vision in one or both eyes.
Types

AMD occurs in two forms. Wet (vascular) and dry
(atrophic). Although only ten percent of all people
with AMD have wet AMD, it is responsible for the vast
majority of severe, AMD-related vision losses. As dry
AMD worsens, new blood vessels may begin to grow and
cause wet AMD. Because these new blood vessels tend
to be very fragile, they will often leak blood and fluid
under the macula. This causes rapid damage to the
macula that can lead to the loss of central vision in a
short period of time.

Dry AMD affects the other ninety percent of cases. The
earliest sign of dry AMD is the development of waste
material deposits, called drusen, that appear as tiny
orange or yellow dots among the retinal pigment
epithelial cells. These deposits are initially tiny and
few in number, but they may grow larger and become
more numerous. Scientists are still not sure what
causes dry AMD. Studies suggest that an area of the
retina becomes diseased, leading to the slow
breakdown of the light-sensing cells in the macula and
a gradual loss of central vision.

Causes

Most cases of macular degeneration are age-related,
meaning older people are more likely to have it. Risk
factors include: being white or female, having a family
member with AMD, smoking, high blood pressure,
farsightedness and obesity. The exact causes are still
unknown. Because the condition often runs in families,
AMD may be hereditary.

Symptoms

The main symptom is central vision loss, which is
gradual in dry AMD and sudden in wet AMD. Other
symptoms include blurry or fuzzy vision, dark spots in
the center of vision, difficulty reading or performing
detail work; and seeing straight lines as wavy or bent.

Treatments

No treatment currently exists for dry AMD. It has been
suggested that taking certain extra vitamins and
minerals may slow the progress of the disease. But this
treatment needs much more research before scientists
can know for sure if it's helpful.

There are two FDA approved treatments available for
wet macular degeneration: photocoagulation and
photodynamic therapy.

Surgeons use laser photocoagulation to treat leakage
that results from wet AMD. The laser beam burns
abnormal blood vessels to seal the leakage. By slowing
or stopping the leakage, the progression of macular
degeneration is also slowed or stopped. Only about
one-tenth of patients with wet AMD are candidates for
this procedure.

Photodynamic therapy (PDT) is a minimally invasive
outpatient procedure. The procedure involves a
light-activated drug and low-intensity, or
non-thermal, laser light. The eye is numbed with eye
drops and a special contact lens is placed on the eye.
The light-activated drug is then administered
intravenously. The laser light is directed through the
contact lens to the affected area of the retina and
closes up leaky blood vessels. Patients may require
recurrent treatments as often as every 3 months for the
first year. After the first year, treatment is required
less frequently.