Ten percent of those with AMD progress to its more severe wet form. In this instance, abnormal blood vessels form and leak fluid, leading to rapid vision loss.

An initial step to diagnosing wet AMD is conducting a funduscopic eye exam, which typically entails having your eyes dilated and may include color photography or fluorescein angiography.

Dry macular degeneration

At the early stage of dry macular degeneration, small deposits under the retina known as drusen can accumulate and lift from its normal position, creating visual distortions. Your eye health specialist may recommend looking through an Amsler grid designed specifically to detect distortions; hold this at an ideal reading distance and cover one eye at a time while looking out for areas in which lines appear wavy or interrupted.

As the disease advances, drusen grow larger and become more frequent while the macula thins, leading to loss of central vision. Straight lines such as door frames and lampposts may no longer appear straight; you might also detect blank or dark spots (scotomas) in your vision which makes reading or driving difficult; eventually your ability to recognize faces and enjoy hobbies could diminish as a result of such changes in central vision.

10-15 percent of those diagnosed with dry AMD will progress to wet AMD over time, where abnormal blood vessels grow under the retina and leak blood and fluid into the eye, leading to faster and more severe vision loss; potentially leading to permanent blindness.

If you have wet AMD, it is important to see your doctor regularly as this condition can rapidly worsen. Treatment involves regular injections of an eye medication into each eye – typically monthly or every other month – in order to stop abnormal blood vessel growth that could potentially result in further vision loss.

As soon as you’re over 50, visiting an eye doctor regularly is one of the best ways to protect your vision and stay on top of macular degeneration and other health concerns. Additionally, tobacco should be avoided and diet rich in antioxidants such as lutein and zeaxanthin may reduce AMD risks; studies have demonstrated this.

Wet macular degeneration

Some individuals with dry macular degeneration progress to wet form of disease, in which abnormal blood vessels form beneath the retina and leak fluid and blood, damaging macula and leading to distortion or blind spots in center of eye (see Figure). Wet macular degeneration can appear suddenly.

Your doctor will perform several tests to identify wet macular degeneration, such as reviewing your medical history and conducting eye exams, visual field tests, slit lamp exams and optical coherence tomography scans to see whether new blood vessels have formed under your retina. Your physician may suggest using an Amsler grid at home to monitor central vision and notify them immediately if straight lines become wavy, blurry or dim.

Wet AMD is caused by a protein called Vascular Endothelial Growth Factor (VEGF). This protein promotes the formation of new, unhealthy blood vessels which leak fluid and blood into the retina, damaging it and leading to vision loss. Lucentis and Avastin are among several drugs designed to block VEGF activity and slow or stop its progress; another effective anti-VEGF therapy called brolucizumab also exists as an option that has proven successful with many patients.

Other treatments for wet macular degeneration may include laser treatment and photodynamic therapy. A laser can seal off leaking blood vessels with precision while an injection of medication could close them off quickly.

Age-Related Macular Degeneration Studies (AREDS and AREDS2) found that taking zinc, vitamins C and E, plus lutein and zeaxanthin can significantly lower your risk of progressing from intermediate to advanced wet AMD by 25 percent – protecting your vision in the process. In addition to nutritional supplements, diet and regular exercise play an integral part in protecting vision loss – regular eye exams in older adults are especially vital as early detection of macular degeneration can prevent irreparable vision loss.

Diagnosis

AMD patients can still see well enough to move around safely, yet may experience difficulty reading, driving and recognising faces. Therefore, it’s essential for first-line health care professionals to understand AMD and recognize early warning signs – such as distortion or wavy lines on an Amsler grid (see below).

Macular degeneration (AMD) is an irreversible condition which gradually reduces central vision, making reading, driving and daily tasks increasingly difficult for those over 50. AMD is the primary cause of irreversible blindness among adults aged 50 and up and can take two forms: dry and wet AMD. Dry AMD occurs when light-sensitive cells in the macula break down over time leading to deposits under the retina called drusen accumulation; wet AMD occurs when abnormal blood vessels grow under the retina leaking fluid into macula from underneath; wet AMD can lead to rapid loss of vision due to abnormal blood vessel growth under retina leaking fluid into macula cells from under retinal blood vessel leakage into macula tissue and damage of macula cells over time leading to deposits forming under retinal deposits known as drusen formation; there are two forms: dry and wet AMD;

Both types of AMD can be managed, though not cured, with healthy diet and weight management and refraining from smoking being effective strategies for limiting further loss of vision. Regular visits to an eye care professional should also be made.

At an eye exam, doctors will test your best corrected vision and examine your retina, the back layer of tissue at the back of the eye that processes light. They’ll look out for yellow deposits known as drusen beneath your retina – an early telltale sign of macular degeneration – as well as test your ability to detect straight lines by asking you to view an Amsler grid made up of horizontal and vertical lines with straight horizontal and vertical lines, to see if you detect any that appear wavy or faded; they will use optical coherence tomography which produces cross sectional images of the retina to look for abnormal blood vessels or leakage of fluid within it.

Fluorescein angiography may also be used, which involves injecting dye into one arm and taking multiple photos of the back of your eye to check for new blood vessels or leakage of fluid under your retina. Results typically become available within one week.

Treatment

At later stages of AMD, your macula gradually degenerates, leading to central vision loss that makes reading, driving or recognising faces difficult; however, peripheral vision typically remains undisturbed.

Your eye doctor will conduct various tests that utilize photography or imaging technology to examine the retina. They may suggest you use an Amsler grid as a means of monitoring any changes to your vision, especially any that involve lines appearing wavy, blurry or dim; such changes could indicate macular degeneration.

If your doctor suspects wet AMD, they may conduct a special test called fluorescein angiography. This involves injecting dye into your arm, before looking at your eye with a magnifying device and camera that captures images of the blood vessels in your eyes to assess whether they’re leaking fluid and distorting vision. This test can reveal whether blood vessels behind your macula are leaking fluid that leads to distortions of vision.

Some treatments can slow the progression of wet macular degeneration and stave off further vision loss, including drugs known as angiogenesis inhibitors that work by blocking chemicals produced in your body that stimulate the formation of new blood vessels. While injections into your eye are currently available, newer formulations of angiogenesis inhibitors have recently been created as eye drops as well.

If you have wet AMD, your doctor may also suggest photodynamic therapy (PDT). PDT uses Visudyne in combination with laser light therapy to seal leaky blood vessels and prevent further vision loss. It can be performed in the eye clinic without being as invasive as expected.

University of Illinois at Chicago researchers have developed a new compound that may offer non-invasive alternative to injections for wet macular degeneration. A paper published by Yulia Komarova and colleagues in Cell Reports Medicine details their discovery of an inhibitor which reverses epigenetic changes related to age that lead to wet AMD.

Ultimately, this discovery could pave the way for an easy-to-use medication without regular injections that would revolutionise treatment for this common eye condition. Unfortunately, no treatment for AMD can restore vision; therefore it’s vitally important that early diagnosis can ensure effective therapies can be put in place as quickly as possible.