Ninety percent of those diagnosed with ARMD have its dry form, which involves the gradual breakdown of macula on retina. It typically affects only central vision; peripheral (side) vision remains unaffected. Certain vitamins and minerals as well as balanced diet and regular visits to eye care professionals may help slow its progression.

Early Diagnosis

Age-Related Macular Degeneration (AMD), one of the leading causes of severe vision loss among adults over 50, involves changes to the macula – a small portion of the retina located inside back layer of eye – due to changes in its cells. AMD can be divided into two stages – “dry” or atrophic and “wet” or exudative AMD. At UF Health experts advise individuals over 50 receive regular comprehensive eye exams to detect this disease, reporting any changes or signs or symptoms to their doctor immediately.

Dry AMD typically starts out with blurred vision due to retinal damage thinning, leading to distortions of straight lines, decreased ability to see fine details and colors, as well as blind spots in the center of vision. However, unlike wet macular degeneration which progresses rapidly with no effective treatment options available – dry AMD usually progresses slowly with easier treatment options available than wet macular degeneration.

Wet AMD is more severe than dry, often leading to sudden and rapid vision loss as new blood vessels form at the back of the eye and leak fluid or blood into the macula, leading to scar tissue formation. Although difficult to treat quickly and early intervention can reduce risks of permanent vision loss.

Fluorescein angiography and optical coherence tomography (OCT) tests from UF Health can quickly diagnose wet AMD. These noninvasive procedures involve injecting light-sensitive dyes into your eye, followed by high-resolution images taken by an OCT instrument which produces color maps of your retina – which allows us to track abnormal blood vessels that may later require laser surgery for removal, as well as medications like bevacizumab, ranibizumab, or pegaptanib which are directly injected into your eye to inhibit angiogenesis – the process whereby new blood vessels form.

Diagnosis of Dry AMD

In dry AMD, the light-sensing cells in the macula begin to break down. These cells send signals to the brain that allow you to see straight lines, shapes and colors. As the number of these cells decrease, the person’s central vision becomes blurry. In dim lighting, the person may also notice a blank spot in the center of their vision. These changes are usually gradual and don’t affect peripheral (side) vision. The classic early symptom of dry AMD is that printed words or straight lines appear wavy or blurry. These problems are caused when fluid from leaking blood vessels lifts the retina off the back of the eye, distorting vision.

If a person has wet AMD, it develops when abnormal new blood vessels grow under the retina and leak blood and fluid. This damages the macula and causes rapid loss of central vision. Wet AMD can be treated with medications injected into the eye or by laser surgery that destroys the fragile, leaky blood vessels. These treatments are most effective if started when the condition is wet and before vision has been lost.

Researchers don’t know what causes the wet form of AMD, but it is believed that a gene deficiency plays an important role. It is also known that certain vitamins and minerals can slow the progression of dry AMD to wet AMD, including dark leafy green vegetables, fish, vitamin E and zinc. Your ophthalmologist can recommend the best combination of supplements for you, based on what your risk is for wet AMD.

There is no treatment for dry AMD, but a few patients will progress to wet AMD. For those, there are drugs injected into the eye called anti-vascular endothelial growth factor (anti-VEGF) that reduces the formation of new blood vessels and slows leaking of existing ones. The drug is delivered to the eye through a very slender needle. Optical coherence tomography angiography, which produces cross sectional images of the retina and macula, can be used to identify drusen and other signs of wet AMD. This test is similar to fluorescein angiography but does not require dye.

Diagnosis of Intermediate AMD

At this stage of AMD (non-exudative), doctors typically observe large, yellow deposits underneath the retina called drusen that have grown larger or more quickly than usual. While not yet causing visual loss, macular degeneration is progressing into its advanced stage for about 15%-20% of patients; left untreated this progression could lead to severe vision loss that causes difficulty reading, driving at night and recognising faces along with reduced depth perception and lack of depth perception.

At this stage, the disease can also begin to distort straight lines by leaking fluid from compromised blood vessels beneath the macula which raises it from its regular position, distorting central vision and distorting straight lines into curves or waves.

Wet macular degeneration (WMD) is an aggressive form of AMD that progresses more quickly. If left untreated, this form can quickly lead to vision loss or blindness as abnormal blood vessels form behind the eye and begin leaking blood and fluid onto the macula, damaging retinal tissues quickly and accelerating vision loss. Wet AMD often manifests by abnormal blood vessels growing behind one or both eyes that start leaking fluid under it which damages it rapidly causing irreparable retinal damage and vision loss.

Fluid and blood can raise the macula out of its normal position and distort central vision, creating dark or empty patches in your central field of view. It is wise to consult your physician if any changes in your vision arise, including darkened or empty spots at the center.

Advanced macular degeneration cannot be reversed, but diet supplements and early diagnosis may help delay its progress into wet form, which causes irreparable vision loss. AREDS trials demonstrated that high-dose nutritional supplementation with antioxidants and zinc significantly decreased the risk of progression to advanced AMD, along with associated vision loss. Physicians highly advise these supplements for their patients. They encourage patients to use an Amsler Grid at home, a simple yet reliable test which helps identify any changes to your vision that you might otherwise miss. Patients are advised to monitor their vision regularly using this grid and report any unusual alterations immediately to their ophthalmologist.

Diagnosis of Advanced AMD

Treatment options for advanced AMD may include vitamin supplements, lifestyle modifications and medical procedures. Though these measures won’t stop AMD from progressing further, they may help slow vision loss. Patients should make regular visits to their eye care provider in order to obtain an accurate diagnosis and the appropriate treatment options.

AMD is an insidious condition that gradually destroys our central vision – essential for reading, driving and seeing fine details – which affects the retina – the thin layer of tissue responsible for sending light signals from your eyeball to your brain – leading to blurred, wavy or dark spots in central vision as well as difficulty seeing straight lines, having dark or empty spaces in the center of vision, difficulty distinguishing colors etc. However it usually doesn’t lead to total blindness but symptoms can include difficulty seeing straight lines, difficulty seeing straight lines, difficulty distinguishing colors etc.

Though AMD cannot be prevented entirely, you can reduce your risk by eating a diet rich in nutrients found in leafy green vegetables and berries, wearing sunscreen to protect your eyes, not smoking and maintaining a healthy weight. Age is the greatest risk factor; those aged 50+ being at highest risk. Genetic link is another contributing factor; people who have an immediate family member with AMD are more likely to develop it themselves; additionally gender can play a factor as women are more prone than men to developing it.

At first, AMD manifests as yellow deposits known as drusen under the retina. While initially harmless, as AMD progresses these can grow larger and cause blurry spots in your central vision. Next comes atrophic areas of retina with sharp borders or more generalized areas forming over time; then comes wet macular degeneration when abnormal blood vessels leak fluid into the macula, leading to either sudden or gradual decreases in visual acuity and distortion of straight lines.

Anti-VEGF treatments, also known as eye injections using fine needles and eye drops that numb, may help slow the progression of wet macular degeneration.