Age-related macular degeneration (AMD) is an eye condition that affects central vision. This results in blurry or dimmed vision and makes reading, driving and seeing fine details difficult or impossible – although it does not usually lead to complete blindness.

Doctors have developed medications to effectively treat wet AMD by stopping abnormal blood vessels from leaking or bleeding into the retina. While injection is typically administered, researchers are working on developing eye drop versions.

Symptoms

Macular degeneration may cause blurry central vision, but does not lead to complete blindness. The condition usually progresses gradually and healthy eye compensates for vision loss by blurring its symptoms; often only becoming apparent in advanced stages; early diagnosis is key in order to prevent permanent vision loss.

As AMD progresses, small deposits called drusen appear in the macula. Although initially they don’t cause symptoms themselves, drusen are an early indicator that damage to retinal cells is occurring. Over time however, as more drusen accumulate, portions of retinal pigment epithelial layer (RPE) lose function, leading to central blind spots or “scotomas”. Over time RPE cells may break down completely, leaving large sections of central retina no longer functional; this phenomenon is known as geographic atrophy.

About 10% of patients develop an aggressive form of macular degeneration known as wet macular degeneration. In this instance, abnormal blood vessels may form underneath the retina and release fluid and blood into it, disrupting its normal functions. Wet AMD symptoms typically appear much quicker than dry AMD ones; symptoms can include distortions to straight lines as well as wavy or distorted images.

Wet macular degeneration can result in permanent blindness if left untreated, yet treatment with anti-vascular endothelial growth factor (VEGF) medication has proven successful in slowing or stopping its progression for 90% of patients and in slowing new blood vessels that leak and cause further vision loss.

Macular degeneration is diagnosed through a comprehensive eye exam with an ophthalmologist or optometrist. He or she will dilate your pupil using drops, then shine multiple light sources into your eyes to get a closer look at your retina and other parts. Sometimes this process uses optical coherence tomography which uses special light waves to scan your eyeball in painless and quick way – usually only taking moments!

Diagnosis

Your doctor will examine your vision by inspecting the retina, the layer of tissue at the back of the eye that processes light. They’ll look out for any yellow deposits called drusen that indicate macular degeneration; and may ask you to look at an Amsler grid – an array of straight lines similar to a checkerboard where any straight line that seems wavy or missing could indicate macular degeneration. They can use your medical history and these tests results to diagnose either wet or dry macular degeneration depending on their results and medical history, leaving an expert medical practitioner capable of making diagnoses or recommendations depending on results.

With dry macular degeneration, vision will gradually deteriorate over time. You’ll likely notice changes to your central vision as the blood vessels that supply the macula leak blood and fluid into surrounding tissue, interfering with its function and potentially leading to irreparable damage of its function.

People with large drusen or who accumulate multiple drusen that converge together are at greater risk for wet form of macular degeneration. In this form of the disease, abnormal blood vessels form under either retinal pigment epithelium or directly under retina and leak blood and fluid through into it, leading to rapid vision loss due to dead photoreceptors surrounded by fluid leakage.

if you suffer from wet macular degeneration, an NYU Langone ophthalmologist will prescribe medications that can stop new blood vessels from growing and prevent leakage of existing ones. They may come as oral pills or intravitreal injections.

Your doctor may suggest taking a genetic test to check for genetic changes that increase the risk of wet or dry macular degeneration. These tests generally involve taking a blood sample, which will then be sent off to be analyzed at a lab. If they detect a change, you should speak to your ophthalmologist regarding treatment options that would best suit you; follow-up visits are then necessary so he or she can assess how effective any therapies have been.

Treatment

Researchers have devised an eye-drop delivery system for macular degeneration medication used in treating dry age-related macular degeneration, the leading cause of blindness for people over 65, to treat macular degeneration – one of the main causes of blindness among those over 65 – which could give people who suffer from dry AMD the medication necessary to prevent further vision loss. Scientists from University of Birmingham’s “cell-penetrating peptide” delivery system has successfully transported drugs directly into retina within minutes and could also deliver anti-vascular endotheliokinase growth factor (VEGF) medications used against wet age-related macular degeneration (WARD).

Damaged by wet age-related macular degeneration, abnormal blood vessels can form and leak into the retina causing scarring of the macula and rapid loss of central vision. This process is known as neovascularization and treated using medications that stop their formation such as Lucentis and Eylea – available through VRMNY to minimize vision loss risks and slow progression in wet macular degeneration.

At photodynamic therapy, your eye doctor will administer anesthetic drops before using a laser to target light-sensitive medicine within your eye. Once activated by the laser, they’ll shine special lights onto your retina to close off abnormal blood vessels and seal any bleeding beneath your retina – this usually occurs on an ongoing basis in their office.

As wet AMD can progress more quickly than dry AMD, some patients require more frequent treatments like monthly injections of medication to slow blood vessel formation. Therefore, the exciting development at University of Birmingham with their cell-penetrating peptide delivery system may offer wet AMD sufferers access to treatment more conveniently and less invasively.

Prevention

Macular degeneration occurs when the macula, a small area at the center of your retina that allows for fine detail and color perception, becomes damaged. Damaged cells may lead to blurry central vision and blind spots appearing within your field of view, or it may progress rapidly leading to permanent vision loss or blindness. For best results, regular eye exams and promptly reporting any changes in vision should help protect against severe macular degeneration vision loss.

Non-exudative (or dry) macular degeneration is the most prevalent form of macular degeneration. This form usually develops gradually over a number of years and typically doesn’t result in total blindness; rather it makes reading, driving or recognising faces more challenging due to visual distortions such as wavy straight lines or other distortions in vision. Risks associated with non-exudative macular degeneration include smoking, high blood pressure, family history and age; it could even increase with smoking!

Wet macular degeneration occurs when abnormal blood vessels grow behind the eye and leak fluid or blood into the macula, disrupting its proper function and leading to permanent vision loss if left untreated. If left untreated, scarring of the macula may ensue and result in scarring leading to irreparable vision loss.

Treatments for wet macular degeneration focus on stopping new blood vessels from leaking fluid and damaging the macula, such as injections of medication into the eye by NYU Langone doctors that slow or even stop development of such fragile blood vessels; such treatments are known as anti-VEGF therapies and have proven successful at slowing or stopping progression of wet macular degeneration in many patients.

Laser photocoagulation can also help treat wet macular degeneration by eliminating abnormal blood vessels that are causing issues. After administering an anesthetic eye drop, your eye doctor will use an intense beam of light directed at areas on your retina where new blood vessels have appeared. Once sealed off, you can return home. Immediately following laser photocoagulation surgery, however, both eyes and skin may be sensitive to sunlight; so for the first few days following it’s important that you stay indoors or wear dark glasses whenever going outside.