Millions of people living with AMD enjoy an excellent quality of life, driving and walking safely, reading, and watching television are all things they are able to do without issue.

Early signs of dry macular degeneration include deposits known as drusen. Although drusen alone do not cause vision loss, their increased size puts you at greater risk for intermediate or advanced stages of macular degeneration.

Dry AMD

AMD occurs when parts of the macula thin with age and develop protein deposits known as drusen, gradually diminishing vision over time. Current treatments do not provide a cure for advanced dry AMD, which usually leads to the loss of central vision; however, treatment may help slow its progress and help prolong life expectancy. Treatment for dry AMD typically entails taking antioxidant vitamins and minerals such as beta-carotene, vitamins C, E and zinc oxide in either eye drops or pills form. According to research from the National Eye Institute’s Age Related Eye Disease Study trial (AREDS), high doses of these nutrients significantly slow progression from intermediate stages of macular degeneration into advanced stages.

Wet macular degeneration occurs when new blood vessels grow beneath the retina and leak fluid or bleed, damaging the macula and leading to rapid central vision loss. Roughly 90% of people living with macular degeneration suffer from this more serious form.

Even though scientists don’t fully understand what causes wet AMD, they do know it’s more likely to appear if you smoke or have risk factors like high blood pressure, obesity and heart disease.

Treatment options available to address wet AMD focus on slowing the formation of new blood vessels. Eye care professionals typically employ fluorescein angiography as one way of looking at blood vessels in your retina and macula, whereby yellow dye injected into one arm travels through blood vessels into photos taken of your eye as the dye travels through them. Furthermore, optical coherence tomography provides very detailed images that allow eye doctors to detect abnormal new vessels in real time.

Intermediate AMD

At the intermediate stage of AMD, individuals will notice symptoms including blurry central vision or difficulty seeing in low light. While these aren’t as severe as advanced AMD symptoms, they still make reading and driving difficult as well as close-up work like cooking or fixing things around the house. Luckily, treatment options have greatly increased since this stage was first identified.

A proven treatment for dry AMD is taking the AREDS formula of vitamins: zinc, copper, lutein and zeaxanthin. Studies have demonstrated this supplement can decrease progression towards advanced AMD. Furthermore, patients should maintain a diet rich in dark green vegetables, fish and healthy fats while limiting smoking and sun exposure as much as possible; regular retinal examinations are key in order to detect AMD early.

Researchers are exploring a number of biomarkers that can predict AMD from early-intermediate stages to later wet macular degeneration stages and serve as tools for evaluating potential new treatments. One test, using measurements such as best-corrected visual acuity, low luminance visual acuity, microperimetry and cone contrast testing is capable of distinguishing disease stages well and can serve as a good predictor of progression from early-intermediate AMD into later wet macular degeneration stages.

Recently, pegcetacoplan was approved as an FDA-approved medication to treat wet AMD. This new treatment works by decreasing levels of vascular endothelial growth factor (VEGF) in the eye – this helps stop new blood vessels from growing while blocking leakage from existing ones, both contributing factors of wet macular degeneration.

Advanced AMD

Advanced AMD causes central vision to decline to such an extent that driving, reading or recognising faces no longer becomes possible. This makes carrying out normal daily activities more challenging as well as hindering participation in social, cultural and sporting activities. Luckily there are treatments which may slow or even reverse disease progression and even improve vision in some instances.

Central vision is the sharpest and clearest portion of your retina that allows you to see fine details, recognize faces, drive safely and shop. Macular degeneration affects central vision in two ways – dry macular degeneration occurs with yellow deposits called drusen beneath the retina that expand and damage it progressively; over time this advanced AMD progresses into geographic atrophy where retina cells waste away and die (an irreversible process).

Wet macular degeneration occurs when abnormal blood vessels form beneath the retina and release fluid or blood, blurring and distorting central vision. Though less common than its dry counterpart, wet macular degeneration is more dangerous because its rapid progression increases vision loss significantly.

Although wet AMD cannot be reversed, treatment can slow the progression and even improve vision in certain cases. Anti-VEGF injections provide one effective therapy. These drugs target and block specific growth factors found within your eye that promote new blood vessel formation; treatment requires multiple visits a month with multiple injections required at each visit – your eyes will be numbed for each visit to ensure maximum comfort during each appointment.

Laser Surgery

Lasers are widely utilized in medicine. From general surgery procedures such as cutting or extracting tissue to treating eye diseases like glaucoma and birthmark removal. Furthermore, YAG lasers are also often employed for cosmetic surgery on facial and neck skin to remove wrinkles or imperfections.

Laser photocoagulation is an effective treatment for wet macular degeneration caused by choroidal neovascularization (CNV), in which new blood vessels form under the retina, leading to fluid or blood leakage into the macula and damaging its cells. Laser photocoagulation destroys abnormal vessels to stop further damage.

Femtosecond laser technology has revolutionized surgical treatments such as SMILE – an advanced cataract procedure using small incisions. It’s far less invasive than traditional surgery and reduces time under the microscope while simultaneously decreasing swelling and scarring.

A YAG laser can also be used to punch holes in the iris of an eye to relieve increased pressure associated with acute angle-closure glaucoma, and treat common birthmarks known as port wine stains on facial and neck skin, caused by malformed blood vessels that absorb green light but reflect red. A YAG laser can also be used to remove blood vessels that create this birthmark as it seals small vessels more effectively than cutting blades while causing less bleeding than traditional surgery techniques.

Injections

Wet macular degeneration occurs when abnormal blood vessels form under the retina at the back of your eye and leak fluid and form scar tissue, leading to severe vision loss and leading to blank spots in your central vision.

Though wet AMD can be more severe than dry AMD, it’s also treatable. Your ophthalmologist will prescribe medication to stop abnormal blood vessel growth (neovascularization) that leads to wet AMD; such injections include bevacizumab, ranibizumab and pegaptanib.

Your doctor will administer eye injections every four weeks to manage wet AMD. A new treatment, brolucizumab, may reduce injection frequency by half.

UF Health is conducting research on another potential new treatment for wet AMD: zinc, copper, lutein and zeaxanthin are proven to lower risk. Your ophthalmologist will work with you to create an appropriate nutritional plan.

Early diagnosis of AMD is crucial to safeguarding your sight. If you notice blurry or distorted central vision, wavy lines in your field of view, faded colors or hues that seem faded or dull then make an appointment immediately with us. Although there is no cure for AMD yet there are ways to slow its progress and enhance quality of life such as magnifiers and tinted glasses; and assistance from organizations providing low vision aids.