Age-related macular degeneration (AMD) can result in loss of central vision but usually doesn’t lead to total blindness. Treating AMD can delay its progress.

One notable advancement has been the creation of an effective treatment for the wet form of vasculitis based on injecting anti-VEGF agents. This represents an impressive breakthrough.

Dry Macular Degeneration

At its onset, dry macular degeneration begins with yellow deposits known as drusen appearing beneath the retinal pigment epithelium (RPE). At first, these small yellowish deposits have no impact on vision; later however, multiple medium-sized drusen may become visible and cause central blurring; finally at geographical atrophy stage there may even be dead tissue areas that develop within the macula and lead to loss of central vision.

At this stage, straight lines may begin to look wavy while the central field of vision becomes gradually distorted and lost. People in this stage can still read, drive and recognize faces; however, detail or colors cannot be recognized or noticed as clearly. If this stage occurs for you it’s essential that you seek medical advice as this could indicate progression towards wet macular degeneration.

If your health care provider confirms that you have dry AMD, taking steps to slow its progression may include quitting smoking, wearing sunglasses to decrease glare and eating a healthy diet that includes fruits and vegetables; vitamin supplements may also provide assistance.

Your eye doctor can diagnose dry AMD through a comprehensive eye exam that includes visual acuity tests and fundus photographs. They may also use fluorescein angiography, an additional diagnostic test designed to measure blood circulation in the macula by injecting special dye into your arm and then taking multiple photos as your back of eye reacts with it, giving them access to abnormal new blood vessels that form in wet macular degeneration.

Wet macular degeneration may be treated with medications known as VEGF inhibitors, which reduce the growth of new blood vessels and can slow damage progression to the macula. Unfortunately, however, these medications do have side effects and may not work effectively for all patients; your ophthalmologist can provide more information regarding them and select an optimal medication regimen suited to you and may suggest working with the U-M Kellogg Eye Center Low Vision Service as part of this approach.

Wet Macular Degeneration

When abnormal blood vessels that form wet AMD leak fluid and blood into the retina, they can lead to serious vision loss. Wet macular degeneration (also known as neovascular age-related macular degeneration – AMD) is far less common than dry AMD; those who have large drusen, many small drusen that run together or focal pigmentation on their retina are at greater risk.

When wet macular degeneration occurs, its fluid leakage can lead to retinal detachment and, left untreated, irreparable vision loss. Accumulated fluid beneath the retina may distort and obscure central vision causing distortion as well as straight-ahead and reading vision loss.

Wet macular degeneration is caused by an excess of the protein called vascular endothelial growth factor, or VEGF. VEGF stimulates abnormal blood vessel growth that bleeds blood into retina, leading to leakage of fluid into retinal tissues. Eye injections of anti-VEGF medications help inhibit their formation and limit fluid leakage from these abnormal blood vessels in retina.

Lucentis was the first FDA-approved treatment for wet macular degeneration and has shown to improve visual acuity in over 90% of patients, while Eylea is showing similar results; VRMNY physicians frequently switch between the two drugs in order to achieve optimal visual outcomes.

Treatment for wet macular degeneration involves frequent appointments and close monitoring of visual changes. Eye exams featuring funduscopic examination and optical coherence tomography scans of your retina can determine whether or not medication is working, as well as if symptoms have stabilized or improved.

Laser therapy may be used in certain cases of wet macular degeneration to destroy leaky blood vessels. This procedure, known as photodynamic therapy or laser vitrectomy, utilizes an light-sensitive drug administered via arm vein to be taken up by low density lipoprotein molecules which bind and dissolve retinal blood vessels – this treatment has proven successful for up to 40% of patients and improve their vision significantly.

Early Diagnosis

Early diagnosis can lead to improved results and quality of life, including better quality of life. Good nutrition and regular exercise can also help slow disease progression. Be sure to visit your healthcare provider on a regular basis, taking their advice on treatment as prescribed. Whenever possible, write down questions you want answered prior to visiting and bring along someone to help remember the answers – this way you’ll make the most out of each visit!

Macular degeneration screening programs that focus on early signs have been created as they are easier and less expensive than screening programs which target entire populations.

Treatment

AMD is a progressive disease, which gradually leads to central vision loss; however, treatments exist that may slow its progress or even restore lost sight. One such treatment method is intravitreal injection of drugs into the eye; this procedure is known as intravitreal injection and should take place under medical supervision while being numbed first. Avastin or Eylea injections block new blood vessel formation in the eye – known as exudative AMD; these injections should be given monthly with about an 85%-95% chance of avoiding severe vision loss while 30-40% chance of producing significant improvements ie: regaining lost central vision regaining lost central vision altogether.

Patient histories often provide us with indicators of macular degeneration. Patients may complain of a blurry spot near the center of their vision that grows larger and darker as the disease advances. Patients often report experiencing distortion in their vision, with lines on windowpanes or tiled floors appearing bent (metamorphopsia). Others experience difficulties reading, driving a car, recognizing faces or reading text books; for this reason it is recommended to test patients using an Amsler grid. The Amsler Grid is a grid that looks similar to a checkerboard, and patients are asked to cover one eye while staring at the black dot in its center. If any straight lines appear wavy, this indicates macular degeneration; treatment options can help improve vision if detected.

Research into treating advanced AMD is ongoing and focused on finding regenerative treatments to replace lost macular pigment epithelium cells, with stem cell transplantation and retinal cell replacement techniques particularly promising. Unfortunately, treating AMD once it reaches advanced stages cannot be accomplished; therefore it is vitally important to detect and treat AMD early before it has completely destroyed your macula.