Macular Degeneration (AMD)

What is macular degeneration?

About 20 million adults in the United States have macular degeneration, as it’s the leading contributor to vision loss in people aged 60 and older. Age-related macular degeneration (AMD) is a chronic eye disease that affects the macula, a small area in the center of the retina responsible for sharp, central vision. 

What are the different types of macular degeneration?

There are two types of macular degeneration: 

Early Dry macular degeneration 

Early Dry macular degeneration affects nearly 90% of people with macular degeneration. It develops when tiny protein deposits called drusen form under the macula, causing inflammation and mild or no symptoms.  Most people at this stage do not know that they have macular degeneration unless they have had an eye exam.  Early symptoms when they do occur include more difficultly in dim light or difficulty adjusting from bright to dark (dark adaptation) environments.  Many people with macular degeneration never advance beyond the early dry stage.  

Advanced macular degeneration (Dry or Wet)

Around 10% of people with macular degeneration have disease progression and develop one (or both) of the advanced forms of macular degeneration.  There is a dry and a wet advanced form of the disease.  “Wet” means that there is a leakage or buildup of fluid in the retina.   “Dry” means there is not.  The advanced wet form is known as “Neovascular”, or “Wet macular degeneration” and the advanced dry form is known as “Geographic Atrophy” or “GA.”  Both advanced forms of AMD can cause central vision loss.  Wet AMD tends to develop suddenly, and Geographic Atrophy tends to evolve slowly.

Wet macular degeneration 

Wet macular degeneration occurs when the retina becomes damaged and new abnormal blood vessels grow underneath of the retina and leak fluid and blood.  This can cause distortion or a partial blind spot in the vision. The wet form is more severe and can cause permanent vision loss unless it is treated quickly. 

We have very effective treatment for Wet macular degeneration, which can stop the progression of vision loss or even restore vision when treated early before scar tissue develops.

While there’s no cure for this eye disease, early detection and treatment significantly increase your chance of maintaining your vision even if you have advanced AMD. 

Geographic Atrophy (GA)

Geographic atrophy, also known as GA, is the advanced dry form of macular degeneration.  In GA, there is a progressive loss of cells in the macula, leading to a gradual deterioration of central vision. 

The term “geographic” refers to the appearance of patches of atrophy in the macula that resembles the shape of a map, with irregular borders of varying sizes.  These areas of atrophy result from the death of the retinal pigment epithelial (RPE) cells and photoreceptors (light-sensing cells).

Symptoms of geographic atrophy include blurred or distorted central vision, difficulty reading or recognizing faces, and decreased contrast sensitivity.  Peripheral vision usually remains intact, but the loss of central vision can significantly impact daily activities such as reading, driving, and recognizing faces.

Geographic atrophy currently has no cure, but there were two novel treatments FDA-approved in 2023 aimed at slowing down the progression of the disease and preserving the vision in affected individuals.

Regular eye exams are crucial for the early detection and management of AMD.

What are the symptoms of macular degeneration?

The symptoms of macular degeneration include:

• Central vision loss
• Gradual or rapid vision loss
• Blurred vision
• Reduced ability to see in dim light
• Seeing colors differently
• Poor vision
• Seeing straight lines as wavy or curved
• Blank or dark spots in your vision

You may not notice anything unusual initially, but your eye doctor can detect even subtle changes during a routine eye exam.

Losing your central vision might make it difficult to drive, read, cook, recognize faces, do home repairs, or work at your job. Severe macular degeneration can cause legal blindness. 

How is macular degeneration diagnosed?

Diagnosing macular degeneration requires an eye exam and vision testing. Dr. Brader examines your retina and macula during a dilated eye exam to look for irregularities.  Main Line Retina has the most advanced imaging technology, including tests that help to identify abnormalities and subtle problems before they affect your vision.

How is macular degeneration treated?

Treating macular degeneration may involve:

• Nutritional supplements
• Medications
• Lifestyle modifications
• Laser therapy

You might take supplements (AREDS2) containing vitamin C, vitamin E, zinc, lutein, zeaxanthin, copper, or other nutrients. 

Lifestyle changes you can make to reduce your risk of macular degeneration include not smoking, maintaining a healthy weight, exercising regularly, eating nutritious foods, and maintaining healthy cholesterol and blood pressure levels.

You might be asked to monitor your vision at home to detect subtle changes in your vision in between visits.  An Amler Grid is an eye test that you can use at home where you view a grid of straight lines with a large dot in the center to identify blurry, wavy, or broken lines. You might also monitor your vision at home with a computerized device (ForeSee Home Monitoring) that can detect changes at an even earlier stage.

Schedule an eye exam at Main Line Retina by phone or online today to screen for macular degeneration.