Macular Degeneration

Age-related macular degeneration (AMD) is a progressive disease that affects the macula, the region of the retina responsible for central vision and fine detail. It is very common in adults ages 55 years or older. As the macula deteriorates, the central field of vision can develop dark, blurry or distorted areas. The visual effects of AMD can make it challenging to recognize faces or read a newspaper or book.

Although there is no cure for macular degeneration, the disease can be managed with the help of a reputable doctor, like Dr. Gregory Johnson or Dr. Gail Kelley of Intracoastal Eye.

What Causes Macular Degeneration?

The exact cause of macular degeneration is still largely unknown. Experts believe both hereditary and environmental factors may be to blame for the deterioration of the macular cells.

The disease is more likely to occur in adults over the age of 55, and those with a family history of AMD. It is more common in Caucasians than African-Americans or Hispanic-Americans. Smoking and being overweight are also thought to be risk factors for AMD.

Wet versus Dry Macular Degeneration

According to the American Academy of Ophthalmology, approximately 80 percent of cases of AMD are the dry or less serious form. In dry AMD, areas of the macula thin with age and protein can clump together, forming drusen. Visual clarity slowly deteriorates, and as areas of the macula start to die, blank spots can appear in central vision.

Wet AMD is the rarer and more serious form of the disease. New, abnormal blood vessels grow under the retina and macula and can leak blood or fluid. This can cause swelling or scarring on the macula. People with wet AMD are more likely to lose vision faster than those with dry AMD. Dark spots can appear in the central field of vision due to blood or fluid accumulating under the macula. Another symptom of wet and dry AMD is that straight lines can appear wavy.

The Diagnosis and Treatment of AMD

AMD is diagnosed with a comprehensive eye exam and testing using advanced technology. Dr. Johnson and Dr. Kelley use high-definition optical coherence tomography to scan the retina and obtain very detailed images of the retina and macula. The Amsler grid, which is a square containing a grid pattern and dot in the middle, can also be used to show problem areas in the visual field. Someone with AMD may notice that the lines of the Amsler grid look wavy or have blank spots.

Currently there is no cure for wet or dry AMD. However, some people with dry AMD take nutritional supplements specifically formulated with certain vitamins and minerals to slow the progression of AMD. Although these supplements cannot eliminate AMD altogether, they may stave off loss of vision to the disease. In cases of wet AMD, special anti-VEGF drugs can be injected into the eyes to reduce the number of abnormal blood vessels in the retina and macula. Sometimes laser therapy is used to seal off leaking blood vessels and reduce the number of vessels.

Frequently Asked Questions About Macular Degeneration

Are all cases of macular degeneration due to advancing age?

Most, not all, cases of macular degeneration are caused by age-related factors affecting the eyes. Early-onset macular degeneration has been linked to the use of certain drugs and inherited conditions such as Stargardt disease. Individuals who smoke or have a family history of macular degeneration are also at higher risk of getting the disease earlier than those who do not smoke or have a family history.

How does AMD affect vision?

It depends on the stage of the disease. Early AMD may not affect vision in any noticeable way, and may only be detected through a comprehensive eye exam.

As the condition gets worse, areas in the center of the visual field may become blurry, dark or blank. Straight lines may appear wavy. Night vision may be especially poor.

What are drusen?

Drusen are small particles or deposits of cellular debris that appear under the retina. Although a few small drusen are common in older adults and usually nothing to worry about, prominent drusen or large numbers of drusen can indicate the early stages of AMD.

How can I prevent my AMD from getting worse?

Our doctors recommend making healthy lifestyle choices, such as not smoking, wearing sunglasses to protect against ultraviolet light and eating a balanced diet of vitamin-rich foods like vegetables, fruits and fish.

Nutritional supplements with the AREDS/AREDS2 formulas, which contain several key minerals and antioxidants, are believed to be beneficial to individuals with the earlier stage of the disease (dry AMD).

What are anti-VEGF drugs?

Anti-VEGF drugs control the development of abnormal blood vessels. VEGF is an acronym for vascular endothelial growth factor, a protein that prompts the body to produce new blood vessels. Injecting anti-VEGF drugs into the eye slows down or prevents the production of weak or leaking blood vessels in cases of wet AMD.

During treatment with anti-VEGF drugs, the eye is completely numbed to prevent any pain or discomfort, and the injections last only a few seconds. The recommended frequency and number of anti-VEGF drug treatments varies by patient, but most patients benefit from treatments every four weeks.

Are there any surgical treatments for AMD?

A laser surgery called photocoagulation can help manage some cases of advanced AMD. The laser seals off abnormal blood vessels beneath the macula to stop them from leaking blood and other fluid. Although this treatment may not restore vision already lost to AMD, it can help slow down future vision loss.  

How do I cope with low vision due to AMD?

There are plenty of visual aids, accessibility features and special devices (e.g., magnifiers or telescopes) available to make reading and other daily activities easier to manage with low vision. Dr. Johnson and Dr. Kelley are happy to provide recommendations and resources.

Does AMD cause total blindness?

AMD does not cause total blindness because it does not affect peripheral vision. However, the disease can severely compromise central vision, which is key for reading, recognizing faces and seeing hand movements. Because central vision is critical to so many daily activities, vision loss to AMD is a serious matter.

Contact Intracoastal Eye

For more information about wet and dry AMD, please contact Dr. Johnson and Dr. Kelley at Intracoastal Eye today. You can call or send us an email.