Adult Macular Degeneration

Overview

Definition

Adult macular degeneration (AMD) is an eye disease that results in a loss in central vision that gets worse over time. The macula is the part of the retina that controls central vision. The retina is the tissue that lines the back of the eye. AMD happens when the macula wears down.

There are two types:

  • Dry form—parts of the macula get thinner and protein deposits called drusen affect vision
  • Wet form—new blood vessels grow under the macula and begin to leak blood and other fluids into the retina
Macular Degeneration
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Causes

The cause is not known. It may be due to a combination of genetics and the environment.

Risk Factors

This problem is more common in adults 50 years of age and older. It is also more common in people with dark-colored eyes.

Other things that may raise the risk are:

  • Prior cataract surgery
  • Farsightedness
  • Smoking
  • Excessive exposure to sunlight
  • A diet that is low in certain vitamins and minerals
  • Alcohol use disorder
  • Heart disease
  • Obesity
  • Having other family members with AMD

SymptomsandDiagnosis

Symptoms

In some people, AMD slowly gets worse and has little effect on vision. In others, it moves quickly and may lead to significant vision loss. It does not cause pain.

Problems may be:

  • Blurred eyesight that may go away in brighter light
  • Problems seeing details in front of the eyes, such as faces or words in a book
  • A small, but growing blind spot in the middle of a person's field of vision
  • Straight lines (such as door frames) appear crooked or distorted

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This may be enough to suspect AMD.

A doctor who treats eyes will do an eye exam and view the retina. This can confirm the diagnosis.

Some people may need images taken of the eyes. This can be done with:

  • Angiography—a dye is used to make blood vessels easier to see
  • Optical coherence tomography (OCT)—uses a dim red light to take a picture of the retina

Treatments

Treatment

Treatment depends on the type and severity of AMD.

Dry AMD

Dry AMD cannot be treated. These things may slow the disease:

  • Vitamin and mineral supplements
  • Not smoking

Wet AMD

The goal of treating wet AMD is to reduce or destroy new blood vessels. Choices are:

  • Laser photocoagulation to destroy new blood vessels with a strong laser light beam
  • Photodynamic therapy uses a light-sensitive dye and laser light to destroy problem blood vessels
  • Vascular endothelial growth factor inhibitor is a medicine that is injected in the fluid in the back of the eye to reduce the number of new blood vessels

Prevention

To lower the risk of this problem:

  • Eat a healthy diet that is rich in fruits, vegetables, fish, and nuts.
  • Make sure to get enough vitamins and minerals.
  • Use a hat and sunglasses when outside.
  • Do not smoke.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Age-Related Macular Degeneration, AMD)

RESOURCES

American Macular Degeneration Foundation https://www.macular.org 

Macular Degeneration Foundation http://www.eyesight.org 

CANADIAN RESOURCES

AMD Alliance International http://www.amdalliance.org 

Canadian Association of Optometrists https://opto.ca 

References

Age-related macular degeneration (AMD). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/age-related-macular-degeneration-amd. Accessed October 29, 2020.

Age-related macular degeneration (AMD). National Eye Institute website. Available at: https://nei.nih.gov/health/maculardegen. Accessed October 29, 2020.

American Academy of Ophthalmology (AAO). Preferred Practice Pattern guidelines on age-related macular degeneration. AAO 2015 Jan.

Macular degeneration. Macular Degeneration Foundation website. Available at: https://eyesight.org/macular-degeneration. Accessed October 29, 2020.

What is macular degeneration? American Academy of Ophthalmology website. Available at: http://www.aao.org/eye-health/diseases/amd-macular-degeneration. Accessed October 29, 2020.