Age-Related Macular Degeneration
What is Age-Related Macular Degeneration?
Age-Related Macular Degeneration (also known as AMD) occurs when the macula is damaged. With AMD, you are unable to see the details of something in front of you, whether it is near or far. However, you are still able to see clearly from your peripheral (side) vision. For example, if you are looking at a person’s face, you may be able to see their hair and ears, but not their facial features, such as eyes, nose and mouth.
There are two types of AMD: Dry AMD and Wet AMD.
80% of people with AMD have dry AMD. Dry AMD is when parts of the macula get thinner due to age and tiny clumps of protein, known as drusen, start to grow. This leads to the loss of your central vision over time.
Although wet AMD is less common than dry AMD, patients with wet AMD lose their vision much faster. Wet AMD is when new, abnormal blood vessels begin to grow under the retina. These blood vessels might begin to leak blood or other fluids, causing the macula, the center of the retina, to lift up from its normally flat position and distort your central vision.
Who is at Risk for Age-Related Macular Degeneration?
The following factors may increase your risk of developing Age-Related Macular Degeneration:
• Family history of AMD
• 50 years of age or older
• Smoking cigarettes
• High cholesterol
• Not maintaining a healthy diet/weight
• Having heart disease.
Although you cannot change your genetics, you can avoid smoking, exercise on a regular basis, and maintain good blood pressure and cholesterol levels to decrease your chance of developing AMD.
Treatment and Prognosis
As of now, there is no treatment for dry AMD. However, if you have serious vision loss or high amounts of drusen then you may may benefit from taking a combination of the following supplements:
• Vitamin C (500 mg)
• Vitamin E (400 IU)
• Lutein (10 mg)
• Zeaxanthin (2 mg)
• Zinc (80 mg)
• Copper (2 mg)
Please ask one of our retina specialists if these vitamins and minerals are recommended for your dry AMD
VEGF, also known as Vascular Endothelial Growth Factor, is a molecule that causes the growth of leaky blood vessels. Anti-VEGF medications help stop the growth of new blood vessels. The following drugs are considered the first line of treatment for all stages of Wet AMD:
• Bevacizumab (Avastin)
• Ranibizumab (Lucentis)
• Aflibercept (Eylea)
Our retina specialists will inject these medications into the affected eye. You may need injections every four weeks to maintain the beneficial effect of the medication. In some instances, you may partially recover vision as the blood vessels shrink and the fluid under the macula is absorbed.
Laser treatment is a less common form of treatment for patients with wet AMD. Laser treatment involves aiming a high energy laser beam at the tiny leaking blood vessels in order to seal them and to stop them from growing.
About 50% of patients will require a retreatment within 3-5 years. Unfortunately, laser treatment will not restore vision that has already been lost. However, the rate of vision loss may be slowed down and some sight may be preserved.
Photodynamic therapy is sometimes used to treat abnormal blood vessels at the center of your macula. In this procedure, a retina specialist injects a drug called verteporfin (Visudyne) into a vein in your arm, which travels to blood vessels in your eye. Then, the retina specialist shines a focused light from a special laser to the abnormal blood vessels in your eye. This laser activates the drug, causing the abnormal blood vessels to close, which stops the leakage.
Photodynamic therapy may improve your vision and reduce the rate of vision loss. Repeated treatments may be required over time, as the treated blood vessels may reopen.
After photodynamic therapy, you will need to avoid bright and direct sunlight.